Chapter Questions

Question 1

Mary is a 4-month old infant who is brought to the clinic for her first checkup. Her mother tells the nurse that the child has never been ill. Which factor would the nurse consider most significant in assessing the baby’s likelihood of receiving immunizations?

1. Allergies to previously admnistered medications
2. Mother’s preconceptions and reservations relating to vaccines
3. Maternal and paternal allergies or reactions to vaccine administration
4. The nurse’s knowledge of the recommended pediatric immunization schedule.

Answer 1

2. Mother’s preconceptions and reservations relating to vaccines

Question 2

The nurse is preparing to administer an MMR vaccination to a 15-month-old child. What would cause the nurse to hold the injection and recheck this order with the provider?

1. The mother tells the nurse that the famly will be going to the beach for the next few weeks.
2. The mother states that she was told that she had a reaction to the injection when she was a child.
3. The mother tells the nurse that her husband is having chemotherapy for Hodgkin’s Lymphoma.
4. The mother tells the nurse that the child’s older brother is home with a cold virus.

Answer 2

3. The mother tells the nurse that her husband is having chemotherapy for Hodgkin’s Lymphoma.

Question 3

The nurse determines that the client understands the teaching given for care required after receiving a tetanus toxoid injection when the client states:

1. “I will keep my arm still for the next 24 hours to give the vaccine time to absorb.”
2. “I will limit my fluid intake for the next 8 hrs in case I have nausea.”
3. ” I will avoid crowds and people with viruses for the next 7 days.”
4. “I will take some (acetaminphen) Tylenol or (ibuprofen) Advil if my arm is sore.”

Answer 3

4.”I will take some (acetaminphen) Tylenol or (ibuprofen) Advil if my arm is sore.”

Question 4

The occupational health nurse will be admnistering hepatitis B vaccine to a new employee. Which assessment finding discovered by the nurse would necessitate withholding the injection? The client is:

1. A two-pack-per-day smoker
2. Known to have transient hypertension
3. Allergic to yeast and yeast products
4. Frightened by needles and injections

Answer 4

3. Allergic to yeast and yeast products

Question 5

A postpartum client received Rh0[D] immune globulin (RhoGAM) therapy after the delivery of an 8-lb baby boy. The nurse performs what important intervention during the coarse of this treatment?

1. Monitors the client for 20 mins following the administration for hypersensitivity reaction
2. Evaluates the laboratory results for thrombocytopenia,anemia, and increased liver enzymes.
3. Provides the client with the information needed to maintain a low-saturated fat, low-cholesterol diet.
4. Instructs the client to use nonmedicated sugar-free lozenges or hard candies to relieve cough.

Answer 5

1. Monitors the client for 20 mins following the administration for hypersensitivity reaction

Question 6

Which instructions should the nurse give a 21-year-old female client being treated with amplicillin (Principen)?

1. Stop taking oral contraceptives because serious adverse effects could occur.
2. Use oral contraceptives as prescribed because antibiotiics do not react with birth control pills.
3. The antibiotic may decreasse the effectiveness of oral contraceptives.
4. The antibiotics when taken with oral contracetives causes toxicity.

Answer 6

3. The antibiotic may decreasse the effectiveness of oral contraceptives

Question 7

The nurse is caring for a client who is receiving intravenous Vancomycin (Vancocin). Which symptom, if present, may indicate that the client is experiencing drug-induced ototoxicity?

1. Erythema of the earlobes and ear canal
2. Inner ear pruritus after infusion is completed
3. Tinnitus aand dizziness when remaining still
4. Ocular paing with purulent drainage

Answer 7

3. Tinnitus aand dizziness when remaining still

Question 8

The client reports abnormal vaginal discharge after completing a prescription of cefotoxime (Claforan). For which condition is the client most likely exhibiting symptoms?

1. Hypersensitivity reaction
2. Superinfection
3. Pseudomembranous colitis
4. Antibiotic toxicity

Answer 8

2. Superinfection

Question 9

The client who has been taking defixime (Suprax) for the past week and a half returns to the provider with reports of “explosive diarrhea,” up to eight times in the last 2 days. The diarrhea is described as “very watery, sometimes with alot of mucus” and the client reports significant weakness. For which condition is the client describing symptoms?

