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101 Cards in this Set

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A father calls because his son has head lice. He reported he used "that special medicated shampoo three times, but nothing happened." He wants to know what to do now. What will the nurse advice first?

Using the nit comb to remove nits from the hair shaft

A teenage boy is taking tretinoin (retin a) for acne. Which statement will the nurse include in the teaching plan?

This drug may cause increase redness of your skin

The preoperative nurse is ready to perform a skin prep with povidine-iodine (betadine) on a patient who is about to have abdominal surgery. Which allergies, if present will be a concert indication to the betadine prep?

Shellfish

A patient is to receive a topical corticosteroid for an allergic rash. When administering this medication, the nurse is aware that which form is generally the most penetrating when applied to the skin?

Ointments

A child has been diagnosed with impetigo, a skin infection. The nurse anticipate that which drug will be used to treat this condition?

Bacitracin

A 55 year old obese patient was diagnosed with candidiasis in the skin folds under her breast. When the nurse sees her at a follow-up visit 2 month later, she complains it has returned. She said she applied the medicine for 1 week and stopped because the itching stop and the cream was messy. Which statement is true regarding fungal infections of the skin?

fungal infection often require prolonged therapy

A patient is admitted to the hospital for possible septicemia. He has a large pressure ulcer on his heels that is open and includes Necrotic Tissue. However, his PT INR values are too high to permit surgical debridement at this time. The nurse expects that which wound care products will be used to treat the wound?

Collagenase (santyl)

The nurse is reviewing the laboratory results for a patient and notes that the patient has positive results for nasal colonization by MRSA . The nurse anticipated order for which medication?

Mupirocin (bactroban)

The nurse is reviewing the medical records of a patient who is receiving care with topical silver sulfadiazine (silvadene). Which finding, if noted, would be a potential Contraindication?

The patient is allergic to sulfa drugs

A female patient Has been taking isotretinoin (Amnesteem) for 3 months. During a follow up appointment, which statement by the patient would be of highest concern to the nurse?

I have been feeling rather down and lonely lately

The nurse is reviewing the use of ophthalmic preparation. Indications for the direct and indirect acting mitotic include which condition?

Open angle glaucoma

A patient has a new prescription for an anti glaucoma eye drops. The next day, she called the clinic and States, the package insert says this medication might make my blue eyes turn brown! Is this true? The nurse realizes that the patient has been prescribed for which eye medication?

Latanoprost (xalatan), a prostaglandin agonist

The nurse is administering dipivefrin (propine) eye drops to a patient who has just started therapy with these drops. What potential systemic effects will the nurse monitor the patient for after this medication is given?

Increase heart rate

A patient has been taking the corticosteroid dexamethasone (Decadron) but has developed bacterial conjunctivitis and have a prescription for gentamicin (Garamycin) ointment. The nurse notes that which interaction is possible if the two drugs are used together?

Immunosuppression May make it more difficult to eliminate the eye infection

When teaching a patient about the proper application of timolol (timoptoc) eye drops, the nurse will include which instructions?

Apply the drops into the conjunctival sac instead of directly into the eye

A patient is about to undergo ocular surgery. The preoperative nurse anticipate that which drugs will be used for local anaesthesia?

Proparacaine (alcaine)

A patient with an eye injury requires an ocular examination to detect the presence of a foreign body. The nurse anticipate that which drug will be used for this examination?

Flourescein sodium (AK-Fluor)

The nurse is administering antibiotic eye drops to a patient for the first time. After the first drop is given, the patient state, that eyedrop is making my eyes sting! Is that normal? Which is the best response by the nurse?

Sometimes these eye drops may cause burning and stinging, but it should go away soon

A patient is receiving ocular cyclosporine (Restasis) and also has an order for an artificial tears products. The nurse includes which instructions in the teaching plan for these medications?

Take the Restasis first, and then wait 15 minutes before taking the artificial tears

The nurse is administering ear drops that contain a combination of an antibiotic and a corticosteroid. What is the rationale for combining these two drugs in Ear drops?

The corticosteroid reduces the inflammation and itching associated with the ear infections

The nurse is preparing to administer a new order for ear drops. Which is a potential contraindication to use of many otic preparations

Perforated eardrum

When reviewing a patient's medical record, the nurse notes in order for carbamide peroxide ear drops. Based on this information, the nurse interprets that these ear drops are being used for which purpose?

To loosen the cerumen for easier removal

The nurse is preparing to do an ear wax emulsifier To a patient and will assess the patient for which contraindication before administering the drops?

