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1. The nurse has been monitoring a patient's progress on anew drug regimen since the first dose and documentingsigns of possible adverse effects. This example illustrateswhich phase of the nursing process?

B. Evaluation

2. When administering a new medication to a patient thenurse reads that it is highly protein bound. The nurse shouldexpect which result?

C. The duration of action of the medication will be longer

3. During the development of a new drug, which would beincluded in the study by the researcher to prevent any bias orunrealistic expectations of the new drug's usefulness?

A. A placebo

4. The nurse is teaching a 16 year old newly diagnoseddiabetic about blood glucose monitoring and the importanceof regulating glucose intake. When developing a teachingplan for this teenager, which of Erikson's stages ofdevelopment should the nurse consider?A. Trust versus mistrustB. Intimacy versus isolationC. Industry versus inferiorityD. Identity versus role confusion

D. Identity versus role confusion

5. A patient is being treated for ethanol alcohol abuse in arehabilitation center. The nurse should include whichinformation when teaching him about disulfiram (Antabuse)therapy?A. He should not smoke cigarettes while on this drug.B. He needs to know about the common over the countersubstances that contain alcohol.C. This drug will cause the same effects as the alcohol did,without the euphoric effects.D. Mouth washes and cough medicatines that containalcohol are safe because they are used in small amounts.

B. He needs to know about the common over the countersubstances that contain alcohol.

6. When reviewing the mechanism of action of a specificdrug, the nurse reads that the drug works by selectiveenzyme interaction. This process occurs when the drug:A alters cell membrane permeability.b. is attracted to a receptor on the cell wall, preventing anenzyme from binding to the receptorc. enhances its effectiveness within the cell walls of thetarget tissue.d. attracts enzymes to bind with it instead of the enzymesnormal target cells, blocking the action of the enzymes.

c. enhances its effectiveness within the cell walls of thetarget tissue.

7. A patient has been selected as a potential recipient of anexperimental drug for heart failure. The nurse knows thatwhen informed consent has been obtained, it indicates thatthe patient:A. has been informed of the possible benefits of the newtherapy.b. will be informed of the details of the study as the researchcontinues.c. will not be sure to receive the actual drug during theexperiment.d. has had the study's purpose, procedures, and the risksinvolved explained to him.

d. has had the study's purpose, procedures, and the risksinvolved explained to him.

8. When the nurse teaches a manual skill such as selfinjection of insulin to a patient what is the best way to set upthe teaching/learning session?A. provide written pamphlets for instruction.B. show a video and allow the patient to practice as neededon his own.C. verbally explain the procedure and provide writtenhandouts for reinforcement.D. After demonstrating the procedure, allow the patient todo several return demonstrations.

D. After demonstrating the procedure, allow the patient todo several return demonstrations.

9. A patient is to receive oral digoxin (Lanoxin) daily;however, because he is unable to swallow, he cannot take toorally, as ordered. What type of problem does this represent?A. "Right time" problemB. "Right dose" problemC. "Right route" problemD. "Right medication" problem

C. "Right route" problem

10. A 60 year old patient is on several new medications andexpresses worry that she will forget to take her pills. Whichaction by the nurse would be most helpful in this situation?A. Teaching effective coping strategiesB. Reducing the number of drugs prescribed.C. Assuring her that she will not forget once she isaccustomed to the routineD. Assisting her with obtaining and learning to use acalendar or pill container.

D. Assisting her with obtaining and learning to use acalendar or pill container.

11. The nurse is performing an admission assessment.Which findings would reflect a component of a culturalassessment?A. The patient uses aspirin as needed for pain.B. The patient has a history of hypertension.C. The patient is allergic to shellfish.D. The patient does not eat pork products for religiousreasons.

D. The patient does not eat pork products for religiousreasons.

12. A patient wants to take the herb valerian to help herselfrest at night. The nurse would be concerned about potentialinteractions if he is taking which drugs?A. DigitalisB. AnticoagulantsC. SedativesD. Immunosuppressant's

B. Anticoagulants

Could be Sedatives too, Jill answer guide statesanticoagulantspg. 199 states drug interactions: CNS depressants, MOAIs,phenytoin, warfarin; may have enhanced relative andadverse effects when taken with other drugs; herbal productsthat have sedative properties

13. When admitting a patient with suspected diagnosis ofchronic alcohol use, the nurse should keep in mind thatchronic use of alcohol might result in which condition?A. Renal failureB. StrokeC. Korsakoff psychosisD. Alzheimer disease

C. Korsakoff psychosis

pg. 97 definition: a syndrome of anterograde and retrogradeamnesia with confabulation (making up stories) associatedwith chronic alcohol abuse; it often occurs together withWernicke encephalopathy

14. The nurse is monitoring a 22 year old patient who is inthe 26th week of pregnancy and has developed gestationaldiabetes and pneumonia. She is given medication that pose apossible fetal risk, but the potential benefits may warrant theuse of the medications in her situation. The nurse recognizesthat these medications are in which U.S. Food and DrugAdministration (FDA) pregnancy safety category?A. Category BB. Category CC. Category DD. Category X

C. Category D

15. During an admission assessment, the nurse discoversthat a patient does not speak English, Which is consideredthe ideal resource for translation?A. The nurse should speak to the patient in the patientsnative language.B. The nurse should speak to a translator form the patient'sfamily.C. The nurse should speak to an adult friend of the family.D. The nurse should use prewritten note cards that includeboth English and the patients language.

A. The nurse should speak to the patient in the patientsnative language.

16. the nurse is setting up a teaching session with an 85 yearold pt. who will be going home on anticoagulant therapy.Which education strategy would reflect consideration of thechanges resulting from aging that exist with this pt?A. show a colorful video about anticoagulation therapy.B. present all the information in one session just beforedischarge.C. give the patient pamphlets about the medications to readat homeD. Develop large print handouts that reflect the verbalinformation presented.

