NURS6521 Week 11 Final Exam Latest 2022 may june all 100 answers

Question 1

Some drugs are given to patients using other routes such as sublingual or topical to avoid movement through the liver and possible side effects.  Which of the following effects is the Nurse Practitioner attempting to avoid by administering certain medications via alternative routes?

 

              Prodrug effect

 

              Plasma concentration-time curve effect

 

              First-Pass effect

 

              Drug-receptor interaction effect

Question 2

A 5-year-old boy needs an IM injection. The least painful and most effective injection site would be the

 

              deltoid muscle.

 

              rectus femoris muscle.

 

              ventrogluteal muscle.

 

              dorsogluteal muscle.

Question 3

A woman has a Chlamydia infection.  Before initiating treatment with a tetracycline antibiotic, the NP should :

 

              perform a pregnancy test

 

              obtain baseline liver function and renal function tests

 

              check her bilirubin and serum amylase levels

 

              Advise her to stop using contraceptive pills

Question 4

A 9-year-old boy was bought to his primary care provider by his mother with signs and symptoms of hookworm infection and will be sent home with a prescription for mebendazole. When provided patient and family education, the nurse should teach the mother with which of the following measures to avoid reinfection following treatment?

 

              The importance of vigilant hygiene for the boy and the other members of the family

 

              The need for the boy to provide serial stool samples for 6 months following treatment

 

              The need to supplement the anthelminthic drug with prophylactic antibiotics

 

              The need to use prescription skin cleansers during treatment and for 6 weeks after

Question 5

A male patient has been brought to the emergency department during an episode of status epilepticus. Diazepam is to be administered intravenously. The APRN will be sure to

 

              administer after diluting the drug with gabapentin in intravenous solution.

 

              inject the diazepam very quickly, 15 mg in 10 to 15 seconds.

 

              inject very slowly, no faster than 100 mg/minute.

 

 

 

              avoid the small veins in the dorsum of the hand or the wrist.

Question 6

A 68-year-old man is being treated for benign prostatic hypertrophy (BPH) and began treatment with finasteride (Proscar) 3 months ago. When planning the care of this patient, what desired outcome should the nurse prioritize?

 

              The patient will remain free of sexual side effects related to drug therapy

 

              The patient will experience complete bladder emptying

 

              The patient will remain free of urethral pain

 

              The patient will not experience hematuria

Question 7

A woman who is in the second trimester of her first pregnancy has been experiencing frequent headaches and has sought advice from her nurse practitioner about safe treatment options. What analgesic can the nurse most safely recommend?

 

              Aspirin

 

              Diflunisal (Dolobid)

 

              Acetaminophen

 

              Ibuprofen

Question 8

Intravenous carmustine has been prescribed for a patient with cancer. The nurse should help relieve the discomfort of pain and burning during the infusion by

 

              slowing the infusion.

 

              decreasing the volume used for dilution.

 

              decreasing the total volume of the primary IV infusion.

 

              administering a dose of 2 units of bleomycin before carmustine.

Question 9

A patient is taking flavoxate hydrochloride (Urispas) to help control an overactive bladder. On a follow-up visit to the clinic, the nurse will question the patient about which of the following?

 

              Chronic diarrhea

 

              Dental hygiene practices

 

              Headaches

 

              Diet

Question 10

An oncology nurse is aware of the risks for injury that exist around the preparation, transportation, and administration of chemotherapeutic agents. In order to reduce these risks of injury, the nurse should take which of the following actions?

 

              Dispose of intravenous lines used for chemotherapy administration in a covered trash can in the patient’s room.

 

              Use an IV system for administration that includes needles to reduce the risk of accidental spills.

 

              Prime the IV tubing with an approved IV solution rather than with the drug itself.

 

              Encourage patients who have been receiving chemotherapy to use a bedside commode rather than a toilet.

Question 11

A Nurse Practitioner is caring for a patient who is at 28 weeks’ gestation and is receiving terbutaline (Brethine) to control preterm labor. Which of the following assessment parameters should the nurse prioritize?

 

              Maternal body temperature

 

              Fetal heart rate (FHR)

 

              Correct fetal position

 

              Fetal blood pressure

Question 12

A Nurse Practitioner is working with a 16-year-old pregnant teen and assessing for behavior that may put the baby at risk. The most important assessment the nurse can make is

 

              whether the pregnant woman uses illegal substances.

 

              whether the pregnant woman has health insurance.

 

              the pregnant woman’s exercise habits.

 

              the pregnant woman’s dietary habits.

Question 13

A 38-year-old pregnant patient admits to the Nurse Practitioner that she is an alcoholic and has been consuming alcohol during her pregnancy. The nurse knows that using alcohol during pregnancy may result in a child who presents with

 

              a high-pitched cry.

 

              microcephaly.

 

              an electrolyte imbalance.

 

              thrombocytopenia.

Question 14

How is hydrocodone eliminated from the body?

