Chapter questions

Question 1

a client with type 1 diabetes will use and combination insulin that includes NPH and regular insulins. the nurse is explaining the importance of knowing the peak times for both insulins. why is this important information for the client to know?

1. the client will be able to estimate the time for the next injection of insulin based on these peaks.
2. the risk of hypoglycemic reaction is greatest around the peak of insulin activity.
3. it is best to plan activities or exercise around peak insulin times for the best utilization of glucose.
4. additional insulin may be required at the peak periods to prevent hyperglycemia.

Answer 1

2. the risk of hypoglycemic reaction is greatest around the peak of insulin activity.

Question 2

the nurse would consider which of the following assessment findings as adverse effects to metformin therapy?

1. hypoglycemia
2. gastrointestinal distress
3. lactic acidosis
4. weight loss

Answer 2

3. lactic acidosis

Question 3

a client was started on rosiglitazone for type 2 diabetes . he tells the nurse that he has been taking it for 5 days, but his glucose levels are unchanged. what is the nurse’s best response?

1. ” you should double the dose. that should help.”
2. “you need to give the drug more time. it can take several weeks before it becomes fully effective.”
3. ” you will need to add a second drug since this one has not been effective.”
4. ” you most likely require insulin now.”

Answer 3

2.”you need to give the drug more time. it can take several weeks before it becomes fully effective.”

Question 4

a young women calls the clinic and reports that her mother has an insulin reaction, and was found unconscious. the young women gave her a glucagon injection 20 mins ago, and her mother woke up, but is still groggy and “does not make sense.” what should the nurse tell the daughter?

1. ” let her wake up on her own, then give her something to eat.”
2. ” place some hard candies in her mouth.”
3. ” just let her sleep. people are sleepy after hypoglycemic episodes.”
4. ” give her another injection and call the paramedics.”

Answer 4

4.” give her another injection and call the paramedics.”

Question 5

the nurse explains the benefits of using the long-acting insulin glargine (lantus) over other insulins. what will the nurse tell the client about this insulin?

1. it does not need to be administered by injection
2. it can be given by intramuscular or subcutaneous injection
3. it does not require blood glucose monitoring
4. it has no definite peak but maintains a steady state of insulin in the body.

Answer 5

4. it has no definite peak but maintains a steady state of insulin in the body.

Question 6

the nurse teaches the client that which type of over the- counter cough preparation is not effectve on coughs associated wth the common cold and allergic rhinitis?

1. dextromethorphan
2. diphenhydramine
3. muclytics
4. pseudoephedrine

Answer 6

4. pseudoephedrine

Question 7

fexofenadine (allegra) is prescribed to treat the symptoms of allergic rhinitis for a client with seasonal allergies. before teaching the client about this drug, what condition would the nurse assess for?

1. a history of osteoporosis
2. a history of peptic ulcer disease
3. a history os psoriasis
4. a history of cardiac disease

Answer 7

4. a history of cardiac disease

Question 8

the nurse is teaching the client about the use of dextromethorphan with guaifenesin (robitussin-DM) syrup for a cough accomplanied by thick mucus. which statement would be part og the client’s teaching?

1. “lie supine for 30 mins after taking the drug.”
2. “drink minimal fluids to avoid stimulating the cough reflex.”
3. ” take the drug with food for best result.”
4. “avoid drinking fluids immediately followin the syrip and then increase overall fluid intake.”

Answer 8

4. “avoid drinking fluids immediately followin the syrip and then increase overall fluid intake.”

Question 9

a client with asthma asks which of the prescribed medications should be used in the event of an acute episode of bronchospasm. the nurse will instruct the client to use :

1. albuterol, a beta agonist bronchodilator, by inhalation.
2. beclomethasone, a glucocorticoid anti-inflammatory drug by inhalation
3. ipratropium, an anticholineric bronchodilator, by inhalation
4. zafirlukas, a luekotriene modifier, by mouth

Answer 9

1. albuterol, a beta agonist bronchodilator, by inhalation.

Question 10

a client is prescribed beclomethasone (Qvar), a glucocorticoid inhaler, education by the nurse will include:

1. “check your heart rate because this may cause tachycardia.”
2. “limit your coffee intake while on this drug.”
3. ” rinse your motuth out well after each use.”
4. “you may feel shaky and nervous after using this drug.”

Answer 10

3.” rinse your motuth out well after each use.”

Question 11

the nurse should inform the client who is prescribed a nebulizer treatment with albuterol (procentil, Vospire) that a common adverse effect is:

1. an increased heart rate with palpitations.
2. a predisposition to infection
3. sedation
4. temporary dyspnea

Answer 11

1. an increased heart rate with palpitations.

Question 12

a 4 year old child with repiratory distress secondary to asthma has an order for a nebulizer treatment. the type of medication most likely to be given for asthma management is a :

1. beta agonist
2. beta antagonist
3. corticosteroid
4. leukotriene modifier

Answer 12

1. beta agonist

Question 13

despite repearted demonstrations of proper inhaler use by the nurse,, the client is unable to return proper demonstration of the training inhaler. The client is becoming frustrated. what is the best action for the nurse to take?

1. encourage the client to keep practicing just a little longer.
2. notify the health care provider that the client is imcompetent
3. provide a spacer for use with the inhaler.
4. switch to an oral form of a beta agonist.

Answer 13

3. provide a spacer for use with the inhaler.

