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Focus on Nursing Pharmacology 6th Edition, Karch Test Bank

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Test Bank For Focus on Nursing Pharmacology 6th Edition, Karch. Note: This is not a text book. Description: ISBN-13: 978-1451128345, ISBN-10: 1451128347.

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Test Bank Focus Nursing Pharmacology 6th Edition, Karch

Chapter 1: Introduction to Drugs

  1. A nurse working in radiology administers iodine to a patient who is having a computed tomography (CT) scan. The nurse working on the oncology unit administers chemotherapy to patients who have cancer. At the Public Health Department, a nurse administers a measles-mumps-rubella (MMR) vaccine to a 14-month-old child as a routine immunization. Which branch of pharmacology best describes the actions of all three nurses?
    A) Pharmacoeconomics
    B) Pharmacotherapeutics
    C) Pharmacodynamics
    D) Pharmacokinetics
  2. A physician has ordered intramuscular (IM) injections of morphine, a narcotic, every 4 hours as needed for pain in a motor vehicle accident victim. The nurse is aware this drug has a high abuse potential. Under what category would morphine be classified?
    A) Schedule I
    B) Schedule II
    C) Schedule III
    D) Schedule IV
  3. When involved in phase III drug evaluation studies, what responsibilities would the nurse have?
    A) Working with animals who are given experimental drugs
    B) Choosing appropriate patients to be involved in the drug study
    C) Monitoring and observing patients closely for adverse effects
    D) Conducting research to determine effectiveness of the drug
  4. What concept is considered when generic drugs are substituted for brand name drugs?
    A) Bioavailability
    B) Critical concentration
    C) Distribution
    D) Half-life
  5. A nurse is assessing the patient’s home medication use. After listening to the patient list current medications, the nurse asks what priority question?
    A) “Do you take any generic medications?”
    B) “Are any of these medications orphan drugs?”
    C) “Are these medications safe to take during pregnancy?”
    D) “Do you take any over-the-counter medications?”
  6. After completing a course on pharmacology for nurses, what will the nurse know?
    A) Everything necessary for safe and effective medication administration
    B) Current pharmacologic therapy; the nurse will not require ongoing education for 5 years.
    C) General drug information; the nurse can consult a drug guide for specific drug information.
    D) The drug actions that are associated with each classification of medication
  7. A nurse is instructing a pregnant patient concerning the potential risk to her fetus from a Pregnancy Category B drug. What would the nurse inform the patient?
    A) “Adequate studies in pregnant women have demonstrated there is no risk to the fetus.”
    B) “Animal studies have not demonstrated a risk to the fetus, but there have been no adequate studies in pregnant women.”
    C) “Animal studies have shown an adverse effect on the fetus, but there are no adequate studies in pregnant women.”
    D) “There is evidence of human fetal risk, but the potential benefits from use of the drug may be acceptable despite potential risks.”
  8. Discharge planning for patients leaving the hospital should include instructions on the use of over-the-counter (OTC) drugs. Which comment by the patient would demonstrate a good understanding of OTC drugs?
    A) “OTC drugs are safe and do not cause adverse effects if taken properly.”
    B) “OTC drugs have been around for years and have not been tested by the Food and Drug Administration (FDA).”
    C) “OTC drugs are different from any drugs available by prescription and cost less.”
    D) “OTC drugs could cause serious harm if not taken according to directions.”
  9. What would be the best source of drug information for a nurse?
    A) Drug Facts and Comparisons
    B) A nurse’s drug guide
    C) A drug package insert
    D) The Physicians’ Drug Reference (PDR)
  10. The nurse is preparing to administer a medication from a multidose bottle. The label is torn and soiled but the name of the medication is still readable. What is the nurse’s priority action?
    A) Discard the entire bottle and contents and obtain a new bottle.
    B) Find the drug information and create a new label for the bottle.
    C) Ask another nurse to verify the contents of the bottle.
    D) Administer the medication if the name of the drug can be clearly read.

Chapter 2: Drugs and the Body

  1. Drugs do not metabolize the same way in all people. For what patient would a nurse expect to assess for an alteration in drug metabolism?
    A) A 35-year-old woman with cervical cancer
    B) A 41-year-old man with kidney stones
    C) A 50-year-old man with cirrhosis of the liver
    D) A 62-year-old woman in acute renal failure
  2. A patient presents to the emergency department with a drug level of 50 units/mL. The half-life of this drug is 1 hour. With this drug, concentrations above 25 units/mL are considered toxic and no more drug is given. How long will it take for the blood level to reach the non-toxic range?
    A) 30 minutes
    B) 1 hour
    C) 2 hours
    D) 3 hours
  3. A patient has recently moved from Vermont to Southern Florida. The patient presents to the clinic complaining of “dizzy spells and weakness.” While conducting the admission assessment, the patient tells the nurse that he have been on the same antihypertensive drug for 6 years and had stable blood pressures and no adverse effects. Since his move, he has been having problems and he feels that the drug is no longer effective. The clinic nurse knows that one possible reason for the change in the effectiveness of the drug could be what?
    A) The impact of the placebo effect on the patient’s response.
    B) The accumulative effect of the drug if it has been taken for many years.
    C) The impact of the warmer environment on the patient’s physical status.
    D) Problems with patient compliance with the drug regimen while on vacation.
  4. An important concept taught by the nurse when providing medication teaching is the need to provide a complete list of medications taken to health care providers to avoid what?
    A) Spending large amounts of money on medications
    B) Allergic reactions to medications
    C) Drug–drug interactions
    D) Critical concentrations of medications in the body
  5. A pharmacology student asks the instructor what an accurate description of a drug agonist is. What is the instructor’s best response?
    A) A drug that reacts with a receptor site on a cell preventing a reaction with another chemical on a different receptor site
    B) A drug that interferes with the enzyme systems that act as catalyst for different chemical reactions
    C) A drug that interacts directly with receptor sites to cause the same activity that a natural chemical would cause at that site
    D) A drug that reacts with receptor sites to block normal stimulation, producing no effect
  6. A nurse is caring for a patient who has been receiving a drug by the intramuscular route but will receive the drug orally after discharge. How does the nurse explain the increased dosage prescribed for the oral dose?
    A) Passive diffusion
    B) Active transport
    C) Glomerular filtration
    D) First-pass effect
  7. A nurse is working as a member of a research team involved in exploring the unique response to drugs each individual displays based on genetic make-up. What is this area of study is called?
    A) Pharmacotherapeutics
    B) Pharmacodynamics
    C) Pharmacoeconomics
    D) Pharmacogenomics
  8. The nurse uses what term to describe the drug level required to have a therapeutic effect?
    A) Critical concentration
    B) Dynamic equilibrium
    C) Selective toxicity
    D) Active transport
  9. A nurse is caring for a patient who is supposed to receive two drugs at the same time. What is the nurse’s priority action?
    A) Wash her hands before handling the medications.
    B) Consult a drug guide for compatibility.
    C) Question the patient concerning drug allergies.
    D) Identify the patient by checking the armband and asking the patient to state his name.
  10. The nurse is talking with a group of nursing students who are doing clinical hours on the unit. A student asks if all intramuscular (IM) drugs are absorbed the same. What factor would the floor nurse tell the students to affect absorption of the IM administration of drugs?
    A) Perfusion of blood to the subcutaneous tissue
    B) Integrity of the mucous membranes
    C) Environmental temperature
    D) Blood flow to the gastrointestinal tract