 

              Skin

 

              Liver

 

              Gastrointestinal tract

 

              Kidney

Question 15

A 29-year-old pregnant patient is extremely upset about having to take medication for a pre-existing medical condition. She is consumed with fear that her baby will be born with a physical deformity or a congenital anomaly but knows that she has to take the medication. She talks constantly about this and is unable to sleep most nights. Which of the following is the most appropriate nursing diagnosis for this patient is?

 

              Injury, Risk to the fetus related to adverse effects of maternal drug therapy

 

              Injury, Risk to the patient related to failure to receive needed drug therapy

 

              Anxiety related to perceived danger of drug therapy to fetus or infant

 

              Noncompliance with Drug Therapy

Question 16

Off label prescribing is:

 

              Regulated by the FDA

 

              Illegal by NPs in all states and provinces

 

              Legal if there is scientific evidence for the use

 

              Regulated by the DEA

Question 17

A nurse practitioner orders a single dose of 2 g Metronidazole orally. How many milligrams will the patient receive in one dose?

 

              1000 mg

 

              2000 mg

 

              3000 mg

 

              4000 mg

Question 18

JC is a 13 year old female to be seen in your clinic today.  You review JC’s medication and realize that which medication is a potential risk of growth suppression in prepubescent children?

 

              Acetaminophen

 

              corticosteroids

 

              Diphenhydramine

 

              Claritin

Question 19

A patient is receiving cefazolin in combination with anticoagulants. To minimize the adverse effects during therapy, the nurse will

 

              monitor the site of injection.

 

              monitor the patient for bleeding gums.

 

              continue therapy until 2 days after symptoms have resolved.

 

              administer the medication with small amounts of food and fluids.

Question 20

Mr. Asberry  is taking Levofloxacin for his sinusitis. He calls your clinic and reports some pain just above the heel of his left foot. The NP should:

 

              change the medication to ofloxacin

 

              reassure the patient that this is a common side effect

 

              discontinue the levofloxacin

 

              change to ciprofloxacin

Question 21

A Nurse Practitioner is going to administer medication to an infant using a medicine dropper. The best method is to open the child’s mouth by gently squeezing the cheeks and placing the drops

 

              at the back of the mouth.

 

              in the buccal pouch.

 

              under the tongue.

 

              on top of the tongue.

Question 22

A 45-year-old female patient is prescribed ciprofloxacin to treat a bronchial infection. A nursing assessment revealed that she started taking daily vitamin supplements about 2 years ago. To maximize the therapeutic effects of the ciprofloxacin therapy, the nurse should advise the patient to

 

              take the vitamins at least 2 hours before or after taking ciprofloxacin.

 

              alternate the dosage of ciprofloxacin and vitamin supplements.

 

              reduce the dosage of vitamin supplements.

 

              reduce the dosage of vitamin supplements and double the dosage of ciprofloxacin.

Question 23

Which of the following statements is false regarding metronidazole?

 

              It is used in combination with clarithromycin and a PPI to treat H. Pylori.

 

              Patient may take standard-release without regard to food. Extended-release should be taken one hour before or 2 hours after meals.

 

              Granules are sprinkled on applesauce, yogurt, or pudding. Mixture should be consumed within 30 minutes without chewing.

 

              There is a potential for disulfiram-like reaction if taken with alcohol.

 

              Do not ingest alcohol during or for 3 days after stopping metronidazole.

Question 24

Which Of the following pharmacologic agents can be used to treat nicotine dependence/ smoking cessation?

 

              Multivitamins

 

              Metoprolol

 

              Sertraline

 

              Bupropion

Question 25

The Nurse Practitioner has established peripheral IV access and begun an infusion of magnesium sulfate on a 29-year-old antepartum patient who is 35 weeks pregnant. Which of the following assessment findings most likely prompted the patient’s physician to order magnesium sulfate for this patient?

 

              Decreased level of consciousness with a sudden onset

 

              The presence of rales and rhonchi and oxygen saturation less than or equal to 80% on room air

 

              Maternal bradycardia accompanied by a prolonged QT interval

 

              Systolic blood pressure readings in excess of 190 mmHg

Question 26

Which of the following patients will be at the greatest risk for anemia and would be the most likely candidate for epoetin alfa therapy?

 

              A 20-year-old female

 

              A 30-year-old pregnant woman

 

              A 62-year-old male with cancer

 

              A 40-year-old male with a high white blood cell count

Question 27

A patient has endocarditis and is taking gentamicin. The Nurse Practitioner will be sure to monitor which of the following?

 

              Potassium level

 

              Creatinine clearance

 

              Serum albumin level

 

              Prothrombin time

Which of the following statements shows the patient’s accurate knowledge of their medication regimen?

 

              I take my alendronate with my breakfast of coffee and cereal.

 

              I take my vitamins an hour after alendronate.

 

              I take my alendronate at 6am then immediately go back to bed.

 

              I take my alendronate at lunch to separate it from my morning meds.

