A patient is diagnosed with peptic ulcer disease. The nurse
realizes that which factor is a predisposing factor for this
condition?
A. HELICOBACTER PYLORI
A student nurse is preparing to administer sucralfate
(Carafate) to a patient. Which statement by the student
nurse demonstrates understanding of sucralfate’s mode of
action?
A) “Sucralfate combines with protein to form a viscous substance that forms a protective covering of ulcer.”
A patient is taking ranitidine (Zantac). What information
should the nurse teach the patient about this drug? (Select all that apply.)
a. Drug-induced impotence is irreversible.
b. The drug must be administered 30 minutes before meals.
c. The drug must be administered separately from an antacid by at least 1 hour.
d. The drug must always be administered with magnesium hydroxide.
e. Smoking should be avoided while taking this drug.
f. Foods high in vitamin B12 should be increased in diet.
c, e, f
When a patient complains of pain accompanying a peptic
ulcer, why should the nurse give an antacid?
action.
d. Antacids neutralize HCl and reduce pepsin activity.
A. Antacids decrease gastric acid secretion.
A patient is taking famotidine (Pepcid) to inhibit gastric
secretions. Which side effects of famotidine will the nurse
teach the patient? (Select all that apply.)
a. Diarrhea
b. Dizziness
c. Dry mouth
d. Headaches
e. Blurred vision
f. Decreased libido
b, d, f
The patient is taking esomeprazole magnesium (Nexium)
for an erosive GERD. Which should the nurse include in
patient teaching?
D. This medication decreases stomach acid secretion.
A patient is receiving the drug somatropin (Genotropin).
The nurse understands that the action of this drug is to
do what?
B. Stimulate growth in long bones at epiphyseal plates
A patient is given desmopressin acetate. The nurse knows
that this drug is used to treat which condition?
D. Diabetes insipidus
A patient is taking levothyroxine (Synthroid). For which
adverse effect would the nurse monitor this patient?
D. Tachycardia
A patient has just begun taking calcitriol (Rocaltrol).
Which is a nursing implication of this drug?
infections.
C. Monitor serum calcium levels.
A patient is given corticotropin (Acthar). The nurse knows
to monitor the patient for which condition?
C. Weight gain
nurse is administering prednisone (Deltasone) to a
newly admitted patient who is taking multiple other drugs.
The nurse should consider which drug interactions with
prednisone? (Select all that apply.)
a. Cardiac and CNS actions are increased when taken
with an adrenergic agent.
b. Potassium-wasting diuretics increase potassium loss,
resulting in hypokalemia.
c. Risk for GI bleeding and ulceration increases when
taken with aspirin or other NSAIDs.
d. Action of prednisone is decreased when taken with
phenytoin (Dilantin) because phenytoin increases glucocorticoid
metabolism.
e. Risk for dysrhythmias and digitalis toxicity increases
when taken with cardiac glycosides.
f. Dosage of antidiabetic agents may need to be increased
when taken concurrently with glucocorticoids.
b, c, d, e, f
The nurse is administering vasopressin (Pitressin) to a
patient. The nurse realizes that nursing implications for
this drug would include which implications? (Select all
that apply.)
a. Record urinary output.
b. Observe the patient’s weight, and note edema.
c. Monitor the patient for decreased blood pressure.
d. Closely monitor the patient’s blood glucose levels.
e. Monitor the patient’s pulse for increased heart rate.
f. Record the patient’s daily calcium levels.
a, b, c, e
A patient is diagnosed with type 2 diabetes mellitus. The
nurse is aware that which statement is true about this
patient?
development.
A. Heredity and obesity are major causative factors.
Antidiabetic drugs are designed to control signs and
symptoms of diabetes mellitus. The nurse primarily
expects a decrease in which?
Antidiabetic drugs are designed to control signs and
symptoms of diabetes mellitus. The nurse primarily
expects a decrease in which?
b. Fat metabolism
c. Glycogen storage
d. Protein mobilization
C. Blood glucose
A patient is to receive insulin before breakfast, and the
time of breakfast tray delivery is variable. The nurse knows
that which insulin should not be administered until the
breakfast tray has arrived and the patient is ready to eat?
B. lispro (Humalog)
A patient is receiving a daily dose of Humulin N insulin
at 7:30 am. The nurse expects the peak effect of this drug
to occur at which time?