Question 14

a client who uses over- the- counter phenylephrine (Neo- synephrine) nasal spray asks the nurse how the medication works. the nurses’s response would be:

1. it helps to shrink the swelling in your nose by tightening the blood vessels there.
2. it works to locally destroy invading organisms that cause colds and flu.
3. it coats the nasal passage to reduce swelling.
4. it is absorbed after you swallow it to act as a decongestant.

Answer 14

1. it helps to shrink the swelling in your nose by tightening the blood vessels there.

Question 15

the health care provider prescribes epinephrine (adrenalin) to a client who was stung by several wasps 30 mins ago. the nurse knows that the primary purpose of this medication for this client is to:

1. stop the systemic release of histamine produced by the mast cells.
2. counteract the formation of antibodies in response to an invading antigen.
3. increase the number of white blood cells produced to fight the primary invader.
4. increase a declining blood pressure and dilate constricting bronchi associated with anaphylaxis.

Answer 15

4. increase a declining blood pressure and dilate constricting bronchi associated with anaphylaxis.

Question 16

a client takes a dose of albuterol (ventolin) prior to bedtime. which effect would the nurse consider normal for this drug?

1. insomnia
2. sleepiness
3. urticaria
4. tinnitus

Answer 16

1.insomnia

Question 17

To elaluate the effectiveness of high-dose dopamine (intropin, dopastat), the nurse would assess the:

1. pupillary response
2. blood pressure
3. level of consciousness
4. gag reflex

Answer 17

2. blood pressure

Question 18

the client has developed severe diarrhea following 4 days of self-administered antacid preparation. the nurse suspects that the diarrhea may be caused by which type of antacid?

1. aluminum compounds
2. magnesium compounds
3. calcium compounds
4. sodium compounds.

Answer 18

2. magnesium compounds

Question 19

the nurse is scheduling the client’s daily medication. when would we be the most appropriate time for the client to receive proton pump inhibitors?

1. at night
2. after fasting at least 2 hours.
3. about 1/2 hour before a meal.
4. about 2 to 3 hours after eating.

Answer 19

3. about 1/2 hour before a meal.

Question 20

a client who has been duodenal ulcers is receiving long-term therapy with ranitidine (Zantac). the nurse includes in the care plan that the client should be monitored for which adverse effects?

1. photophobia and skin irratations
2. neutropenia and thrombocytopenia
3. dyspnea and productive coughing
4. urinary hestitation and fluid retention

Answer 20

2. neutropenia and thrombocytopenia

Question 21

the prescriber orders sucralfate (carafate) for a client with peptic ulcer disease. the nurse should question the order if the client is concurrently taking:

1. proton pump inhibitors
2. calcium salt antacids
3. h2 receptors antagonists.
4. aluminum salt antacids.

Answer 21

4. aluminum salt antacids.

Question 22

the nurse who is caring for a client with gastroesophageal reflux disease hsould question the order or which drug?

1. h2 receptors antagonists
2. proton pump inhibitors
3. antibiotics
4. antacids

Answer 22

3. antibiotics

Question 23

A client who has taken sibutramine(meridia) in the past for the treatment of obesity in concerned about continued risks involved with the drug, even though it is no longer being taken. The nurse knows that sibutramine was noted to increase the risk of cardiovascular adverse effects. Which of the following should the client who has taken the drug in the past do?

1. Continue with routine exam with the provider to detect any long term effects.
2. Not to worry about any effects if they didn’t occur when the drug is taken
3. Begin to see a cardiologist monthly until any cardiovascular risk has been ruled out
4. Contact the drug company about follow-up programs

Answer 23

1

Question 24

The client has been started on orlaistat (xenical). The nurse would teach this client to take this medication:

1. once in the morning
2. When a feeling of hunger is noticed
3. Before daily exercise
4. Just prior to each meal containing fats

Answer 24

4

Question 25

When taking orlistat (alli) , the nurse would instruct the client to do which of the following? 1. Drink at least 2to 3 liters of diet soda per day. 2. Always wear sunscreen when outdoors or when exposed of direct sunlight 3. Rise slowly from a sitting or supine position 4. Take a daily vitamin supplement containing fat soluble vitamins

Answer 25

4

Question 26

A nurse is instructing a client to take orlistat ( xenical) about adverse effects of medication. Which symptoms indicate the presence of an expected adverse effects? 1. Flatus with discharge and oily stool 2. Heartburn and dyspepsia 3. Constipation and fecal impaction 4. Nausea with projectile vomiting

Answer 26

1

Question 27

the client is taking diphenoxylate with atropine (lomotil). what does the nurse asses when montoring the therapeutic effects? 1. reduction of abdominal cramping 2. minimal passage of flatus 3. decrease in loose, watery stools 4. increased bowel sounds

Answer 27

3. decrease in loose, watery stools

Question 28

the client who is taking sulfasalazine (azulfidine) develops a sore thoart, bruising, and severe fatigue. the nurse determnes that the client is most likely experiencin drug-induced: 1. stevens-johnson syndrome 2. blood dyscrasias 3. idiosyncratic reaction 4. hypersensitivity response

Answer 28

2. blood dyscrasias

Question 29

a nurse should question the order for pancrelipase (pancreaze) for which client? 1. the client wth allergy to pork products 2. the client with hypertension 3. the client with coronary artery diesease 4. the client with hypersensitivity to iodine products

Answer 29

1. the client wth allergy to pork products

Question 30

a health care provider order magnesium hydroxide (milk of magnesia) for a client with constipation, secondary to postoperative opioid use. before administering the drug, the nurse wuld assess: 1. blood pressure. 2. dosage of the opiod drug prescribed 3. the clients ability to ambulate to the bathroom 4. bowel sounds

Answer 30

4. bowel sounds