Chapter 3: Toxic Effects of Drugs

  1. A nurse is planning patient teaching about a newly prescribed drug. What is a priority teaching point included by the nurse to improve compliance and safety?
    A) List of pharmacies where the drug can be obtained
    B) Measures to alleviate any discomfort associated with adverse effects
    C) The cost of the brand name drug compared with the generic form
    D) Statistics related to Phase III testing for the prescribed drug
  2. A patient presents at the clinic complaining of vaginal itching and a clear discharge. The patient reports to the nurse that she has been taking an oral antibiotic for 10 days. The nurse is aware that the patient is experiencing what?
    A) An adverse reaction from the antibiotic
    B) A drug toxicity effect of the antibiotic
    C) An overdose of the drug that is damaging to more than one body system
    D) A superinfection caused by the antibiotic, which has destroyed normal flora
  3. A 42-year-old male patient is brought to the emergency department by ambulance. The patient is in distress. The nurse suspects an anaphylactic reaction resulting from taking oral penicillin. What assessment findings are important in making this diagnosis?
    A) Blood pressure (BP): 186/100, difficulty breathing
    B) Hematocrit (Hct): 32%, decreased urine output
    C) Temperature: 102º, swollen joints
    D) Profuse sweating, Blood Pressure: 92/58
  4. A patient with seasonal allergies is taking an antihistamine to relieve itchy, watery eyes, and a runny nose. When planning teaching for this patient, the nurse would include what teaching point?
    A) Advise the patient to limit fluid intake to dry out mucous membranes.
    B) Advise the patient to avoid driving or operating machinery.
    C) Advise the patient to report strange dreams or nightmares.
    D) Advise the patient to decrease dietary fat.
  5. A nurse is providing teaching to a group of patients who are beginning drug therapy for acquired immunodeficiency syndrome (AIDS). What should be included in her instructions to the group?
    A) “Take your medications as directed. Poisoning occurs with overdosage causing damage to more than one body system.”
    B) “Renal injury results from first-pass effect when the drug is excreted from the system.”
    C) “A blood dyscrasia due to drug therapy can be serious. Call us if your skin looks yellowish or you experience itching.”
    D) “Most drugs are metabolized in the liver and the first indication of damage is dark red papules, which should be reported immediately.”
  6. The pharmacology instructor is talking to the nursing students about potassium-sparing diuretics and how they can lead to hyperkalemia, indicated by what assessment finding?
    A) Urine output of 1,500 mL/24 hours
    B) Blood pressure of 98/60
    C) Potassium level of 5.9 mEq/L
    D) Calcium level of 11.4 mg/dL
  7. An 80-year-old patient presents at the clinic for a follow-up appointment. She is taking a macrolide antibiotic and is experiencing tinnitus. The nurse is talking with family members about home care for the patient. What should the nurse include in her instructions regarding home care?
    A) Keep the patient in a prone position when in bed.
    B) Eliminate salt from the patient’s diet.
    C) Provide protective measures to prevent falling or injury.
    D) Monitor exposure to sunlight.
  8. Oral antidiabetic drugs can cause alterations in glucose metabolism. Patients who are taking these drugs would need to be observed for what?
    A) Increased urination
    B) Deep Kussmaul’s respirations
    C) Thirst and hot or flushed skin
    D) Confusion and lack of coordination
  9. A patient is taking chloroquine (Aralen) for rheumatoid arthritis. What problem reported by the patient would the nurse suspect may be an adverse reaction of the medication?
    A) “I have to urinate all the time.”
    B) “Sometimes I have blurred vision.”
    C) “I have tingling in my arms and legs.”
    D) “Sometimes I feel like I am off balance.”
  10. A 68-year-old patient who must take antihistamines for severe allergies is planning a vacation to Mexico. The nurse will encourage the patient to do what?
    A) Avoid sightseeing during the hottest part of the day.
    B) Discontinue the antihistamines if he becomes extremely restless.
    C) Decrease the dosage of the drugs if he experiences excessive thirst.
    D) Continue taking the antihistamines even if he begins to hallucinate.

Chapter 4: The Nursing Process in Drug

  1. A 70-year-old patient has just received a drug that can cause sedation. What would be the priority nursing diagnosis for this patient?
    A) Noncompliance: Cost of the drug
    B) Deficient knowledge: Unfamiliar with drug therapy
    C) Risk for injury: Related to adverse effects of the drug
    D) Ineffective health maintenance: Need for medication
  2. What is the responsibility of the nurse related to the patient’s drug therapy? (Select all that apply.)
    A) Teaching the patient how to cope with therapy to ensure the best outcome
    B) Providing therapy as well as medications
    C) Evaluating the effectiveness of therapy
    D) Altering the drug regimen to optimize outcome
    E) Recommending appropriate over-the-counter medications to treat adverse effects of prescription drug therapy
  3. The nurse is gathering assessment data from a medication history of a 38-year-old man with four children. What assessment information would be most important in providing care for this patient?
    A) The medication history of the patient’s mother and/or father
    B) The name of the patient’s pharmacy
    C) Insurance, financial support, and stability for the patient and his family
    D) The last time the patient was hospitalized
  4. During what phase of the nursing process would the nurse be required to consider the efficacy of nursing interventions related to drug therapy?
    A) Assessment
    B) Nursing diagnosis
    C) Interventions
    D) Evaluation
  5. When the nurse reads in the drug handbook the section related to recommended dosage, it is important to remember that this suggested dosage is based on what?
    A) A 40-year-old man
    B) An average-sized adult
    C) A 150-pound adult male
    D) A healthy young adult
  6. A nurse is caring for a child on the pediatric unit. A drug is ordered for the child, but no pediatric dose is listed for the drug. To make sure that the right dose has been ordered, what will the nurse use to calculate the correct dose?
    A) Surface area
    B) Height
    C) Birth date
    D) Adult dosage
  7. You are evaluating the discharge teaching you have done with your patient concerning drug therapy. What statement from the patient would indicate that teaching had been effective?
    A) “I have to take three pills each day and I can take them at the time that fits my schedule.”
    B) “I should take the white pill in the morning because the doctor wants me to take it.”
    C) “I will add the names and dosages of these new drugs to my medication list in my wallet.”
    D) “I have prescriptions at different pharmacies. I shop around for the best price for each drug.”
  8. The nurse would expect to see an adjusted dosage in what patients? (Select all that apply.)
    A) Young adult women
    B) Middle-aged men
    C) Infants
    D) Neonates
    E) Older adults
  9. When taking a medication history on a patient why should the nurse ask about the use of complementary or alternative therapies?
    A) Patients starting on new drugs are usually not compliant with medical regimens.
    B) Many drug-alternative therapy interactions can cause serious problems.
    C) Natural products may be more effective and the prescribed drug may not be needed.
    D) The cost of the drug and the alternative therapy may be too expensive for the patient to handle.
  10. The nurse is reviewing the patient’s medication orders and finds an order stating “amoxicillin 250 mg every 8 hours.” What would the nurse question regarding this order?
    A) Dose
    B) Route
    C) Frequency of administration
    D) Allowance for generic substitution

Chapter 5: Dosage Calculations

  1. The nurse is calculating a drug dosage and converting from milligrams to grams. What measurement system is the nurse using?
    A) Metric system
    B) Apothecary system
    C) Household system
    D) Avoirdupois system
  2. The nurse teaches a young mother the importance of administering appropriate dosages of acetaminophen (Tylenol) and determines further teaching is needed when the mother makes what statement?
    A) “The children’s dosage will change with time as they grow.”
    B) “My baby’s dose of Tylenol is about 1 half an adult dose.”
    C) “It is important to give the right dose to prevent toxic effects of the medication.”
    D) “My children’s dose of Tylenol should be based on their weight or age.”
  3. A nurse calculates the pediatric patient’s medication dosage using Clark’s rule and uses what formula?
    A) Infant’s age in months/150 months times the average adult dose
    B) Child’s age in years/child’s age in years plus 12 times the average adult dose
    C) Weight of child in pounds/150 pounds times the average adult dose
    D) Surface area in square meters/1.73 times the average adult dose
  4. The nurse receives a new medication order for a patient to administer 240 mg of medication per day in equally divided doses every 6 hours. How many mg of the drug should the nurse administer for each dose?
    Ans: 60 mg
    Feedback:
    Because there are 24 hours in a day, giving a drug every 6 hours would mean giving the drug 4 times a day. Because the total daily dose is 240 mg, dividing that dose by 4 would mean each dose should be 60 mg.
    5. A physician orders 500 mL of IV solution be administered over 8 hours. If the IV infusion set delivers 15 drops per mL, how many drops per minute should the nurse administer to the patient?
    A) 15 drops/min
    B) 20 drops/min
    C) 32 drops/min
    D) 64 drops/min
  5. The nurse is teaching a diabetic patient to self-administer Humulin insulin, supplied in a vial labeled 100 units/mL. The provider has ordered 32 units of Humulin insulin to be taken each morning. How many mL of insulin would the patient prepare for one dose?
    A) 0.032 mL
    B) 0.32 mL
    C) 3.2 mL
    D) 0.64 mL
  6. The provider orders a maintenance dose of oral aminophylline, 3 mg/kg every 6 hour. The patient weighs 50 kg. How many mg should the nurse administer to the patient in a 24-hour period?
  7. The physician writes an order for oxazepam for a 6-year-old child. The nurse verifies that there is no established dosage for children 6 to 12 years of age for oxazepam. The nurse knows that the usual adult dose is 10 mg tid. What would the nurse calculate the appropriate dose to be?
    A) 0.03 mg tid
    B) 0.3 mg tid
    C) 1.8 mg tid
    D) 3.3 mg tid
  8. A newly admitted patient has orders to receive 1,000 mL of normal saline IV over 8 hours. If the IV infusion set is a microdrip set that delivers 60 drops per mL, how many drops per minute should the nurse administer to the patient?
    A) 60 drops/min
    B) 125 drops/min
    C) 240 drops/min
    D) 480 drops/min
  9. The nurse is preparing to administer cefadroxil 1 g PO. The medication is supplied in 500-mg tablets. How many tablets will the nurse administer?
    A) 0.5 tablet
    B) 1 tablet
    C) 2 tablets
    D) 3 tablets