1. Antibiotic- induced peptic ulcer diease
2. Antibiotic-associated malabsorbtion
3. GI-associated hypersensitivity
4. Clostridium difficule- associated diarrhea

Answer 9

4. Clostridium difficule- associated diarrhea

Question 10

The client who is taking imipenem-cilastatin (Primaxin) reports shortness of breath, mouth, and tongue swelling , and generalized itching. For which of the following does the nurse iinitially asses the client?

1. Hypersensitivity reaction
2. Blood dyscrasias
3. Beta-lactamase induction
4. Drug toxicity

Answer 10

1. Hypersensitivity reaction

Question 11

The nurse is teaching a client who recently was diagnosed with an upper respiratory infection and is prescibed ampicillin (Principen). The nurse would evaluate the session as being successul if the client states which of the following?

1. ” I should take this medication on an empty stomach with a full glass of water.”
2. “I can expect my tongue to become black and furry.”
3. “Once I stop coughing, I should stop taking this medication.”
4. ” If I miss a dose, I should take two doses together to catch up.”

Answer 11

1. ” I should take this medication on an empty stomach with a full glass of water.”

Question 12

While teaching the client about taking oral tetracycline, which of the following does the nursse advise the client to do?

1. Consume calcium-rich products to decrease the duration of the antibacterial effect.
2. Use a soft toothbrush and floss teeth gently to remove staining on teeth.
3. Report any ringing in the ears or dizziness
4. Avoid direct exposure to sunlight and apply sun black when outdoors.

Answer 12

4. Avoid direct exposure to sunlight and apply sun black when outdoors

Question 13

The nurse determines that the client understands the use of azithromyocin (Zithromax) when the client makes which statement?

1. “It only needs to be taken once-daily because it last longer.”
2. “It causes more nausea than most other antibiotics in this classification.”
3. “It must be taken on an empty stomach.”
4. ” It is ineffective if taken with calcium-rich foods. “

Answer 13

1. “It only needs to be taken once-daily because it last longer.”

Question 14

The client is receiving amikacin (Amikin) for a bacterial infection. Which adverse effects does the nurse include in the plan of care to monitor the client’s status?

1. Weight gain
2. Visual disturbances
3. Mental depression
4. Urinary frequency

Answer 14

1. Weight gain

Question 15

The health care provider orders gentamicin( Garamycin) for a client with a postoperative wound infection. Whch laboratory result should prompt the nurse to consult ith the prescriber about possible nephrotoxicity of this drug?

1. Elevated serum creatinine level
2. Decreassed blood urea nitrogen (BUN ) level
3. Increased WBC count
4. Elevated serum iron level

Answer 15

1. Elevated serum creatinine level

Question 16

The client is prescribed ciprofloxacin (Cipro) and is instructed to take each dose of medication as evenly spaced apart during the day as possible. The nurse recognizes that this instruction is essential because:

1. The medication can cause sleep pattern disturbances
2. Pathogenic bacteria have extremely rapid growth and reproduction rates.
3. Superinfection may develop if a dose of medication is missed.
4. Allergic reactions are more likely to occur if a dose is missed.

Answer 16

2. Pathogenic bacteria have extremely rapid growth and reproduction rates.

Question 17

A client has been receiving levofloxacin (Levaquin) IV for septicemia for 2 weeks and will be given the drug orally at home. Which discharge instruction would be most appropiate for the nurse to give this client?

1. Report any unusual joint or tendon pain or difficulty with movement or walking.
2. Take a daily multivitamin supplement with the levofloxacin
3. Exposure to direct sunlight will help increase absorbtion of vitamin D, which is impaired by this medication.
4. Limit fluid intake to less than 1500 mL per day.

Answer 17

1. Report any unusual joint or tendon pain or difficulty with movement or walking.

Question 18

A client had been given a prescripton for ciprofloxacin (Cipro). The nurse checks the client’s history because this drug should be used cautiously, or is contraindicated, in clients with what condition?