 

              I take alendronate with a full glass of water.

Question 29

On the advice of her sister, a 52-year-old woman has visited her nurse practitioner to discuss the potential benefits of hormone replacement therapy in controlling the symptoms of menopause. Which of the following responses by the nurse is most appropriate?

 

              “We’ll have to check your bone density first, because if it’s too low then it’s not safe to start HRT.”

 

              “Actually, most of the current research is suggesting that HRT may not be all that effective in treating the symptoms of menopause.”

 

              “It’s important to balance the possible benefits of HRT with the fact that it might increase your risk of heart disease and stroke”

 

              “HRT might be quite beneficial to you, and it carries the additional benefit of modest protection against breast cancer.”

Question 30

A male patient has been on long-term bicalutamide (Casodex) therapy. In order to assess adverse effects of the drug therapy, the nurse will closely monitor which of the following?

 

              Visual function

 

              Blood counts

 

              Pap test results

 

              Liver function

Question 31

Which antibiotic is most frequently associated with “Red man Syndrome”

 

              Rifampin

 

              Vancomycin

 

              Amphotericin B

 

              Ciprofloxacin

Question 32

An immunocompromised cancer patient has developed cryptococcal meningitis and been admitted to the intensive care unit for treatment with amphotericin B. How should the nurse most safely administer this drug?

 

              Hang the drug by piggyback with lactated Ringer’s and infuse over several hours to minimize the risk of infusion reaction

 

              Infuse the drug over 2 to 4 hours into a central line using an infusion pump

 

              Flush the patient’s central line with normal saline and infuse the amphotericin B by intravenous push over 5 to 7 minutes.

 

              Place the patient on a constant infusion of amphotericin B at a rate determined by the patient’s body weight.

Question 33

The nurse recognizes that the potential for teratogenic drug effects is not static throughout the prenatal and postnatal periods. The potential for teratogenic effects is highest during

 

              breast-feeding of the neonate.

 

              the first 2 months of pregnancy.

 

              the two to 3 weeks prior to delivery.

 

              the second trimester.

Question 34

A Nurse Practitioner working in a cancer center is preparing to administer medication to a 5-year-old child. The nurse will calculate the drug dosage by using

 

              body surface area.

 

              weight.

 

              age in months.

 

              age in years.

Question 35

A Nurse Practitioner is aware that the concept of selective toxicity is foundational to antimicrobial therapy. Which of the following statements most accurately describes selective toxicity?

 

              A drug harms microbes without harming human cells.

 

              A drug’s effect on microorganisms is proportionate to dose.

 

              Most microbes may be collected from a host and cultured on an alternative medium.

 

              A drug can be isolated and produced in a controlled manner in a laboratory setting.

Question 36

A 3-year-old boy has developed otitis media and requires antibiotics. In order to increase the chance that the boy will take his prescribed medication, the nurse should

 

              teach the boy about the fact that he will feel much better after he takes his medications.

 

              have the mother hold the child firmly and sooth him while the drugs are administered.

 

              offer a choice between liquid and chewable medications, if possible.

 

              insert a central intravenous line.

Question 37

Lyrica is what controlled substance schedule?

 

              C-II

 

              C-III

 

              C-IV

 

              C-V

 

              C-VI

 

Question 38

The clinical nurse educator who oversees the emergency department in a children’s hospital has launched an awareness program aimed at reducing drug errors. What measure addresses the most common cause of incorrect doses in the care of infants and children?

 

              Having nurses check their math calculations with a colleague before administering a drug.

 

              Ensuring that a full assessment takes place no more than 30 minutes before giving a drug.

 

              Recording drug administration in both the nurse’s notes and the medication administration record (MAR)

 

              Avoiding intravenous administration of drugs whenever possible.

Question 39

Tetracyclines are contraindicated in children younger than eight years old because of?

 

              Development of significant diarrhea

 

              Risk of kernicterus

 

              Adverse effects on Bone growth

 

              Risk of developing cartilage problems

Question 40

Lily, the nurse practitioner is seeing Mr. Reynolds today. She would recognize that which of the following is a potential adverse side effects of autonomic-anticholinergic agents?

 

              Reduced GM motility

 

              Increased symptoms of benign prosthetic hypertrophy

 

              Bradycardia

 

              Photosensitivity

Question 41

Baby Jasmine is a 5 mth old breastfed infant with a fever.  Treatment for her fever may include:

 

              Acetaminophen suppository

 

              “baby” aspirin

 

              Ibuprofen suppository

 

              Alternating acetaminophen and ibuprofen

Question 42

A patient with AIDS has developed a number of secondary infections in recent weeks, including Kaposi’s sarcoma. As a result of this most recent diagnosis, his care team has opted to begin treatment with interferon alfa-2a. The nurse is aware that this drug will address the etiology of Kaposi sarcoma by

 

              inhibiting tumor growth by enhancing inflammation.

 

              potentiating the effects of phagocytes and macro

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