B. 5:00 pm
A patient is prescribed glipizide (Glucotrol). The nurse
knows that which side effects and adverse effects may be
expected? (Select all that apply.)
a. Tachypnea
b. Tachycardia
c. Increased alertness
d. Increased weight gain
e. Visual disturbances
f. Hunger
b, e ,f
A nurse is teaching a patient how to recognize symptoms
of hypoglycemia. Which symptoms should be included in
the teaching? (Select all that apply.)
a. Headache
b. Nervousness
c. Bradycardia
d. Sweating
e. Thirst
f. Sweet breath odor
a, b, d
A patient is newly diagnosed with type 1 diabetes mellitus
and requires daily insulin injections. Which instruction
should the nurse include in the teaching of insulin
administration?
a. Teach family members how to administer glucagon by
injection when the patient has a hyperglycemic
reaction.
b. Instruct the patient about the necessity for compliance
with prescribed insulin therapy.
c. Teach the patient that hypoglycemic reactions are more
likely to occur at the onset of action time.
d. Instruct the patient in the care and handling of the
insulin container and syringe.
b. Instruct the patient about the necessity for compliance
with prescribed insulin therapy.
The nurse is administering atropine 0.3 mg IV to a
75-year-old patient with a heart rate of 45, and his heart
rate decreases to 38. What is the most likely
explanation?
a. Atropine exerts its effects by stimulating the vagus
nerve.
b. The ordered dose was too low.
c. Adenosine was indicated, not atropine.
d. Atropine typically slows heart rate first and then
increases it.
b. The ordered dose was too low.
An 80-year-old woman with a hip fracture received morphine
3 mg IV 20 minutes ago. The patient’s son runs to
the nurses’ station and says that his mother is no longer
responding to him. What actions should the nurse take?
a. Assess the patient; call for additional assistance;
support breathing with a bag-valve-mask device as
indicated, and prepare to administer flumazenil.
b. Call the physician and report that the patient most
likely suffered a stroke and now has elevated intracranial
pressure; prepare to administer mannitol.
c. Assess the patient; call for additional assistance;
support breathing with a bag-valve-mask device as
indicated, and prepare to administer naloxone.
d. Explain to the patient’s son that the morphine is
taking effect and that unresponsiveness is the desired
outcome to best manage her pain.
c. Assess the patient; call for additional assistance;
support breathing with a bag-valve-mask device as
indicated, and prepare to administer naloxone.
The nurse is caring for a 21-year-old woman with a
closed head injury. Her intracranial pressure is 35 (normal
<20). Her serum osmolality is 330. The nurse should
anticipate which action?
a. Administer mannitol.
b. Withhold mannitol at this time, but take other measures
to reduce intracranial pressure.
c. Administer sodium nitroprusside.
d. Take no action at this time because the patient has a
serum osmolality of 330, which will offset the effects
of the elevated intracranial pressure.
b. Withhold mannitol at this time, but take other measures
A dopamine infusion was started in a patient’s antecubital
vein during resuscitation after cardiac arrest. The electronic
infusion device is now sounding an alert for an
occlusion. What is the most important immediate
concern for the nurse?
a. Infiltration with phentolamine will be necessary if
there is extravasation.
b. An interruption in the infusion can produce hypotension
in the patient.
c. The device will need to be reported to the hospital’s
clinical engineering department for service.
d. The patient could develop hypertension as a result of
the alarm.
b. An interruption in the infusion can produce hypotension
in the patient.
Adenosine is ordered for a patient in the emergency
department. Immediately after intravenous administration,
the nurse observes a short period of asystole on the
cardiac monitor that resolves spontaneously. What is the
most appropriate initial action for the nurse?
a. Call for the doctor.
b. Prepare epinephrine and atropine for intravenous
administration.
c. Initiate CPR.
d. Closely observe the patient and the cardiac monitor.
b. Prepare epinephrine and atropine for intravenous administration.
A patient on the medical-surgical unit has suffered an
acute anaphylactic reaction during infusion of an IV
antibiotic with hives and bronchospasm. The nurse practitioner
has written a number of stat medication orders.
What is the priority medication to administer first?
D. epinephrine
The nurse receives a stat order to administer 50% dextrose
solution intravenously to a 1-year-old child with
hypoglycemia. How should this medication best be prepared
for safe administration to the child?