Chapter 6: Challenges to Effective Drug Therapy

  1. A nurse is preparing a drug for administration to a patient. The drug does not have an indicated use for the patient’s medical diagnosis. What should the nurse do?
    A) Administer the drug as ordered.
    B) Question the prescriber concerning the ordered drug.
    C) Ask a coworker his or her thoughts about the ordered drug for the patient.
    D) Ask the patient why the drug has been prescribed for him or her.
  2. According to Center for Disease Control and Prevention (CDC) recommendations, what is the role of the nurse in preparing for the possibility of bioterrorism?
    A) Post updated information on signs and symptoms of infections caused by biological agents
    B) Provide guidelines for treating patients exposed to, or potentially exposed to, biological agents
    C) Remain current on recognition and treatment of infections caused by biological weapons
    D) Advocate for increased funding for research involving bioterrorism and patient treatment
  3. How can the nurse find the most up-to-date information about emergency preparedness related to bioterrorism agents?
    A) Read textbooks devoted to the topic.
    B) Ask coworkers to explain current events.
    C) Read journal articles about bioterrorism agents.
    D) Visit the Centers for Disease Control and Prevention (CDC) Web site.
  4. The nurse is assessing a diabetic patient who has presented at the clinic reporting several hypoglycemic episodes during the past 3 weeks. The nurse questions the patient about the use of herbal or alternative therapies, suspecting what herbal remedy could cause the hypoglycemic episodes?
    A) St. John’s wort
    B) Kava
    C) Fish oil
    D) Ginseng
  5. A 22-year-old patient calls the clinic and tells the nurse that she has been depressed and is thinking about taking St. John’s wort but wants to know if it is safe first. The nurse begins by questioning what other medications the patient takes and would be concerned about a drug-alternative drug interaction if the patient is also taking what type of medication?
    A) Antihistamines
    B) Analgesics
    C) Antibiotics
    D) Oral contraceptives
  6. A patient tells the clinic nurse that he or she has been taking over-the-counter (OTC) Pepcid to relieve acid indigestion for several years. This is the first time the patient has ever reported this issue to a health care provider. As part of the teaching plan for this patient, the nurse explains what risk associated with not sharing OTC drug use with the provider?
    A) The OTC drug could be more expensive than seeking health care advice.
    B) The drug could mask symptoms of a serious problem that is undiagnosed.
    C) Use of the drug could cause a rebound effect of Pepcid.
    D) The drug could interact with several cold medicines.
  7. What patient populations would the nurse expect is most likely to be prescribed a drug for an off-label use?
    A) Adolescent and middle-aged adult patients
    B) Patients with diabetes or heart disease
    C) Obstetric and neonatal patients
    D) Pediatric and geriatric patients
  8. A patient calls the clinic and asks to speak to a nurse. The patient questions the nurse about the use of a drug that was advertised on TV. The patient tells the nurse he or she is sure that the drug will make him or her feel the same way as described in the commercial. What response is most appropriate for the nurse to make?
    A) “I’m glad that you want to be involved in treatment decisions but you are not qualified to decide what medications are best for your condition.”
    B) “It’s important to remember that drug advertisements emphasize the positive effects of drug therapy and not the adverse effects or contraindications.”
    C) “You need to remember that the drugs being advertised are much more expensive than other drugs that have the same effect.”
    D) “I’ve seen those advertisements and I would want to take that medication too if I had the condition it was designed to treat.”
  9. The clinic nurse is talking with a patient about information concerning a drug her or she bought online. What is the nurse’s responsibility to the patient concerning this information?
    A) Encourage the patient to seek information about drugs from a pharmacist.
    B) Explain that information obtained from the Internet is not always accurate.
    C) Offer the patient a drug reference guide to read and learn more about the drug.
    D) Interpret the information and explain it in terms that the patient will understand.
  10. The triage nurse in the emergency department sees a patient suspected of abusing amphetamines brought in by friends. While assessing this patient, what would the nurse be likely to find if steroids are being abused?
    A) Hypertension
    B) Bradycardia
    C) Drowsiness
    D) Elated mood

Chapter 7: Introduction to Cell Physiology

  1. A researcher is studying chromosomal disorders. What part of the human cell would the researcher be interested in studying?
    A) Cytoplasm
    B) Membrane
    C) Nucleus
    D) Organelles
  2. Which of these body cells has the greatest number of mitochondria?
    A) Tibia bone cells
    B) Breast tissue
    C) Cardiac muscle
    D) Subcutaneous skin
  3. When hormones, formed within the cell, move across the cell membrane, the process is called what?
    A) Endocytosis
    B) Exocytosis
    C) Phagocytosis
    D) Pinocytosis
  4. What substances move freely in and out of a cell by diffusion?
    A) Electrolytes
    B) Enzymes
    C) Hormones
    D) Proteins
  5. There can be interference with cancer chemotherapy in what phase of the cell cycle?
    A) G0 phase
    B) G1 phase
    C) G2 phase
    D) S phase
  6. The pharmacology instructor is discussing the histocompatibility of the cell. What is the importance of a cell’s histocompatibility antigen?
    A) It reproduces cells when other cells die.
    B) It recognizes cells as self-cells that belong in the body.
    C) The antigen produces antibodies to viral invaders.
    D) The antigen stimulates the production of white blood cells.
  7. A patient on the unit has a deep decubitus ulcer. The family asks why the nurse debrides the ulcer and removes the dead cells. What is the nurse’s best response to explain to the family why debridement is performed?
    A) The lysosomes released by the dead cells in the area continue to kill other cells, destroying more tissue.
    B) The dead cells no longer contain histocompatible antigens causing a greater inflammatory response.
    C) Removing dead tissue forces oxygen to enter the damaged cells to regenerate them and to promote healing.
    D) The doctor ordered the procedure to be performed so it is done the way it is ordered because orders are always followed.
  8. A patient is extremely dehydrated from vomiting and diarrhea causing his or her blood to become hypertonic. What effect does the nurse expect this will have on the red blood cells?
    A) They will swell and eventually rupture.
    B) Red blood cells will migrate to the bone narrow.
    C) The cells will shrink and shrivel, decreasing their oxygen-carrying ability.
    D) The red cells will precipitate out of circulation.
  9. The nurse is caring for four patients. Which patient would the nurse expect to have a faster recovery period based only on the process of mitosis?
    A) A 32-year-old female patient who had surgery for ulcerated colitis
    B) A 72-year-old man who had surgery for colon cancer
    C) A 28-year-old woman who had breast reduction surgery
    D) A 65-year-old man who had surgery for breast cancer
  10. When chemotherapeutic agents interfere with cellular physiology, it results in what?
    A) Cellular death or alterations
    B) Diffusion
    C) Endocytosis
    D) Homeostasis

