NURS 6521 Midterm Exam
1. In order to promote therapeutic drug effects, the Nurse
Practitioner should always encourage patients to: take their
medication at the prescribed times.
2. A female patient with a diagnosis of type 1 diabetes
mellitus has been experiencing increasing neuropathic pain
in recent months, a symptom that has not responded
appreciably to conventional analgesics. The patient's care
provider has begun treatment with gabapentin (Neurontin).
How is the addition of this drug likely to influence the
management of the patient's existing drug regimen?: It is
unlikely to influence the patient's other medications because
gabapentin does not interact with other drugs.
3. of the following assessment findings should an assisted
living facility has begun taking daily oral Following an
assessment by her primary care provider, a 70-year-old
resident of doses of levothyroxine. Which prompt the nurse to
withhold a scheduled dose of levothyroxine?: The resident's
apical heart rate is 112 beats/minute with a regular rhythm
4. processes protects the lower respiratory system?: Cilia
sweep foreign ma- terial and mucus upward toward the trachea
and larynx where they can then be swallowed.
5. A 62-year-old man has been prescribed lovastatin. The
Nurse Practitioner will instruct the patient to take the
medication: at bedtime.
6. A Nurse Practitioner who provides care for older adults is
aware of the high incidence of drug interactions in this
population. When educating a group of seniors about the
prevention of drug interactions, the Nurse Practi- tioner
should encourage them to: consult their care provider before
taking new over-the-counter medications.
7. A Nurse Practitioner is teaching an older adult patient about
polypharma- cy. Which of the following statements best
describe this term?: Taking several drugs simultaneously
8. A diabetic patient being treated for obesity tells the Nurse
Practitioner that he is having adverse effects from his drug
therapy. The patient has been taking dextroamphetamine for
2 weeks as adjunct therapy. Which of the following adverse
effects would need the Nurse Practitioner's immediate
attention?: Increased blood glucose
9. A 22 year old patient is transitioning from oral agents to
insulin. He will be taking 20 units of lantus at bedtime and
regular insulin before meals. What instructions should the NP
provide about the timing and dose of regular
insulin?: Take 1 unit of regular insulin for each 10 grams of
carbohydrate to be consumed 15 minutes before each meal
10. decongestants should not be used chronically (>5 days)
because they can cause: rebound rhinitis/congestion
11. The parents of a 7-year-old boy who has just been
diagnosed with allergic asthma are being taught about their
son's medication regimen by the nurse. The nurse is currently
teaching the parent's about the appropriate use of
a "rescue drug" for acute exacerbations of their son's
asthma. What drug should the nurse suggests the parents to
use in these situations?: Albuterol
12. A 70-year-old woman with a history of atrial fibrillation
takes digoxin and verapamil to control her health problem.
Verapamil achieves a therapeutic effect by: blocking
adrenergic receptors and producing antisympathetic effects.
13. A patient receives 25 units of NPH insulin at 7.AM. At
what time of day should the nurse advise the patient to be
most alert for a potential hypoglycemic reaction?: Late
afternoon
14. A child with sinusitis has been on antibiotics for seven
days and his symptoms are not improving., All of the
following are options to prescribe for the patient now
EXCEPT:: Amoxicillin/clavulanic acid
15. The Nurse Practitioner's assessment of a communitydwelling
adult
sug-
gests
that
the
client
may
have
drug
allergies
that
have
not
been
previously
documented.
What
statement
by
the
client
would
confirm
this?:
"I
broke
out
in
hives
and got
terribly
itchy
when
I started
a new
prescription
last
year."
16. A homeless man who is well known to care providers at the
local hospital has been admitted to the emergency
department after having a seizure out- side a mall. The man is
known to be a heavy alcohol user and is malnourished with a
very low body mass index. How are this patient's
characteristics likely to influence possible treatment with
phenytoin?: The patient's protein deficit will likely increase the
levels of the free drug in his blood.
17. A patient has been prescribed a histamine-2 (H2) receptor
antagonist
for the treatment of GERD. Why are H2RAS more effective than
H1 receptor antagonists in the treatment of diseases of the
upper GI tract?: The parietal cells of the stomach have H2
receptors but not H1 receptors.
18. A 24-year-old factory worker has been prescribed
guaifenesin for the first time. Which of the following will be a
priority assessment by the nurse before the patient's first
dose?: The amount of alcohol consumption
19. In light of her recent high blood pressure readings, a
patient has been started on a thiazide diuretic and metoprolol
(Lopressor), which is a beta-adrenergic blocker. What is the
most likely rationale for using two
medications to address the patient's hypertension?: Using
the two drugs to treat a health problem may create a synergistic
effect.
20. A woman with numerous chronic health problems has
been diagnosed with a benign gastric ulcer has begun
treatment with ranitidine (Zantac). Which of the following
teaching points should the nurse provide to this patient?:
"Quitting smoking will significantly increase the chance that this
drug will heal your ulcer."
21. The APRN should educate a diabetic patient that beta
blockers may mask the signs and symptoms of: hypoglycemia
22. A patient has been prescribed a drug that can be selfadministered
at
home.
Which
of
the
following
would
be
the
most
important
information
for
the
nurse
to
relate
to
the
patient
concerning
self-administration
of
a drug?:
The
therapeutic
effects
and possible
adverse
effects
23. Advanced practice nurse prescribing of scheduled
medications is af- fected most by:: Combined state medical /
pharmacy /nursing prescribing board regulations
24. The APRN is treating a patient with type 2 diabetes. The
patient is on the maximum dose of metformin and glucotrol.
Current weight 212 pounds. Labs from this morning indicate a
fasting blood sugar of 312 and HBA1C of 9. The APRN wants to
start the patient on Lantus 0.2 unit/kg. What dose and instruc-
tions should the APRN provide?: Give 19 units of Lantus
subcutaneously prior to bedtime.
25. A 75-year-old woman is prescribed magnesium hydroxide
for constipa- tion. The nurse's assessment reveals that the
patient is being treated for rheumatoid arthritis and
hypertension. The patient lives in assisted living and is on a
low- sodium diet. Before the magnesium hydroxide therapy
be- gins, it will be most important for the nurse to assess the
patient's: medication history.
26. A female patient is taking 0.125 mg of digoxin daily for
heart failure. At a recent clinic visit she reports that since she
has been on the drug, she can breathe better and her heart
rate has been around 74 beats per minute. nurse weighs the
patient and notices that she has gained 10 pounds since the
digoxin therapy was started. The patient is concerned that the
additional weight will necessitate an increase in the
medication. Which of the following is an appropriate
response by the nurse?: "No, the drug dosage will likely stay the
same."
27. A 72-year-old man is prescribed theophylline for
symptomatic relief of bronchial asthma. Which of the following
findings would alert the nurse to the need for close
monitoring?: Need for additional bronchodilation
28. A patient has a history of tonic-clonic seizures that have
been success- fully treated with phenytoin (Dilantin) for
several years. Phenytoin achieves a therapeutic effect by:
decreasing the influx of sodium into neurons.
29. A man who smokes one pack of cigarettes daily has been
diagnosed with chronic bronchitis. He has been prescribed
theophylline by his family doctor. What effect will the patient's
smoking status have on the therapeutic use
of theophylline?: The patient may require higher doses of
theophylline than a nonsmoker