B. Dilute 1 : 1 with sterile water to produce dextrose 25%.
A 51-year-old woman has been reportedly taking Xanax
for a severe anxiety disorder following her mother’s
death. She was brought into the emergency department
because she became unresponsive while at work in an
insurance office. Knowing her history, what should the
nurse anticipate administering?
D. flumazenil
A 25-year-old woman was admitted to the emergency
department after a successful prehospital resuscitation
from cardiac arrest owing to an asthma attack. On arrival,
her pulse oximeter reading is 85%. Given her condition, what is the most important initial medication to administer
as ordered?
D. oxygen
The nurse practitioner orders epinephrine 0.3 mg IM for
a severe allergic reaction to a bee sting in an adult patient.
Which concentration of epinephrine should the nurse
select to administer this particular dose?
a. 1 : 10,000
b. 1 : 1000
c. 1 : 100
d. 1 : 10
d. 1 : 10
The emergency physician orders activated charcoal for a
teenage girl who took an intentional overdose of aspirin
and several unknown drugs from her parent’s medicine
cabinet. Upon preparing to administer the activated
charcoal by mouth, the nurse notes that the patient has
become very somnolent and opens her eyes only to a
noxious stimulus. Which action by the nurse is most
appropriate at this point?
a. Immediately discuss the change in the patient’s mental
status with the physician so that the plan of care can
be reevaluated.
b. Immediately insert a nasogastric tube, and administer
the activated charcoal.
c. Immediately elevate the head of the patient’s stretcher,
and coax her to drink the activated charcoal while
applying noxious stimuli as necessary to keep her
awake.
d. Give only half the dose now, and wait until her mental
status improves before giving the remainder of the
dose.
a Immediately discuss the change in the patient’s mental
status with the physician so that the plan of care can
be reevaluated.
While getting dressed to go home after minor outpatient
surgery on his leg for removal of a mole, a 62-year-old
patient notifies the nurse that he has severe chest pain.
He is also diaphoretic and complains of shortness of
breath. The surgeon is notified and orders administration
of aspirin 325 mg PO while quickly making arrangements
to transfer the patient to the emergency department.
Which is the best course of action by the nurse?
a. Question the aspirin order because the patient justhad a surgical procedure and might have bleedingcomplications.b. After checking for drug allergies, first instruct thepatient to chew the aspirin tablet and then administerthe aspirin.c. After checking for drug allergies, instruct the patientto swallow the aspirin tablet whole.d. Suggest to the surgeon that the enteric-coated form ofaspirin might be better tolerated by the patient toavoid GI distress.
b. After checking for drug allergies, first instruct the
patient to chew the aspirin tablet and then administer
the aspirin.
A patient complains of constipation and requires a laxative.
In providing teaching for this patient, the nurse
reviews the common causes of constipation, including
which cause?
B. Poor dietary habits
A patient with nausea is taking ondansetron (Zofran). She
asks the nurse how this drug works. The nurse is aware
that this medication has which action?
D. Blocks serotonin receptors in the CTZ
A patient who has constipation is prescribed a bisacodyl
(Dulcolax) suppository. Which explanation will the nurse
use to explain the action of bisacodyl?
a. Acts on smooth intestinal muscle to gently increase
peristalsis
b. Absorbs water into the intestines to increase bulk and
peristalsis
c. Lowers surface tension and increases water accumulation
in the intestines
d. Pulls salts into the colon and increases water in the feces
to increase bulk
a. Acts on smooth intestinal muscle to gently increase
peristalsis
A patient is using scopolamine (Transderm-Scōp) to
prevent motion sickness. About which common side effect
should the nurse teach the patient?
C. Vomiting
When metoclopramide (Reglan) is given for nausea, the
nurse plans to caution the patient to avoid which
substance?
A. Alcohol
The nurse is administering diphenoxylate with atropine
(Lomotil) to a patient. Which should be included in the
patient teaching regarding this medication? (Select all that apply.)
a. Caution the patient to avoid laxative abuse.
b. Record the frequency of bowel movements.
c. Caution the patient against taking sedatives
concurrently.
d. Encourage the patient to increase fluids.
e. Instruct the patient to avoid this drug if he or she has
narrow-angle glaucoma.
f. Teach the patient that the drug acts by drawing water
into the intestine.