Chapter 8: Anti-infective Agents

  1. A patient asks the nurse how an anti-infective produces a therapeutic effect. What key point will the nurse explain to this patient?
    A) Drugs used to treat infections date back to the 17th century.
    B) All anti-infectives work in the same way to destroy organisms.
    C) Selective toxicity determines the appropriate drug dosage needed.
    D) The goal of anti-infectives is to interfere with normal functioning of the organism.
  2. The nursing student learns about anti-infectives in class and demonstrates the need to study more when making what statement about how anti-infectives work?
    A) Some anti-infectives interfere with biosynthesis of the pathogen’s cell wall.
    B) Some anti-infectives prevent the cells of the organism from using essential substances.
    C) Many anti-infectives interfere with the steps involved in protein synthesis.
    D) Some anti-infectives interfere with ribonucleic acid (RNA) synthesis in the cell leading to cell death.
  3. The nurse administers a drug to treat Neisseria gonorrhoeae that works on no other bacteria. How would the nurse describe this drug?
    A) Broad spectrum
    B) Narrow spectrum
    C) Bactericidal
    D) Bacteriostatic
  4. The nurse has provided patient teaching for a patient who will be discharged to home on an anti-infective. What statement made by the patient indicates the nurse needs to provide additional teaching concerning the use of anti-infectives?
    A) “Antibiotics will not help me when I have a viral infection.”
    B) “A bacterial culture will be done before antibiotics are prescribed for me.”
    C) “I could develop diarrhea as a result of taking an antibiotic.”
    D) “I will stop taking the antibiotic as soon as I feel better.”
  5. The nurse attends a class on preventing resistance to anti-infectives and learns that the critical concept in preventing the development of resistant strains of microbes is what?
    A) Exposure of pathogens to an antimicrobial agent without cellular death
    B) Drug dosages that are below a therapeutic level
    C) The duration of drug use
    D) Frequency of drug ingestion
  6. The pathophysiology class is learning how microorganisms develop resistance to anti-infective drugs. What is one way the nursing students would learn that microorganisms develop resistance to anti-infective drugs?
    A) By rearranging their deoxyribonucleic acid (DNA) to produce membranes that are permeable to the drug
    B) By producing an enzyme that stimulates the drug
    C) By changing the cellular membrane to allow the drug entry into the cell
    D) By altering binding sites on the membrane or ribosomes so that the drug cannot enter the cell
  7. The nurse, writing a care plan for a patient on an aminoglycoside, includes what intervention to reduce the accumulation of the drug in the kidney?
    A) Avoid caffeine intake.
    B) Increase fluids.
    C) Decrease activity.
    D) Increase consumption of fruits and vegetables.
  8. When conducting patient teaching about using antibiotic medications, what is it critical for the nurse to include to help stop the development of resistant strains of microorganisms?
    A) Antibiotics should be used quickly to treat colds and other viral infections before the invading organism has a chance to multiply.
    B) Antibiotic dosage should be reduced and used for shorter periods of time to reduce unnecessary exposure to the drug.
    C) Prescriptions for antibiotics should be readily available so they can be filled as soon as patients suspect they have an infection.
    D) It is very important to take the full course of an antibiotic as prescribed and not save remaining drugs for future infections.
  9. A patient is told that he or she will have to undergo extensive dental surgery. The dentist prescribes a course of antibiotic therapy before beginning the procedures and continuing for 5 days after the procedure. What is this is an example of?
    A) Chemotherapy
    B) Curative treatment
    C) Prophylaxis
    D) Synergism
  10. A patient is receiving meropenem (Merrem IV). What drug-related reaction will the nurse assess for?
    A) Gastrointestinal toxicity
    B) Hepatic toxicity
    C) Nephrotoxicity
    D) Neurotoxicity

Chapter 9: Antibiotics

  1. A 32-year-old female patient is admitted to the floor with a superinfection. Her orders read tigecycline (Tygacil) 100 mg IV followed by 50 mg IV every 12 hours infused over 30 to 60 minutes for 5 days. What would be important for the nurse to educate this patient about?
    A) Analgesics
    B) Antihistamines
    C) Contraceptives
    D) Decongestants
  2. A patient with a gram-negative infection is being treated with an aminoglycoside. What system should the nurse expect to monitor closely while the patient is taking this medication?
    A) Respiratory system
    B) Ophthalmic system
    C) Renal system
    D) Musculoskeletal system
  3. How would the nurse describe selective toxicity?
    A) Selective toxicity interferes with a biochemical reaction common to many different organisms.
    B) Selective toxicity will decrease invading bacteria by interfering with the pathogens’ ability to reproduce.
    C) Selective toxicity will eliminate bacteria by interrupting protein synthesis and damaging the pathogen’s cell wall.
    D) Selective toxicity is the ability of the drug to kill foreign cells without causing harm to one’s own body cells.
  4. A local bioterrorism medical team is learning about germ warfare. The team is instructed that a fluoroquinolone may be used to prevent an outbreak of anthrax infection. What fluoroquinolone would the nurse be most likely to administer for this purpose?
    A) Ciprofloxacin (Cipro)
    B) Gemifloxacin (Factive)
    C) Norfloxacin (Noroxin)
    D) Sparfloxacin (Zagam)
  5. A clinic nurse is caring for a 66-pound child who has acute otitis media. The physician has ordered ceftibuten (Cedax) 9 mg/kg per day PO for 10 days. The drug comes in an oral suspension of 90 mg/5 mL. How many mL will the nurse administer?
    A) 5 mL
    B) 10 mL
    C) 15 mL
    D) 20 mL
  6. A 78-year-old woman, who lives alone and is forgetful, is being seen by her home health nurse. In reviewing the patient’s medication, the nurse discovers that the patient is taking Azithromycin (Zithromax) for urethritis. Why would this be a good choice of antibiotics for this patient?
    A) The half-life of the drug is 3 to 7 hours.
    B) It is taken only once a day.
    C) It has very few adverse effects.
    D) It can be given without consideration to drug–drug interactions.
  7. A 12-year-old patient with a complicated skin infection has been admitted to the pediatric unit. The physician has ordered Ertapenem (Invanz). What is the nursing priority?
    A) Transcribe the order to the medication administration record (MAR).
    B) Perform hand hygiene before preparing the medication.
    C) Assess the patient’s renal and hepatic functions.
    D) Question the order by calling the physician who prescribed it.
  8. A 22-year-old female is diagnosed with mycobacterial tuberculosis. The physician orders rifampin (Rifadin) 600 mg PO daily. What should the nurse question the patient about?
    A) Her diet
    B) Sun exposure
    C) Type of exercise she does
    D) Use of contact lenses
  9. The nurse is providing discharge teaching to a patient who is being sent home on oral tetracycline (Sumycin). What instructions should the nurse include?
    A) Take the medication only once a day.
    B) Check pulse rate and hold the drug if lower than 60 beats per minute (bpm).
    C) Take the drug on an empty stomach.
    D) Take the medication with 2 ounces of water.
  10. A 28-year-old patient has been prescribed penicillin for the first time. What nursing diagnosis would be most appropriate for this patient?
    A) Acute pain related to gastrointestinal (GI) effects of the drug
    B) Deficient knowledge regarding drug therapy
    C) Imbalance nutrition: less than body requirements related to multiple GI effects of the drug
    D) Constipation

Chapter 10: Antiviral Agents

  1. The nurse explains why viruses are so difficult to treat when making what statement?
    A) Viruses are contained inside the human cell and cannot be destroyed without destroying the cell.
    B) Release of interferons by the host cell makes the virus replicate more quickly allowing the virus to spread.
    C) Drugs exist to treat all viral infections but they carry serious adverse effects and the benefit often does not outweigh the risk.
    D) Individual antiviral drugs are often effective in treating many different viruses because one virus in a category behaves like others in the same category.
  2. While calculating the drug dose of antiviral medications for children who have AIDS a pediatric nurse uses what?
    A) The viral complications
    B) The child’s age
    C) The severity of the virus
    D) The child’s weight
  3. A patient taking nevirapine (Viramune) as part of combination therapy for treatment of HIV took 200 mg/daily PO for 14 days. The patient is now taking 200 mg PO bid. How many mg of the medication is the patient taking daily?
    A) 100 mg
    B) 200 mg
    C) 300 mg
    D) 400 mg
  4. What medication is only administered intravenously and is used to treat cytomegalovirus (CMV)?
    A) Cidofovir (Vistide)
    B) Foscarnet (Foscavir)
    C) Valacyclovir (Valtrex)
    D) Valganciclovir (Valcyte)
  5. A hospitalized patient is receiving an antiviral drug to treat cytomegalovirus. What is the nurse’s priority action after administering the antiviral drug?
    A) Monitor vital signs every hour.
    B) Decrease fluid intake.
    C) Keep side rails up.
    D) Encourage the patient to ambulate 10 minutes after each dose.
  6. A nurse is caring for a patient with HIV. What lab tests would the nurse monitor when a protease inhibitor has been ordered for this patient?
    A) A fasting blood sugar and 2-hour postprandial blood sugar
    B) Urine specific gravity and urine pH
    C) Serum alanine aminotransferase and bilirubin
    D) Arterial blood gases and O2 saturation
  7. A patient with renal impairment and HIV has had a medication change. What drug would be considered the drug of choice for this patient?
    A) Atazanivir (Reyataz)
    B) Lopinavir (Kaletra)
    C) Nelfinavir (Viracept)
    D) Ritonavir (Norvir)
  8. The nurse is caring for a patient with hepatitis B. The patient is taking adefovir (Hepsera). Which medication would the nurse question if it were ordered?
    A) Cimetidine (Tagament)
    B) Diltiazem (Cardizem)
    C) Diphenhydramine (Benadryl)
    D) Telbivudine (Tyzeka)
  9. A nurse is caring for a stroke victim in the intensive care unit. The nurse notices a cold sore and requests medication. Docosanol (Abreva) is ordered. Before applying the medication, the nurse would first?
    A) Clean the area to be treated and then pat it dry.
    B) Assess the area for open lesions or abrasions.
    C) Put gloves on to protect herself.
    D) Prepare applicator for drug administration.
  10. A patient with AIDS is taking an antiviral agent. What comment by the patient would indicate that the teaching plan was effective?
    A) I feel like I do when I have the flu.
    B) I will continue to take the over-the-counter medication for my allergies.
    C) Excessive fatigue and a severe headache are common adverse effects of my medication.
    D) This drug will cure AIDS.