Drainage from the ear canal

The nurse is administering an otic preparation as part of treatment for a severe fungal ear infection. Why is pramoxine added to the otic medication?

It is a local anesthetic that causes temporary relief of pain

The nurse is aware that adrenergic drugs produce effects similar to which of these nervous systems?

Sympathetic nervous system

Which adrenergic drug stimulates beta 1 adrenergic receptors, the result is an increase force of contraction, which is known as what type of effect?

Positive inotropic

When a patient is taking an adrenergic drug, the nurse expect to absorb which effect?

Increase heart rate

The nurse recognizes that adrenergic drugs can cause relaxation of the bronchi and bronchodilation by stimulating which type of receptors?

Beta2-adrenergic

A 58 year old man has had a myocardial infarction (MI), has begun rehabilitation and is ready for discharge. He is giving a prescription for metoprolol (lopressor) and becomes upset after reading the patient education pamphlet. "I don't have high blood pressure why didn't my doctor give me this medication?" What explanation by the nurse is correct?

Studies have shown that this medication has greatly increase survival rates in patients who have had a heart attack

A patient is taking an alpha blocker as treatment for benign prostatic hyperplasia. The nurse will monitor for which potential drug effect?

Orthostatic hypotension

When monitoring a patient who is taking a cholinergic drug, the nurse will watch for which cardiovascular effect?

Bradycardia

A cholinergic drug is prescribed for a patient with a new diagnosis of myasthenia gravis, in the nurse provides instructions to the patient about the medication. What is important to include in the teaching?

Take the medication 30 minutes before eating to improve swallowing and chewing

A patient is receiving a dose of edrophonium (tensilon). The nurse recognizes that this drug is given to determine the diagnosis of which disease?

Myasthenia gravis

The nurse is about to administer a stat dose of intravenous atropine sulfate to a patient who is experiencing a symptomatic cardiac dysrhythmia. During administration of this drug, the nurse will monitor the patient closely for which adverse effect?

Tachycardia

The nurse will monitor for which adverse effect when administering an anticholinergic drug?

Dry mouth

The nurse is reviewing a patient medication history in notification is taking the cholinergic blocker tolterodine (Detrol). Which is an indication for this medication?

Urge incontinence

The nurses working in a preoperative admitting unit administers an anticholinergic medication to a patient before surgery. What is the purpose of this drug in the preoperative setting?

Reduce urinary frequency

A patient has been taking tolterodine (detrol), but today her prescriber painter to a newer drug darifenacin (enablex). What advantage does darafenacin have over the tolterodine?

The incidence of dry mouth is much lower with darifenacin

The nurse is preparing for a community education program on hypertension. Which of these parameters determine the regulation of arterial blood pressure?

Cardiac output and systemic vascular resistance

A patient's blood pressure elevates - 270 / 150 mm Hg, in a hypertensive emergency is obvious. He is transferred to the intensive care unit and started on a sodium nitroprusside (nipride) drip to be titrated per his response. With this medication, the nurse knows that the maximum dose of this drug should be infused for how long?

10 minutes

A patient with type 2 diabetes mellitus has been found to have trace proteinuria. The prescriber write an order for an ACE inhibitor. What is the main reason for prescribing this class of drug for this patient?

Renal protective effect

The nurse is reviewing the orders for a patient and notes in new order for an ACE inhibitor. The nurse checks the current medication orders, knowing that this drug class may have a serious interaction with what other drug class?

NSAIDS

A calcium channel blocker is prescribed for a patient, the nurse provides instruction to the patient about the medication. Which instruction is correct?

A high-fiber diet with plenty of fluids will help prevent the constipation that may occur

While assessing a patient who is receiving intravenous digitalis, the nurse recognizes that the drug has a negative chronotropic effect. How would this drug effect be evident in the patient?

Decrease heart rate

A patient has been placed on milrinone infusion as part of the therapy for end stage heart failure. What adverse effect of this drug will the nurse watch for when assessing this patient during the infusion?

Cardiac dysrhythmias

When starting a patient on A anti dysrhythmic therapy, the nurse will remember that which problem is a potential adverse effect of any antidysrhythmic drug?

Dysrhythmias

A patient has a digoxin level of 1.4 ng / ml. The nurse interprets that this level is

Within the therapeutic range

The nurse administering the phosphodiesterase inhibitor milrinone (primacor) recognizes that this drug will have a positive inotropic effect. Which result reflect this effect?

Increase force of cardiac contractions

A patient has been prescribed warfarin (coumadin) in addition to a heparin infusion. The patient asked the nurse why he has to be on two medications. The nurse's response is based on which rationale?