1. A history of anxiety disorder and nervousness
2. Clients over the age of 65
3. A history of penicillin allergy
4. Clients with myasthenia gravis

Answer 18

4. Clients with myasthenia gravis

Question 19

Which is the most important goal of nursing care for a client receiving polymyxin B ointment on a laceration?

1. promote wound healing
2. sterilize the skin and mucous membranes
3. prevent allergic reactions
4. maximize pain relief

Answer 19

1. promote wound healing

Question 20

An older client is prescribed sulfisoxazole (Gantrisin). Knowing that one of the major adverse effects of this drug is crystalluria, what should the nurse instruct the client to do?

1. Limit intake of foods high in calcium such as milk, cheese, and yogurt
2. Avoid changing positions (lying down, sitting, or standing) rapidly
3. Increase fluid intake to 2 to 3 L per day
4. Avoid consuming alcoholic beverages while taking this medication

Answer 20

3. Increase fluid intake to 2 to 3 L per day

Question 21

The nurse understands that which of the following is the main purpose of nitrofurantoin (Furadantin)?

1. Prevent recurrent urinary tract infections
2. Relieve the pain associated with urinary tract infections
3. Promote effective urinary elimination and prevent stasis
4. Reduce pathogenic microorganisms specific to pyelonephritis

Answer 21

1. Prevent recurrent urinary tract infections

Question 22

The nurse is collecting health data from a client with diabetes who has a urinary tract infection before starting an order for trimethoprim-sulfamethoxazole (Bactrim, Septra). Which questions asked by the nurse would be most important? Select all that apply

1. “Have you ever had migraine headaches?”
2. “Are you allergic to any sulfa drugs?”
3. “Do you empty your bladder before and after sexual intercourse?”
4. “When was your last menstrual period?”
5. “What drugs do you use to manage your diabetes?”

Answer 22

2. “Are you allergic to any sulfa drugs?”
3. “Do you empty your bladder before and after sexual intercourse?”
4. “When was your last menstrual period?”

Question 23

The nurse is providing the client with discharge instructions concerning silver sulfadiazine (Silvadene) cream, which has been ordered to treat a significant skin infection. Which statement by the client indicates to the nurse that the teaching session was effective?

1. “I should use this cream on non-infected surfaces surrounding the infections to prevent additional infections”
2. “If this medication causes stinging or burning, I should stop the drug and report that to my doctor immediately as a drug allergy”
3. “If I experience any nausea and it continues for more than 24 hours, I will contact my doctor”
4. “I must avoid foods high in potassium”

Answer 23

3. “If I experience any nausea and it continues for more than 24 hours, I will contact my doctor”

Question 24

The client is to receive nitrofurantoin (Furadantin) for a urinary tract infection. A nurse should question the order for the client with which condition?

1. Pulmonary disease
2. Diabetes
3. Rheumatoid Arthritis
4. Angina and Hypertension

Answer 24

1. Pulmonary disease

Question 25

A client taking trimethoprim-sulfamethoxazole (Bactrim, Septra) develops a reddish-purplish papular rash surrounded by areas of eryhthema. The rash should be evaluated by the provider because it may indicate which skin condition? 1. A fungal superinfection 2. Viral skin eruptions 3. Dermatologic toxicity including Stevens-Johnson syndrome 4. Non-adherence with drug therapy

Answer 25

3. Dermatologic toxicity including Stevens-Johnson syndrome

Question 26

A client who is receiving isoniazid (INH) reports tingling and numbness of the fingers and toes. The nurse knows that these symptoms are most likely due to the drugs ability to: 1. Increase the sensibility of nerve endings 2. Decrease the activity of pyridoxine (vitamin B6) 3. Accelerate the excretion of neurotransmitters 4. Enhance skin receptors for ascorbic acid (vitamin C)

Answer 26

2. Decrease the activity of pyridoxine (vitamin B6)

Question 27

Ethambutol (Myambutol) has been included as part of an multidrug regimen to treat a client with active tuberculosis. Prior to starting this drug, which screening tests should the client have? 1. Coagulation studies 2. Sputum cultures 3. Uric acid level 4. Hepatic function tests 5. Vision acuity and vision color sense screening