Chapter 11: Antifungal Agents

  1. A 17-year-old male patient with athlete’s foot is extremely upset that he cannot get rid of it. He calls the clinic and asks the nurse whether the doctor can give him an antibiotic to “cure the infection.” What should the nurse include in the explanation of treatment for fungal infections?
    A) “Fungi differ from bacteria in that the fungus has flexible cell walls that allow for free transfer into and out of the cell.”
    B) “Protective layers contain sterols, which change the membrane permeability.”
    C) “The composition of the protective layers of the fungal cell makes the organism resistant to antibiotics.”
    D) “Fungi cell walls contain Candida, which makes the cells rigid.
  2. The nurse admits a 1-year-old child to the pediatric intensive care unit (ICU) with cryptococcal meningitis. What drug will the nurse anticipate receiving an order for to treat this child?
    A) Amphotericin B (Fungizone)
    B) Fluconazole (Diflucan)
    C) Griseofulvin (Fulvicin)
    D) Ketoconazole (Nizoral)
  3. The nurse is teaching the patient about a newly prescribed systemic antifungal drug. What sign or symptom will the nurse instruct the patient to report to the provider immediately?
    A) Unusual bruising and bleeding
    B) Constipation or diarrhea
    C) Red and dry eyes
    D) Increased appetite with weight gain
  4. A patient who has a tinea infection calls the clinic and complains of intense local burning and irritation with use of a topical antifungal drug. Even before asking the patient, the nurse suspects he or she is applying what medication?
    A) Butoconazole (Gynazole I)
    B) Ciclopirox (Loprox)
    C) Econazole (Spectazole)
    D) Haloprogin (Halotex)
  5. A patient asks the nurse if he or she should use a topical antifungal. The nurse is aware that the most important contraindication to topical antifungals is what?
    A) Hepatic impairment
    B) Renal impairment
    C) Congestive heart failure
    D) Known allergy to any of the antifungal drugs
  6. A patient with high cholesterol is taking lovastatin (Mevacor). What drug would the nurse question if it was ordered for this patient?
    A) Nifedipine (Procardia)
    B) Ciprofloxacin (Cipro)
    C) Itraconazole (Sporanox)
    D) Oxazepam (Serax)
  7. An 85-year-old man who is a resident in an extended-care facility has athlete’s foot. After applying an antifungal cream, what is the nurse’s next action?
    A) Wipe away excess medication from the affected area.
    B) Wrap a sterile kling dressing around both feet.
    C) Elevate the feet for 30 minutes.
    D) Apply clean dry socks.
  8. A patient comes to the clinic and is diagnosed with a vaginal fungal infection. The nurse provides patient information for self-administration of a vaginal antifungal medication. What will the nurse include in the instructions?
    A) “Insert low into the opening of the vagina.”
    B) “Discontinue use during menstruation.”
    C) “Remain recumbent for at least 15 minutes after insertion.”
    D) “Rub the cream into the vaginal wall after insertion.”
  9. A patient who is using a topical antifungal agent to treat mycosis calls the clinic to report a severe rash that is accompanied by blisters. What will the nurse instruct the patient to do?
    A) “Continue the drug as the prescription indicates.”
    B) “Scrub the rash with soap and water.”
    C) “Stop using the drug immediately.”
    D) “Decrease the amount of the medication used.”
  10. The nurse admitted a 25-year-old woman to the unit. What would be the most important thing for the nurse to assess before administering ketoconazole?
    A) Complete blood count (CBC) and blood glucose
    B) Eating and sleeping habits
    C) Height and weight
    D) Renal and hepatic function

Chapter 12: Antiprotozoal Agents

  1. The patient is having an acute malarial attack with chills and fever. The nurse knows chills and fever are caused by what?
    A) Formation of sporozoites into the system
    B) Rupture of red blood cells due to invasion of merozoites
    C) Invasion of the tsetse fly into the central nervous system
    D) Release of amastigotes into the blood vessels
  2. The nurse is caring for a patient of Greek descent who plans to travel to an area of the world in which malaria is endemic. What should this patient be tested for before administering antimalarial medications?
    A) Tay-Sachs’ disease
    B) Glucose-6-phosphate dehydrogenase (G6PD) deficiency
    C) Plasmodium
    D) Penicillin allergy
  3. The nurse is caring for a patient who is being treated with quinine (Qualaquin) for drug-resistant malaria. The nurse will monitor the patient for cinchonism that will present with what manifestations?
    A) Diarrhea, nausea, and fever
    B) Yellowing of the sclera and skin
    C) Tremors and ataxia
    D) Vomiting, tinnitus, and vertigo
  4. Patients receiving chloroquine (Aralen Phosphate) for malaria prophylaxis should receive patient teaching from the nurse, which includes instructions to receive what regularly?
    A) Cardiovascular studies
    B) Eye exams
    C) Immunizations
    D) Pulmonary studies
  5. A 28-year-old woman is planning to be part of a mission team going to Central Africa. She will take mefloquine (Lariam) once a week, beginning 1 week before traveling to Africa until 4 weeks after leaving Africa. What precaution will the nurse teach this patient is needed?
    A) “Avoid excessive weight gain.”
    B) “Have regular cancer screening.”
    C) “Use contraceptives to avoid pregnancy.”
    D) “Stop the medication if diabetes is diagnosed.”
  6. The nurse is writing a plan of care for a patient receiving antimalarial drug therapy. What nursing diagnosis would be appropriate for this patient if common adverse effects were indicated?
    A) Disturbed sensory perception (visual) related to central nervous system effects
    B) Imbalanced nutrition: more than body requirements
    C) Constipation
    D) Ineffective breathing pattern
  7. During a lecture on intestinal parasites, the students learn that what is the most commonly diagnosed intestinal parasite infection in the United States?
    A) Amebiasis
    B) Giardiasis
    C) Leishmaniasis
    D) Trichomoniasis
  8. A patient has been diagnosed with trichomoniasis. Before beginning tinidazole (Tindamax) therapy, what should the nurse question the patient about?
    A) Working conditions
    B) Use of alcohol
    C) Recent visit to a beach or desert
    D) Possibly having AIDS
  9. The nurse is caring for a patient with acquired immunodeficiency syndrome (AIDS) who has been diagnosed with Pneumocystis jiroveci pneumonia. The patient is taking multiple oral agents to treat AIDS. What would be the drug of choice for this patient?
    A) Nitazoxanide (Alinia)
    B) Chloroquine
    C) Metronidazole
    D) Pentamidine
  10. A patient with giardiasis is being treated with metronidazole. What comment by the patient would indicate that the nurse needs to provide further teaching?
    A) I can continue to work delivering pizza because the disease is not contagious.
    B) I will not lose my hair during drug therapy.
    C) I know I will experience diarrhea during this time.
    D) I shouldn’t experience irregular menstrual periods.

Chapter 13: Anthelmintic Agents

  1. A public health nurse is speaking to parents of first graders. When discussing worm infection, the nurse will explain that the most common type found in U.S. school-aged children is what?
    A) Pinworms
    B) Roundworms
    C) Threadworms
    D) Whipworms
  2. A mother of a 3-year-old child brings her child to the clinic. The child is diagnosed with pinworms. What drug would be the best choice for the patient?
    A) Pyrantel (Pin-Rid)
    B) Ivermectin (Stromectol)
    C) Mebendazole (Vermox)
    D) Albendazole (Albenza)
  3. A nurse is teaching a young mother about administering pyrantel (Pin-Rid, others) to her 5-year-old child. What will the nurse emphasize about how the agent is given?
    A) In 3 doses as a 1-day treatment
    B) In a morning dose and an evening dose for 3 days
    C) B.I.D. for 10 days
    D) Give only once
  4. A patient has been diagnosed with roundworms and is to be treated with albendazole. A priority nursing assessment of this patient would be to determine if the patient is taking what?
    A) Cimetidine (Tagamet)
    B) Pioglitazone (Actos)
    C) Alprazolam (Xanax)
    D) Loperamide (Imodium)
  5. What would be a priority nursing action related to the care of a patient taking albendazole (Albenza)?
    A) Check blood pressure, pulse, and respirations
    B) Weigh the patient
    C) Monitor renal function
    D) Encourage small, frequent meals
  6. The nurse is caring for an adult patient receiving a prescription for an anthelmintic drug. What is a possible nursing diagnosis for this patient?
    A) Constipation
    B) Disturbed body image
    C) Acute confusion
    D) Imbalanced nutrition: More than body requirements
  7. A nurse is teaching a patient who has been diagnosed with trichinosis. The nurse will include in the discussion that trichinosis is caused by roundworms having what effect?
    A) Disruption of the host’s normal cellular functions causing cell death and resulting in disease
    B) Invasion of body tissues seriously damages lymphatic tissue, lungs, the central nervous system, heart, and liver
    C) Exposure to the delicate mucous membranes of the anus and colon producing local irritation
    D) Easily passed from one individual to another resulting in rapid spreading within a work place
  8. When instructing a patient about the therapeutic effectiveness of an anthelmintic drug, the nurse would be sure to include what?
    A) Any person exposed to the patient should also be treated.
    B) The drugs should never be taken with food.
    C) The infected person should be isolated.
    D) Strict hygiene measures are important in eradicating the worm.
  9. The nurse is caring for a patient diagnosed with hookworms. The patient is receiving mebendazole (Vermox). What would the nurse expect to see in this patient?
    A) Increased bilirubin
    B) Decreased hematocrit and hemoglobin
    C) Increased aspartate transaminase levels
    D) Decreased blood sugar
  10. A patient is taking an anthelmintic that is absorbed systemically. What adverse effect should the nurse inform the patient might be experienced?
    A) Abdominal discomfort
    B) Diarrhea
    C) Loss of hair
    D) Pain

