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    Exam Review

    1. The healthcare provider prescribes the antibiotic tetracycline HCl for an adult client that arrived at an outpatient clinic. Which instruction should the nurse include in the teaching plan for this client?
      A)
      Protect the skin from sunlight while taking the drug.
      B)
      Take with orange juice to enhance GI absorption.
      C)
      Return to the clinic weekly to obtain serum drug levels.
      D)
      Take with milk or antacids to prevent gastrointestinal (GI) irritation.
    2. The nurse administers risedronate to a client with osteoporosis at 0700. The client asks for a glass of milk to drink with the medication. Which action should the nurse take?
      A)
      Instruct the client that it is necessary to take nothing but water with the medication.
      B)
      Assign an unlicensed assistive personnel (UAP) to bring the client a glass of low fat milk.
      C)
      Withhold the medication until the client's breakfast tray is available on the unit.
      D)
      Consult with a pharmacist about scheduling the dose one hour after the client eats.
    3. The nurse is planning care for a client with major depression who is receiving a new prescription for duloxetine. Which information is most important for the nurse to obtain?
      A)
      Recent use of other antidepressants.
      B)
      Weight change in the last month.
      C)
      Family history of mental illness.
      D)
      Liver function laboratory results.
    4. While assessing a client who takes acetaminophen for chronic pain, the nurse observes that the client's skin looks yellow in color. Which action should the nurse take in response to this finding?
      A)
      Check the client's capillary glucose level.
      B)
      Advise the client to reduce the medication dose.
      C)
      Report the finding to the healthcare provider.
      D)
      Use a pulse oximeter to assess oxygen saturation.
    Page 1 of 10

    Exam Review

    1. Prior to administering oral doses of calcitriol and calcium carbonate to a client with hypoparathyroidism, the nurse notes that the client's total calcium level is 14 mg/dL (3.5 mmol/L). Which action should the nurse implement?
      A)
      Hold the calcitriol but administer the calcium carbonate as scheduled.
      B)
      Hold the calcium carbonate, but administer the calcitriol as scheduled.
      C)
      Hold both medications until contacting the healthcare provider.
      D)
      Administer both prescribed medications as scheduled.
    2. On admission, the healthcare provider prescribes a broad spectrum antibiotic for a client with a gram-negative infection. Before administering the first dose, it is most important for the nurse to implement which prescription?
      A)
      Monitor for signs of sodium and fluid retention.
      B)
      Wound and blood specimens for culture and sensitivity.
      C)
      Complete blood count and serum electrolytes.
      D)
      Irrigation and topical antibiotic application to wound area.
    3. A client with Parkinson's disease who is taking carbidopa/levodopa reports that urine appears to be darker in color. Which action should the nurse take?
      A)
      Encourage an increase in oral intake.
      B)
      Measure the client's urinary output.
      C)
      Explain that color change is normal.
      D)
      Obtain a specimen for a urine culture.
    4. A female client with multiple sclerosis reports having less fatigue and improved memory since she began using the herbal supplement, ginkgo biloba. Which information is most important for the nurse to include in the teaching plan for this client?
      A)
      Nausea and diarrhea can occur when using this supplement.
      B)
      Anxiety and headaches increase with the use of ginkgo biloba.
      C)
      Aspirin and non-steroidal anti-inflammatory drugs interact with ginkgo.
      D)
      Ginkgo biloba use should be limited and not taken during pregnancy.
    Page 2 of 10

    Exam Review

    1. A client in the surgical recovery area asks the nurse to bring the largest possible dose of pain medication available. Which action should the nurse implement first?
      A)
      Determine when the last dose was administered.
      B)
      Encourage the client to use diversional thoughts to manage pain.
      C)
      Ask the client to rate the current level of pain using a pain scale.
      D)
      Review the history for a past use of recreational drugs.
    2. Prior to administering the evening dose of carbamazepine, the nurse notes that the client's morning carbamazepine level was 8.4 mg/L (35.6 mcmol/L). Which action should the nurse take?
      A)
      Notify the healthcare provider of the carbamazepine level.
      B)
      Administer the carbamazepine as prescribed.
      C)
      Assess the client for side effects of carbamazepine.
      D)
      Withhold this dose of carbamazepine.
    3. A client is receiving intravenous (IV) vancomycin and the nurse plans to draw blood for a peak and trough to determine the serum level of the drug. Which collection times provide the best determination of these levels?
      A)
      Immediately after completion of the IV dose and 30 minutes before the next administration of the medication.
      B)
      One hour after completion of the IV dose and one hour before the next administration of the medication.
      C)
      Thirty minutes into the administration of the IV dose and 30 minutes before the next administration of the medication.
      D)
      Two hours after completion of the IV dose and two hours before the next administration of the medication.
    4. A young adult female client who is planning to become pregnant asks the nurse if she can continue taking isotretinoin for cystic acne. Which information is most important for the nurse to provide this client?
      A)
      Breast feeding is not recommended while taking this medication.
      B)
      Baseline liver function results must be obtained during therapy.
      C)
      Do not take multiple vitamins that contain vitamin A while taking this drug
      D)
      Discontinue this medication one month before attempting to conceive
    Page 3 of 10