Answer 27

2. Sputum cultures 3. Uric acid level 4. Hepatic function tests 5. Vision acuity and vision color sense screening

Question 28

A client is identified by ethnic background as a possible slow acetylator and will be closely followed after beginning isoniazid therapy for latent tuberculosis. To ensure that this client does not experience adverse effects related to the acetylation process, both ___________ and ___________ will be monitored frequiently

Answer 28

Hepatic function tests and serum drug level

Question 29

A client with HIV infection who also has a Mycobacterium avium complex infection is started on clarithromycin (Biaxin) and ethambutol (Myambutol). What appropriate teaching should the nurse give this client? 1. You will remain contagious until the drug treatment is completed 2. These drugs will only be required for a short period of time, approximately 2 to 3 weeks. 3. Drug therapy will be stopped if CD4 count drops below 50 cells/mL 4. It will be necessary to continue these drugs for a prolonged period of time to adequately treat the infection.

Answer 29

4. It will be necessary to continue these drugs for a prolonged period of time to adequately treat the infection.

Question 30

The client diagnosed with Mycobacterium leprae (leprosy) and is being treated with dapsone (DDS). Which nursing assessment findings would indicate the client is experiencing adverse effects from this therapy? 1. Discoloration of the skin, cornea, and conjunctiva 2. Chronic constipation, chills, and dehydration 3. Hypoglycemia, impaired memory, and impotence 4. Memory loss, nervousness, and pruritus

Answer 30

1. Discoloration of the skin, cornea, and conjunctiva

Question 31

Clients with diabetes who take isoniazid (INH) may require more frequent monitoring of blood glucose levels. What effect does isoniazid have on glucose levels? 1. It may decrease glucose levels 2. It has no known effects on glucose levels 3. It may increase glucose levels 4. It causes rapid rises and falls of glucose levels

Answer 31

3. It may increase glucose levels

Question 32

A client with AIDS has been given a prescription for oral fluconazole (Diflucan) to prevent Candida infection. Considering the client's primary diagnosis and the order for fluconazole, what essential teaching will the nurse provide? 1. Keep a food diary and request anti-nausea medications if eating becomes problematic. 2. Maintain regular low-impact exercise daily to avoid loss of muscle mass 3. Wear a high-filtration mask if going out in public 4. Avoid all fat-based soaps and allow the body to air-dry after bathing.

Answer 32

1. Keep a food diary and request anti-nausea medications if eating becomes problematic.

Question 33

The nurse is caring for a client with onychomycosis (nail fungus) who is receiving oral terbinafine (Lamisil) for treatment. The client questions the need for 3 months' worth of pills. What is the nurse's best response? 1. "the health care provider will evaluate the nails monthly and stop treatment earlier if warranted" 2. "It is cheaper to buy more pills at one time than on a monthly schedule" 3. "The extensive prescription avoids the need for short term, potentially toxic doses" 4. "Nails grow slowly and the nail beds must receive adequate length of treatment to eliminate the infection"

Answer 33

4. "Nails grow slowly and the nail beds must receive adequate length of treatment to eliminate the infection"

Question 34

The nurse knows that pretreatment with corticosteroids, antihistamines, and antipyretics prior to the administration of Amphotericin B is given for what effect? 1. They enhance the effectiveness of Amphotericin B 2. They eliminate toxic by-products by Amphotericin B 3. They reduce the severity of adverse effects associated with Amphotericin B 4. They increase the half-life of Amphotericin B

Answer 34

3. They reduce the severity of adverse effects associated with Amphotericin B

Question 35

A client with diabetes treated with oral anti-diabetic medications is receiving oral fluconazole (Diflucan) for treatment of long-standing tinea cruris (jock itch). The nurse will instruct the client to monitor blood sugar more frequently while on this drug because of what potential drug effects? 1. Fluconazole (Diflucan) antagonizes the effects of antidiabetic drugs. 2. Fluconazole (Diflucan) may increase blood sugar levels 3. Fluconazole (Diflucan) may decrease blood sugar levels 4. Fluconazole (Diflucan) may enhance the effects of antidiabetic drugs.