Chapter 14: Antineoplastic Agents

  1. The process of cancerous cells exhibiting a loss of cellular differentiation and organization leading to a loss of their ability to function normally is called what?
    A) Anaplasia
    B) Angiogenesis
    C) Autonomy
    D) Metastasis
  2. The mitotic inhibitors interfere with the ability of a cell to divide and they block or alter deoxyribonucleic acid (DNA) synthesis, thus causing cell death. What is important for the nurse to remember when administering these drugs?
    A) The nurse should encourage the patient to eat six small meals a day.
    B) The nurse should avoid any skin, eye, or mucous membrane contact with the drug.
    C) The nurse should avoid using a distal vein.
    D) The nurse should check for extravasation when the infusion is over.
  3. A nurse is preparing an antineoplastic agent for a 9-year-old cancer patient. Before administering an antineoplastic agent, what is the nurse’s priority action?
    A) Wash his or her hands.
    B) Identify the child by checking the arm band and asking him or her to state his or her name.
    C) Ensure a quiet environment so the patient can sleep during administration of the drug.
    D) Check laboratory studies to determine most recent measures of bone marrow function.
  4. A patient with leukemia receives rasburicase (Elitek) before administering chemotherapy. What is the nurse’s priority assessment after administration of this medication?
    A) Blood glucose levels
    B) Serum potassium levels
    C) Serum calcium levels
    D) Uric acid levels
  5. The nurse is caring for a patient at risk of severe-to-fatal interstitial lung disease. What antineoplastic agent is the nurse administering that carries this risk?
    A) Valrubicin (Valstar)
    B) Erlotinib (Tarceva)
    C) Histrelin acetate (Vantas)
    D) Triptorelin pamoate (Trelstar Depot)
  6. The nurse is caring for a patient who has just been diagnosed with adenocarcinoma of the pancreas. What antineoplastic does the nurse suspect the patient will receive?
    A) Bleomycin (Blenoxane)
    B) Daunorubicin (DaunoXome)
    C) Idarubicin (Idamycin)
    D) Mitomycin (Mutamycin)
  7. The nurse is caring for a patient receiving cyclophosphamide (Cytoxan). What is the priority nursing action for this patient?
    A) Monitor urinalysis results.
    B) Provide small, frequent meals.
    C) Administer an antiemetic when needed.
    D) Provide oral care.
  8. A 42-year-old woman with breast cancer has had a radical mastectomy. She will have radiation therapy and then begin chemotherapy. Drug therapy will consist of a combination of doxorubicin, cyclophosphamide, and paclitaxel. What will the nurse include in her teaching plan concerning the drug therapy?
    A) Stay on a low-fat diet during the course of the drug therapy.
    B) Take special care when shaving or when brushing her teeth.
    C) Continue to go to church or to the mall just as she did before the diagnosis of cancer.
    D) Stay in bed 2 days after each administration.
  9. The nurse should exercise caution when administering antimetabolites to a patient diagnosed with what?
    A) Bone marrow suppression
    B) Diabetes mellitus
    C) Hypertension
    D) Seizure activity
  10. The nurse is caring for a patient who is receiving a combination of antineoplastic agents. The patient will most likely lose his or her hair. Why would the nurse suggest that he or she get a wig or use appropriate head cover?
    A) People may be uncomfortable seeing his or her bald head.
    B) The hair will likely grow back if the head is covered at all times.
    C) His or her self-esteem will be better if the head is covered.
    D) Heat is lost through the head and it is important to cover it during extremes in temperature.

Chapter 15: Introduction to the Immune

  1. The body’s first-line barrier defense is considered to be what?
    A) Mast cells
    B) Mucous membranes
    C) Skin
    D) T cells
  2. The nurse recognizes what patient has lost a barrier defense increasing his risk for infection?
    A) A 68-year-old man diagnosed with prostate cancer
    B) A 24-year-old man diagnosed with partial thickness burns
    C) A 13-year-old boy diagnosed with chickenpox
    D) A 72-year-old man diagnosed with bacterial pneumonia
  3. After reviewing the results of a complete blood count on a patient who is diagnosed with an acute infection, what will the nurse expect to see elevated?
    A) Basophil count
    B) Eosinophil count
    C) Hematocrit
    D) Neutrophil count
  4. A new mother calls the clinic and tells the nurse her toddler has a temperature of 102ºF. How does the nurse explain why the mother should not be alarmed?
    A) “A fever is the body’s way of fighting an infection and supporting the body’s immune system.”
    B) “Neutrophils release pyrogen, a fever-causing substance, which helps act as a catalyst for the body’s inflammatory and immune responses.”
    C) “Leukotrienes activated by arachidonic acid attract neutrophils to start the process of fighting inflammation.”
    D) “Inflammation causes the activation of a chemical called Hageman factor that initiates a process to bring more blood to the injured area and allows white blood cells to escape into the tissues.”
  5. A patient presents to the emergency department with an infected wound on his left forearm. The nurse explains the inflammatory response caused by the injury will occur in what sequence?
    A) Heat, pain, redness, swelling
    B) Swelling, pain, redness, heat
    C) Redness, swelling, heat, pain
    D) Pain, redness, swelling, heat
  6. The patient with AIDS asks the nurse why his cytotoxic T cells are so important. What is the nurse’s best response to explain the actions of cytotoxic T cells?
    A) Cells that are programmed to identify specific proteins or antigens
    B) Cells that can either destroy a foreign cell or mark it for aggressive destruction
    C) Cells that respond to chemical indicators of immune activity and stimulate other lymphocytes to be more aggressive and responsive
    D) Cells that respond to rising levels of chemicals associated with an immune response to suppress or slow the reaction
  7. A patient has a minor laceration on the left arm. What does the nurse know that will cause a patient to experience muscle and joint aches, a low-grade fever, and sleepiness when an inflammatory reaction is initiated?
    A) Bacterial toxins
    B) Interferon activity
    C) Leukotriene activity
    D) Phagocytosis
  8. What body defense needs to be reduced in the patient following organ transplantation?
    A) Major histocompatibility complex
    B) Barrier defenses
    C) Lymphoid tissues
    D) Eosinophils
  9. The nurse is teaching a class on the inflammatory response for other nurses and discusses the role of factor XII or the Hageman factor. What substance does Hageman’s factor activate to cause kininogen to be converted to bradykinin?
    A) Arachidonic acid
    B) Prostaglandins
    C) Leukotrienes
    D) Kallikrein
  10. A patient who has received a heart transplant has been given an order for drugs that block T cell activity. What is the rationale behind this order?
    A) To manufacture antibodies to the foreign proteins
    B) To stimulate wound healing
    C) To combine with a complement to cause a massive inflammatory reaction
    D) To prevent an inflammatory reaction against the transplanted heart