Heparin is used to start anticoagulation so as to allow time for the blood levels of warfarin to reach therapeutic levels

A patient who is taking warfarin therapy has a headache and calls the prescriber's office to ask about taking a pain reliever. The nurse expect to receive instructions for which type of medication

Acetaminophen (Tylenol)

The patient has had a recent prosthetic heart valve surgery and is receiving anticoagulant therapy. While monitoring the patient's laboratory work, then those interpret that the patient INR level of 2.5 indicates that

The patient's warfarin dose is at a therapeutic level

A patient has received an overdose of intravenous heparin, and is showing signs of excessive bleeding. What substance is the antidote for heparin overdose?

Potassium sulfate

The nurse is reviewing a new medication orders for a patient who has an epidural catheter for pain relief. One of the orders is lovenox, A LMWH. What is the nurses priority action?

Contact the prescriber because the LMWH cannot be given if the patient has an epidural catheter

The nurse will monitor a patient for signs and symptoms of hyperkalemia if the patient is taking which of these diuretics

Spironolactone (aldactone)

When monitoring a patient who was taking hydrochlorothiazide, the nurse notes that what drug is most likely to cause a severe reaction with a diuretic

Digitalis

A patient is started on a diuretic for antihypertensive therapy. The nurse expects that a drug and which class is likely to be used

Thiazide diuretics

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

Recent myocardial infarction

During a teaching session for a patient on anti thyroid drugs, the nurse will discuss which dietary instructions?

Avoid foods containing iodine

When reviewing the drugs taken by a patient who will be starting fluid replacement preparations, the nurse know that an interaction may occur with which of these drugs

Oral antidiabetic drugs

When monitoring a patient who is taking a thyroid replacement hormones, which adverse effect needs to be reported to the prescriber

Palpitations

When monitoring a patient's response to oral antidiabetic drugs, the nurse know that which lab result what indicate a therapeutic response

Fasting blood glucose level between 70 and 100 mg / DL

A patient in the emergency department was showing signs of hypoglycemia and had a fingerstick glucose level of 34 mg / dL. The patient has just become unconscious. What is the nurses next action?

Administer intravenous glucose (50% dextrose)

The nurse is preparing to administer insulin intravenously. What statement about the administration of intravenous insulin is true

Only regular insulin can be administered intravenously

A patient has been diagnosed with metabolic syndrome and it started on biguanide metformin (glucophage) . The nurse knows that the purpose of the metformin, in this situation, is which of these

To decrease insulin resistance

When monitoring a patient who is taking a systemically administered glucocorticoid, the nurse will monitor for signs of what condition

Hypokalemia

A patient will be starting therapy with a corticosteroid. The nursery views the patients orders and those that an interaction may occur if the corticosteroid is taken with which of these drug classes

NSAIDS

A patient is taking fludrocortisone for Addison's disease, and his wife is concerned about all of the problems that may occur with this therapy. When teaching them about therapy with this drug, the nurse will include which information?

It needs to be taken with food or milk to minimize gastrointestinal upset

A glucocorticoid is prescribed for a patient. The nurse checks the patient's medical history knowing that glucocorticoid therapy is contraindicated in which disorder

Peptic ulcer disease

A patient who has been on long-term corticoids therapy has had surgery to correct an abdominal hernia. The nurse keep in mind that with potential effect of this medication may have the most impact on the patient's recovery

Delayed wound healing

A 51 year old woman will be taking SERMs as part of treatment for postmenopausal osteoporosis. The nurse views potential contraindications, including what condition

Venous thromboembolism

A nurse recognizes that use of estrogen drugs is contraindicated in which patient

A woman with a history of thrombophlebitis

The nurses 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

I will take it in the morning with an 8 ounce glass of water

821 year old male athlete admits to using androgenic steroids. The nurse tells him that which of these is a possible adverse effect of these drugs

Liver damage

During the administration of trust car, the nurse must remember what's important precaution?

