NURS 6521 Midterm Exam (Walden University) 2023

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