Chapter 16: Anti-inflammatory, Antiarthritis

  1. A nurse has admitted a 10-year-old child to the short-stay unit. The child has complained of chronic headaches and his or her mother reports that he or she gives him or her acetaminophen (Tylenol) at least twice a day. What will the nurse evaluate?
    A) Renal function
    B) Hepatic function
    C) Respiratory function
    D) Cardiac function
  2. The nurse is discussing ethnic differences in response to medication with your nursing students. What group of people would the nurse tell the students may have a decreased sensitivity to pain-relieving effects of anti-inflammatory drugs and should be educated concerning signs and symptoms of gastrointestinal bleeding from use of these drugs?
    A) African Americans
    B) White Americans
    C) Hispanics
    D) Asians
  3. A patient, newly diagnosed with ulcerative colitis, has been admitted to the short-stay unit. What salicylates does the nurse anticipate will be ordered for this patient?
    A) Balsalazide (Colazal)
    B) Sodium thiosalicylate (generic)
    C) Choline magnesium trisalicylate (Tricosal)
    D) Salsalate (Argesic)
  4. The nurse is caring for a 66-pound child with orders for choline magnesium trisalicylate (Tricosal). The orders read 50 mg/kg/d PO in two divided doses. How many milligram will the patient receive per dose?
    A) 250 mg
    B) 500 mg
    C) 750 mg
    D) 1,000 mg
  5. A nurse is caring for a patient with severe rheumatoid arthritis who takes anti-inflammatory agents on a regular basis. What medication should the nurse question if ordered by the physician to be taken in addition to the anti-inflammatory agent?
    A) Oral antidiabetic agent
    B) Calcium channel blocker
    C) Beta-blocker
    D) Antibiotic
  6. A nurse is assessing a patient who has been taking nonsteroidal anti-inflammatory drugs (NSAID). What statement by the patient indicates to the nurse that the patient has a good understanding of the use of this therapy?
    A) “I drink a glass of wine just about every night.”
    B) “I asked my doctor to check for blood in my stool regularly.”
    C) “I do not like to swallow tablets so I crush them.”
    D) “I drink as little water as possible when I take my medication.”
  7. A salicylate has been prescribed for a 15-year-old patient who has been diagnosed with arthritis. The mother is concerned about giving her child a salicylate. What salicylates could the nurse tell this mother are recommended for use in children?
    A) Salsalate (Argesic)
    B) Olsalazine (Dipentum)
    C) Sodium thiosalicylate (generic)
    D) Choline magnesium trisalicylate (Tricosal)
  8. A mother has brought her 6-year-old child to the clinic. The child has a fever of 102.8ºF and is diagnosed with the flu. What medication will the nurse suggest for this child?
    A) Etanercept (Enbrel)
    B) Penicillamine (Depen)
    C) Acetaminophen (Tylenol)
    D) Aspirin (Bayer)
  9. A nurse is presenting an educational event for a group of new parents. One topic that the nurse addresses is the overuse of acetaminophen, which can cause liver toxicity. What would the nurse tell the parents it is important to do?
    A) “Do not give acetaminophen (Tylenol) unless you receive a doctor’s order.”
    B) “Check the label of over-the-counter (OTC) medications carefully to watch for inclusions of acetaminophen in the ingredients.”
    C) “Monitor their child’s temperature carefully and regulate the Tylenol dose based on the fever.”
    D) “Mix OTC children’s medications to get the best coverage for their child’s symptoms.”
  10. A mother asks the nurse how acetaminophen works. What statement best describes the therapeutic action of acetaminophen?
    A) Acetaminophen (Tylenol) works by blocking the increase of interleukin-1.
    B) Acetaminophen reacts with free-floating tumor necrosis (TNF) factor released by active leukocytes.
    C) Acetaminophen acts directly on the hypothalamus to cause vasodilation and sweating.
    D) Acetaminophen is taken up by macrophages, thus inhibiting phagocytosis and release of lysosomal enzymes.

Chapter 17: Immune Modulators

  1. A patient has been diagnosed with hairy cell leukemia. The patient is to begin taking interferon alfa 2b. What will the nurse include in her instructions to the patient concerning this drug?
    A) Avoid drinking alcohol while taking the drug.
    B) Continue to maintain maximal physical activity.
    C) Increase fluid intake while taking the drug.
    D) Treat constipation with over-the-counter laxatives.
  2. The health care provider plans to inject an interferon directly into the patient’s wart. What interferon will the nurse prepare?
    A) Interferon alfa 2a (Roferon-A)
    B) Interferon alfacon 1 (Infergen)
    C) Interferon alfa n3 (Alferon N)
    D) Interferon beta 1a (Avonex)
  3. A 30-year-old woman has been diagnosed with leukemia and will be using an immune modulator for treatment. What will be important to discuss with the patient when the nurse provides patient teaching about her treatment?
    A) The need to continue oral contraceptives
    B) The need to use barrier contraceptives while taking the drug
    C) The need to avoid sexual intercourse while taking the drug
    D) The importance of taking an aspirin daily to decrease the adverse effects of the drug
  4. The nurse has an order to administer oprelvekin (Neumega) to a patient for the first time. Before administering the drug, what allergy would the nurse want to specifically question the patient about?
    A) Egg products
    B) Escherichia coli–produced products
    C) Lactose intolerance
    D) Penicillin
  5. The physician has decided to prescribe T- and B-cell suppressors for a patient diagnosed with psoriasis. What drug will be ordered for this patient?
    A) Alefacept (Amevive)
    B) Azathioprine (Imuran)
    C) Cyclosporine (Neoral)
    D) Glatiramer acetate (Copaxone)
  6. A patient who is receiving an immune suppressant has been admitted to the unit. What would be a priority action by the nurse?
    A) Monitor nutritional status.
    B) Provide patient teaching regarding the drug.
    C) Protect the patient from exposure to infection.
    D) Provide support and comfort measures in relation to adverse effects of the drug.
  7. A nurse is discussing interferon alfa 2b with a patient. What will the nurse encourage the patient to do while taking this drug?
    A) To avoid crowds
    B) To increase salt intake
    C) To decrease milk intake
    D) To eat three meals a day
  8. A 70-year-old patient with acute myelocytic leukemia is receiving sargramostim (Leukine). What is a priority nursing action for this patient?
    A) Providing a quiet environment
    B) Increasing fluids
    C) Providing comfort measures related to nausea
    D) Encouraging appropriate dietary intake
  9. The nurse is caring for a patient in the immediate postoperative period following cardiac transplantation who is receiving mycophenolate (CellCept) twice a day IV. What will the nurse teach the patient regarding drug therapy? (Select all that apply.)
    A) The drug will be given orally as soon as possible.
    B) Take the medication three times a day.
    C) Avoid people with contagious diseases.
    D) Ask a pharmacist about drug–drug interactions before taking any over-the-counter (OTC) drug.
    E) Never miss a dose of medication.
  10. The nurse administers aldesleukin to a patient diagnosed with renal cell carcinoma. When assessing the patient a few days later, what abnormal findings would the nurse attribute to the medication? (Select all that apply.)
    A) Increased lymphocyte count
    B) Increased red blood cell count
    C) Increased platelet count
    D) Irregular pulse rate
    E) Increased blood pressure

Chapter 18: Vaccines and Sera

  1. The nursing instructor is discussing immunity with her clinical group. What statement would the instructor make that would be accurate about immunity?
    A) Active immunity occurs with injected antibodies that react with specific antigens.
    B) Serum sickness results when the body fights antibodies injected as a form of active immunity.
    C) Passive immunity occurs when foreign proteins are recognized and the body produces antibodies.
    D) Passive immunity is limited, lasting only as long as the antibodies circulate.
  2. A mother brings her 18-month-old child into the clinic for a well-baby check-up. A nurse will administer measles, mumps, and rubella vaccine (MMR) to the child. What dosage will the nurse administer?
    A) 1.0 mL subcutaneously
    B) 0.75 mL subcutaneously
    C) 0.5 mL subcutaneously
    D) 0.25 mL subcutaneously
  3. A public health nurse is on a mission trip to Africa where she is administering Dryvax. The patient asks the purpose of this drug and the nurse explains it will prevent what?
    A) Yellow fever
    B) Smallpox
    C) Chickenpox
    D) Rabies
  4. The mother of a newborn is learning about immunization schedules. The nurse tells this mother her child will ideally receive the immunization for measles, mumps, and rubella (MMR) on what schedule?
    A) 2 months, 4 months, between 6 and 18 months, and between 4 and 6 years
    B) 2 months, 4 months, 6 months, and between 12 and 15 months
    C) Between 12 and 15 months and between 4 and 6 years
    D) Between 24 months and 18 years of age
  5. A 14-year-old boy is brought to the clinic by his mother. The patient has a note from his basketball coach explaining that a member of the team has been diagnosed with hepatitis A infection. The nurse notes that the patient has an extensive list of allergies. What is the nurse’s priority action when administering the immune globulin?
    A) Perform a hepatitis A antibody check.
    B) Monitor the patient carefully and have emergency equipment ready if needed.
    C) Apply ice to the injection site to slow the absorption of the serum.
    D) Give the patient aspirin and a corticosteroid before the injection to modulate reaction.
  6. A nurse is providing patient education to the mother of a child receiving a first immunization. The nurse tells the mother that after the injection, it is normal for the child to exhibit what signs and symptoms?
    A) Vomiting and diarrhea
    B) High fever and sweating
    C) Lethargy, drowsiness, and irritability
    D) Pain, redness, and swelling at site of injection
  7. A 69-year-old patient comes to the clinic to talk to the nurse. The patient asks the nurse about when he should get the pneumonia vaccine. The patient’s medical record reveals that he received the vaccine at age 55. What should the nurse tell the patient?
    A) “This vaccine is only given once and you have already had it.”
    B) “This vaccine is given every 10 years and you will be due next year.”
    C) “This vaccine is only repeated if the first dose was given before age 65. You should have another vaccine.”
    D) “This vaccine is no longer recommended. Don’t worry about getting pneumonia.”
  8. A mother has brought her infant to the clinic for the first immunization. What would the nurse be sure to include when providing patient education for the infant’s mother?
    A) Avoid having her child get more than one vaccine at a time.
    B) Stop the immunizations after 2 years of age.
    C) Keep a written record of the child’s immunizations.
    D) Omit immunizations if the injections are too upsetting for her child.
  9. A mother brings her 18-month-old son into the clinic for his diphtheria, tetanus, and pertussis vaccine. The child has a runny nose, a fever of 102.4ºF and is coughing. What should the nurse do?
    A) Administer the vaccine but monitor the child afterward for an extended time period.
    B) Give an antipyretic and administer vaccine when temperature is within normal range.
    C) Administer a reduced dose of the vaccine today and a normal dose when child is healthy.
    D) Hold the immunization until the child is free of allergic or cold-like symptoms.
  10. When discussing vaccines in class, a student asks the nursing instructor what an antitoxin is. What is the instructor’s best response?
    A) It is an immune serum for snake bites.
    B) It is a type of vaccine.
    C) It is a form of active immunity.
    D) It is a form of passive immunity.