    Exam Review

    1. The nurse is planning to administer the antiulcer gastrointestinal (GI) agent sucralfate to a client with peptic ulcer disease. Which action should the nurse include in this client's plan of care?
      A)
      Give sucralfate on an empty stomach.
      B)
      Assess for secondary Candida infection.
      C)
      Administer sucralfate once a day, preferably at bedtime.
      D)
      Monitor for electrolyte imbalance.
    2. The nurse administers naloxone to a client with opioid-induced respiratory depression. One hour later, nursing assessment reveals that the client has a respiratory rate of 4 breaths/minute, oxygen saturation of 75%, and is unable to be aroused. Which action should the nurse implement?
      A)
      Prepare to assist with chest tube insertion.
      B)
      Initiate cardiopulmonary resuscitation (CPR).
      C)
      Determine Glasgow Coma Scale score.
      D)
      Administer a second dose of naloxone.
    3. A client with benign prostatic hyperplasia receives a new prescription of tamsulosin. Which intervention should the nurse perform to monitor for an adverse reaction?
      A)
      Perform a bladder scan.
      B)
      Assess urine output.
      C)
      Monitor blood pressure.
      D)
      Obtain daily weights.
    4. A client is receiving a secondary infusion of azithromycin 500 mg in 500 mL of normal saline (NS) to be infused over 2 hours. The intravenous (IV) administration set delivers 10 gtt/mL. How many gtt/min should the nurse regulate the infusion? (Enter numerical value only. If rounding is required, round to the nearest whole number.)
    Page 4 of 10

    Exam Review

    1. A client with chemotherapy-induced nausea receives a prescription for metoclopramide. Which adverse effect is most important for the nurse to report?
      A)
      Diarrhea.
      B)
      Involuntary movements.
      C)
      Nausea.
      D)
      Unusual irritability.
    2. The nurse initiates an infusion of piperacillin-tazobactam for a client with a urinary tract infection. Five minutes into the infusion, the client reports not feeling well. Which client manifestation should the nurse identify as a reason to stop the infusion?
      A)
      Hypertension.
      B)
      Bradycardia.
      C)
      Pupillary constriction.
      D)
      Scratchy throat.
    3. A female client who is a vegetarian has a new prescription for warfarin. The client states she eats leafy green vegetables every day. How should the nurse respond?
      A)
      Suggest that the client replace the leafy vegetables with a protein source such as nuts or beans.
      B)
      Commend the client for her healthy lifestyle and encourage her to continue her current diet habits.
      C)
      Advise the client that the healthcare provider needs to be made aware of her current diet.
      D)
      Confirm that her diet choices will help the medication be more effective in preventing blood clots.
    4. The nurse is caring for a client who has been taking ibuprofen. Which finding is most important for the nurse to report to the healthcare provider?
      A)
      Hematemesis.
      B)
      Insomnia.
      C)
      Dizziness.
      D)
      Nausea.
    Page 5 of 10

    Exam Review

    1. An older adult with iron deficiency anemia is being discharged with a prescription for ferrous sulfate enteric-coated tablets. To promote best absorption of the medication, which information should the nurse include in the discharge instructions?
      A)
      Wait 2 hours after meals to take the tablet.
      B)
      Bedtime is the best time to take the tablet.
      C)
      Take the tablet with a daily multivitamin.
      D)
      Crush the tablets and mix with pudding.
    2. A client with pneumonia who has an emergent episode of respiratory distress is intubated and transferred to the intensive care unit. The client's chest x-ray shows consolidation in the left lobe, and physical assessment reveals diminished lung sounds. The nurse administers acetylcysteine as prescribed per nebulization via endotracheal tube. Which therapeutic response of this medication should the nurse expect?
      A)
      Bronchodilation and wheezing.
      B)
      Unpleasant smell when using the medication.
      C)
      Increased sputum, requiring suctioning.
      D)
      Hypotension.
    3. The nurse admits a client with a diagnosis of stage 4 cancer. The client has a prescription to wear a subcutaneous morphine sulfate patch for pain. The client is short of breath and difficult to arouse. While performing a head to toe assessment, the nurse discovers four patches on the client's body. Which action should the nurse take first?
      A)
      Apply oxygen face mask.
      B)
      Administer a narcotic reversal drug.
      C)
      Remove the morphine patches.
      D)
      Monitor blood pressure.
    4. A client with heart failure (HF) develops hyperaldosteronism and spironolactone is prescribed. Which instruction should the nurse include in this client's plan of care?
      A)
      Cover your skin before going outside.
      B)
      Monitor skin for excessive bruising.
      C)
      Limit intake of high-potassium foods.
      D)
      Replace salt with a salt substitute.
    Page 6 of 10