It must not be handled by pregnant women

A 73 year old male patient is in the clinic for a yearly physical and is asking for a prescription for viagra. He has listed on his health history that he is taking a nitrate for angina. The nurses is aware that which problem occur if viagra is taking with a nitrate

Significant decrease in blood pressure

A patient with a long term intervenous catheter is going home. The nurse knows that if he is allergic to seafood with antiseptic agent is contraindicated

Betadine

A patient who has been hospitalized for two weeks has developed a pressure ulcer that contains MRSA. Which drug with the nurse expect to be chosen for therapy

Vancomycin

The nurse is reviewing the medication orders for a patient who will be receiving zyvox therapy. Which other medication or medication class if ordered will be a potential interaction concern

SSRI antidepressants

A 79 year old patient is receiving a quinolone as treatment for a complicated incision infection. The nurse will monitor for which adverse effect that is associated with these drugs

Tendonitis and tendon rupture

A patient who is HIV positive has been receiving medication therapy that includes retrovir. However the prescriber has decided to stop retrovir because of his dose limiting adverse effect. Which of these conditions is the dawning adverse effect of retrovir therapy

Bone marrow suppression

The nurses discussing adverse effects of antitubercular drugs with a patient who has active tuberculosis. With potential adverse effects of antitubercular drug therapy for the patient report to the prescriber

Numbness and tingling of extremities

The nurse is preparing to administer morning medications to a patient who has been newly diagnosed with tuberculosis. The patient asks why do I have to take so many different drugs? Which response by the nurse is correct

Taking multiple drugs reduces the chance that the tuberculosis will become drug resistant

A patient with severe fungal infection has orders for voriconazole (V fend) . The nurse is reviewing the patient's medical record and will be concerned if which assessment finding is noted

History of cardiac dysrhythmias

A patient who has been on methotrexate therapy is experiencing mild pain. Her husband called to see if he can give her aspirin for the pain. The nurses responses based on the fact that aspirin

Can lead to methotrexate toxicity

A patient is receiving irinotecan along with other antineoplastic drugs, as treatment for ovarian cancer. The nurse will monitor for which potentially life-threatening adverse effect that is associated with this drug

Delayed onset cholinergic diarrhea

A patient diagnosed with lymphoma has an allergy to one of the proposed chemotherapy drugs. The tumor has not responded to other types of treatment. The nurse expects oncologist to follow which course of treatment

The chemotherapy will be given along with supportive measures to treat a possible allergic reaction

Just before the second course of chemotherapy the lavatory calls to report that the patients neutrophil count was 450 cells/mm3. The nurse expects at the oncologist will follow which course of treatment

Chemotherapy will be withheld until the neutrophil count returns to normal levels

A female patient is receiving palliative therapy with androgen hormones as part of treatment for inoperable breast cancer. The nurse will discuss with the patient with potential body image changes that may occur as adverse effects

Hirsutism and acne

When monitoring a patient who is on immunosuppressant therapy with Imuran the nurse will monitor for which lab result

White blood cell count

A 45 year old man has received a series of immunization drugs and preparation for a trip to a developing country. Within hours his wife bring him to the emergency department because he has developed edema of the face, tongue, and throat and is having trouble breathing. The nurses specs that, based on the face and sister and symptoms, he is experiencing what condition

Serum sickness

A patient is in the Urgent Care Center after experiencing a black widow spider bite. The nurse prepared to give which product to treat his injury

Anti venom for antisera

During an admission assessment the patient tells the nurse that he has been celebrating his heart burn for one year with over the counter prilosec. The nurse is the way that the self treatment may have which result

Mask symptoms of serious underlying disease

A patient who has been on antibiotic therapy for 2 weeks has developed persistent diarrhea. The nurse expect which medication class to be ordered to treat this diarrhea

Probiotics

A laxative has an order for a patient. The nurse checks the patient's medical history and will be concerned if which condition is present?

Abdominal pain of unknown origin

A patient is receiving lactulose three times a day. The nurse knows that the patient is not constipated and is receiving this drug for which reason

High ammonia levels due to liver failure

The nurse is preparing to administer relistor a peripheral acting opiate antagonists. This drug is appropriate for which patient

A terminally ill patient who has opiate induced constipation

A patient is receiving a tube feeding through a gastrostomy. The nurse aspects of which type of drugs will be used for my gastric emptying for this patient

Prokinetic drugs, such as metoclopramide

The nurses administering intravenous iron dextran for the first time to a patient with anemia. After giving a test does, how long will the nurse way before administering the remaining portion of the dose

1 hour

A patient has been receiving epoetin alfa (Epogen) for severe iron deficiency anemia. Today the provider change the order to darbepoetin (aranesp). The patient questions the nurse, what is the difference in these drugs? Which response by the nurse is correct

Aranesp is a longer acting form, so you will receive your injections

A patient is receiving a nutritional supplement via an enteral feeding tube. The nurse will monitor for which common adverse effect

Diarrhea

The nurse is preparing to administer medications to a patient who is receiving a feeding via a gastric tube. When reviewing the patient's medication list, the nurse notes a potential concern about a food drug interaction is which medication is listed

Phenytoin (dilantin)