Chapter 19: Introduction to Nerves and the Nervous System

  1. What part of the neuron carries information into the neuron from other neurons?
    A) Axon
    B) Dendrite
    C) Nucleus
    D) Soma
  2. When a neuron is stimulated and causes depolarization of the nerve, what occurs?
    A) Calcium rushes into the cell.
    B) Sodium rushes into the cell.
    C) Potassium rushes into the cell.
    D) Sodium and potassium are actively pumped out to the cell.
  3. What neurotransmitter inhibits overexcitability and is important in preventing seizure activity in a patient?
    A) Acetylcholine
    B) Dopamine
    C) Gamma-aminobutyric acid (GABA)
    D) Serotonin
  4. The nurse is caring for a patient who has an injured hindbrain. What would the nurse expect to find altered when assessing the patient?
    A) Arousal and awareness
    B) Basic vital functions
    C) Coordination and motor activity
    D) Learning and motivation
  5. A female patient has experienced a stroke affecting the right side of her brain. What will the nurse expect to assess in this patient?
    A) Inability to recall the name of her best friend
    B) Inability to state her telephone number
    C) Inability to distinguish a spoon from a fork
    D) Inability to recall how to apply her makeup
  6. The nurse is caring for a patient with meningitis who is not responding to the prescribed antibiotic and whose condition continues to deteriorate. What rationale will the nurse give the family to explain why the antibiotic is not as effective as it was hoped?
    A) The meninges do not have a blood supply.
    B) The blood–brain barrier prevents the antibiotics from crossing into the brain.
    C) The circle of Willis redirects the antibiotic elsewhere.
    D) The pressure in the hindbrain prevents entry into the skull.
  7. An 87-year-old woman undergoes extensive surgery for an acoustic neuroma (a benign tumor of the inner ear), and 6 hours after surgery, she hemorrhages and goes into a coma. After awaking and 2 months of therapy, she is transferred to a long-term care facility. Due to damage in the midbrain, the nurse caring for the patient will expect the patient to exhibit what?
    A) Difficulty in sleeping
    B) Difficulty in hearing
    C) Difficulty in distinguishing hot and cold
    D) Difficulty in speaking
  8. A nurse is caring for a patient who is having an adverse drug reaction. The patient is experiencing tremors, is unable to hold his or her head up, and is having difficulty sitting up in bed. The nurse suspects that this is due to what?
    A) An interference with the extrapyramidal system
    B) A faulty engram
    C) An alteration in the reticular activating system
    D) An interference with a neurotransmitter
  9. A nurse is working on a surgical unit and has several patients who require preoperative teaching. Which patient demonstrates behavior indicating this is an appropriate time to begin teaching?
    A) A patient who is wide eyed and extremely frightened about being put to sleep
    B) A patient who appears to be unconcerned about what is happening and wants to watch his favorite TV show
    C) A patient who is clearing her throat several times while asking the nurse questions during their conversation and who appears to be slightly stressed
    D) A patient who is getting up and down from the bed, talking very fast, and appears to be extremely anxious
  10. The nursing instructor explains the limbic system contains what neurotransmitters?
    A) Acetylcholine, epinephrine, and serotonin
    B) Gamma-aminobutyric acid, dopamine, and serotonin
    C) Epinephrine, dopamine, and gamma-aminobutyric acid
    D) Epinephrine, norepinephrine, and serotonin

Chapter 20: Anxiolytic and Hypnotic Agents

  1. The nurse is caring for a patient in a state of hypnosis, which means the patient is in what state?
    A) A state of extreme sedation in which the person no longer senses or reacts to incoming stimuli.
    B) A state of tranquility in which the person can be made to do whatever is suggested by others.
    C) A feeling of tension, nervousness, apprehension, or fear with high levels of awareness.
    D) A state in which the brain is no longer sending out signals to the body.
  2. A nurse is caring for a 4-year-old child who is receiving a barbiturate. What common adverse effect would the nurse assess for?
    A) Decrease in respirations
    B) Vomiting
    C) Excitability
    D) Dry mucous membranes
  3. A nurse is caring for a 9-year-old patient and has received an order for diazepam (Valium) 10 mg given orally q.i.d. What is the nurse’s priority action?
    A) Perform hand hygiene and prepare the drug.
    B) Send the order to the hospital pharmacy.
    C) Determine when to administer the first dose.
    D) Call the physician and question the order.
  4. A nurse is discussing the use of alprazolam (Xanax) with a 68-year-old patient. What statement indicates that the patient has an understanding of the drug?
    A) “When I stop having panic attacks, I can stop taking the drug.”
    B) “This drug will calm me down in about 30 minutes after I take it.”
    C) “One dose will keep me calm for about 24 hours.”
    D) “I am taking an increased dose because of my age.”
  5. A nurse is about to administer a parenteral benzodiazepine to a female patient in the hospital before the performance of a procedure. What is the priority nursing action before administration of the drug?
    A) Make sure that the side rails are up and the bed is in the lowest position.
    B) Close the blinds and ensure appropriate room temperature for the patient.
    C) Help the patient out of bed to the bathroom and encourage her to void.
    D) Ask all visitors to leave the room and remain in the waiting area.
  6. The nurse is caring for a 36-year-old man who experienced a seizure 30 minutes before coming into the emergency room, where he begins to have another. What barbiturate has the fastest onset and would be most appropriate to give to the patient to quickly stop the seizure?
    A) Amobarbital (Amytal Sodium)
    B) Mephobarbital (Mebaral)
    C) Phenobarbital (Luminal)
    D) Secobarbital (Seconal)
  7. What anxiolytic drugs would be given to a premenopausal patient who is a registered nurse planning to return to work at the hospital after anxiety is controlled?
    A) Alprazolam (Xanax)
    B) Buspirone (BuSpar)
    C) Diazepam (Valium)
    D) Clorazepate (Tranxene)
  8. A patient arrives at the emergency room after attempting suicide by taking an entire bottle of diazepam. What antidote will the nurse most likely administer?
    A) Phenobarbital (Luminal)
    B) Dexmedetomidine (Precedex)
    C) Flumazenil (Romazicon)
    D) Ramelteon (Rozerem)
  9. The nurse is caring for a resident in a long-term care facility who is African American with a history of an anxiety disorder. The patient is receiving oral lorazepam (Ativan) 2 mg t.i.d. When developing this patient’s plan of care, what priority assessment will the nurse include?
    A) Depression
    B) Extreme sedation
    C) Phlebitis
    D) Nightmares
  10. An elderly patient has been taking zolpidem (Ambien) as a sleep aid for the past 2 months. On admission to the assisted-living facility, it is determined that the drug is no longer needed. What is an important nursing consideration concerning this drug?
    A) Hallucinations are common.
    B) The drug needs to be withdrawn gradually.
    C) Another anxiolytic will need to be substituted.
    D) Sundowning is common with withdrawal from this drug.

AND MUCH MORE