Answer 35

3. Fluconazole (Diflucan) may decrease blood sugar levels

Question 36

Zidovudine (Retrovir, AZT) is prescribed for a client. Which statement by the client would indicate that further medication-related teaching is needed? 1. "Antiretroviral therapy must be continued for the remainder of my life" 2. " The human immunodeficiency virus vaccine only created temporary immunity against the disease." 3. "The medication schedule can be adjusted daily depending on my activities." 4. "Many human immunodeficiency virus-infected individuals are able to live symptom-free due to the medication."

Answer 36

2. " The human immunodeficiency virus vaccine only created temporary immunity against the disease."

Question 37

Emtricitabine (Emtriva) is included as part of HAART regimen for a patient newly diagnosed with HIV. While lower in toxicity that other NRTIs, a potentially fatal adverse effect known to occur is: 1. Ventricular cardiac dysrhythmias 2. Pulmonary fibrosis 3. Necrotic bowel syndrome 4. Lactic acidosis

Answer 37

4. Lactic acidosis

Question 38

The nurse is aware that myelosuppression may be a problem for some clients recieving zidovudine (Retrovir). Which finding would indicate that this adverse effect is present? 1. Increase in serum blood urea nitrogen levels 2. Increase in white blood cell count 3. Decrease in platelet count 4. Decrease in blood pressurre

Answer 38

3. Decrease in platelet count

Question 39

A client has been taking tenofovir (Viread) for the past 5 years as part of a HAART regimen. The client would like to include some alternative and complementary health activities to improve his overall health. Which activity may be contraindicated for this client? 1. Yoga and guided imagery 2. Massage therapy 3. Meditation and journaling 4. Weekly visits to a chiropractor

Answer 39

4. Weekly visits to a chiropractor

Question 40

An important inclusion in a teaching plan prepared for the client who is taking permethrin (Nix) is: 1. Nix can be applied after body lotion is applied 2. All body hair, including eyelashes and eyebrows, can be treated with lindane 3. Lice cannot live outside the body 4. In addition to hair shafts, examine the inner thigh areas, gluteal folds, and pubic areas for lice.

Answer 40

4. In addition to hair shafts, examine the inner thigh areas, gluteal folds, and pubic areas for lice.

Question 41

A client is being treated with a course of topical desoximetasone (Topicort) for atopic dermatitis. In planning teaching for this client, which adverse effects would the nurse anticipate? 1. Burning and stinging of the skin in the affected area 2. Development of localized pruritus and hives 3. Hair loss in the application area 4. Worsening of acne vulgaris

Answer 41

1. Burning and stinging of the skin in the affected area

Question 42

A client has been prescribed topical tretinoin (Retin-A) for treatment of acne unresponsive to over-the-counter products. What essential information should the nurse include in the client's teaching? 1. Wash the face thoroughly 3 times a day with an antiacne soap while using this medication 2. Plan to expose the involved skin areas to sunlight for a minimum of 15 minutes each day. 3. Use only mild soaps, warm water, and pat the skin dry to avoid excessive irritation 4. Alternate the topical tretinoin (Retin-A) with benzoyl peroxide on an every-other-day rotation for best results

Answer 42

3. Use only mild soaps, warm water, and pat the skin dry to avoid excessive irritation

Question 43

Benzocaine (Americane) has been recommended to a 17-year-old client for treatment of a mild sunburn. What should the client be taught about using this product? 1. It may be used on superficial and partial- thickness sunburns 2. Warming the lotion under warm water will prevent a chilled sensation when applied 3. A small test area should be used if the drug has not been used before to assess for allergy 4. Cover the treated area with a light dressing wrapped in plastic wrap to keep it from rubbing off

Answer 43

3. A small test area should be used if the drug has not been used before to assess for allergy

Question 44

A client who has been prescribed isotretinoin (Accutane) must comply with the iPledge Program because of the risk of _________ effects

Answer 44

teratogenic effects