D. Develop large print handouts that reflect the verbalinformation presented.

17. During a nursing assessment, which questions by thenurse allows for greater clarification and additionaldiscussion with the patient?A "Are you allergic to penicillin?"B. "What medications do you take?"C. "Have you had a reaction to this drug?"D."Are you taking this medication with meals?"

B. "What medications do you take?"

18.When administering drugs, the nurse remembers that theduration of action of a drug is defined as the time it takesA. For a drug to elicit a therapeutic response.B. For a drug to achieve its maximum therapeutic response.C. To remove a drug from circulation.D. For a drug's concentration to be sufficient to cause atherapeutic response.

D. For a drug's concentration to be sufficient to cause atherapeutic response.

19. The nurse is administering drugs to neonates and shouldconsider which factor that may contribute to drug toxicity?A. the lungs are immature.B. the kidneys are small.C. the liver is not fully developed.D. excretion of the drug occurs quickly.

C. the liver is not fully developed.

20.An elderly patient with a new diagnosis of hypertensionwill be receiving a new prescription for an antihypertensivedrug. the nurse expects which type of dosing to occur withthis drug therapy:A. drug therapy will be based on the patients weightB. drug therapy will be based on the patient's ageC. the patient will receive the maximum dose that isexpected to reduce the blood pressureD. the patient will receive the lowest possible dose at first,and then the dose will be adjusted as needed.

D. the patient will receive the lowest possible dose at first,and then the dose will be adjusted as needed.

21. Which situation is an example of a medication error?A. a patient refuses her morning medicationsB. A patient received a double dose of a medication becausethe nurse did not cut the pill in half.C. A patient develops hives after having started an IVantibiotic 24 hours earlierD. A patient complains of severe pain still present 60minutes after a pain medication was given.

B. A patient received a double dose of a medication becausethe nurse did not cut the pill in half.

22. The nurse is reviewing facts about pharmacology. Theterm legend drug refers to which item?A. over the counter drugsB. prescription drugsC. orphan drugsD. herbal products

B. prescription drugs

23. The nurse gave a sleeping pill to an elderly patient atbedtime. two hours later the patient is irritable and restlessand unable to sleep. the nurse recognized that the patientsresponse is reflective of which reaction?A allergic reactionB. mutagenic effectC. idiosyncratic reactionD. teratogenic reaction

C. idiosyncratic reaction

24. the medication order reads, "Give ondansetron 24mg, 30minutes before beginning chemotherapy to prevent nausea."the nurse notes that the route is missing from the order. whatis the nurses best action?A. giving the medication intravenously because it is fornausea preventionB. giving the medication orally because the tablets areavailable in 24 mg dosesC. contacting the prescriber to clarify the route of themedication orderedD. holding the medication until the prescriber returns toclarify the order.

C. contacting the prescriber to clarify the route of themedication ordered

25. Which activity best reflects the implementation phase ofthe nursing process for a patient who is newly diagnosedwith type 1 diabetes mellitus?A. providing education regarding self injection techniqueB. setting goals and outcome criteria with the patients inputC. recording a drug history regarding over the countermedications use at homeD. formulating nursing diagnoses regarding knowledgedeficit related to new treatment regimen.

A. providing education regarding self injection technique

26. A patient calls the clinic to ask about taking cranberrydietary supplement capsules because a friend recommendedthem. the nurse will discuss which possible concern when apatient is taking cranberry supplements?A. it may increase the risk for bleeding if the patient istaking anticoagulants.B. it may increase the risk of toxicity of somepsychotherapeutic drugs.C. It may reduce elimination of drugs that are excreted bythe kidneysD. Cranberry may increase the intensity and duration ofeffects of caffeine.

C. It may reduce elimination of drugs that are excreted bythe kidneys

27. The nurse is transcribing a verbal medication order.which is the proper notation of the dose of the drug ordered?A. digoxin .125 mgB. digoxin .1250 mgC. digoxin 0.125mgD. digoxin 0.1250mg

C. digoxin 0.125mg

28. a 29 year old male is admitted to the intensive care unitwith the following symptoms: restlessness, hyperactivereflexes talkativeness, confusion and periods of panic,tachycardia, and fever. the nurse suspects that he may beexperiencing the effects of taking which substance?A. opiatesB. alcoholC. stimulantsD. depressants

C. stimulants

29. During discharge patient teaching the nurse reviewsprescriptions with a patient. which statement is correct aboutrefills for an analgesic that is classified as Schedule C-III?A. no prescription refills are permitted.B. refills are allowed only by written prescription.C. the patient may have no more than 5 refills in a 6- monthperiodD. the patient may have no more than 6 refills in a 12 monthperiod.

C. the patient may have no more than 5 refills in a 6-monthperiod

container must have warning label pg. 53

30. When the nurse considers the timing of a drug dose,which of the factors listed below is appropriate to considerwhen deciding when to give a drug?A. the patient's ability to swallowB. the patients weightC. the patients last mealD. the patients allergies

C. the patients last meal

31. During an assessment, a patient tells the nurse that heeats large amounts of garlic for its cardiovascular benefits.which drug or drug classes, if taken, would have a potentialinteraction with the garlic?A. Acetaminophen (Tylenol)B. InsulinC. Antilipemic drugsD. Sedatives

B. Insulin

pg. 456 Contraindications: pts. who will undergo surgery intwo weeks and pts. with human immunodeficiency virusinfection or diabetes.

Potential drug interactions: may inhibit iodine uptake,interact with: warfarin, diazepam, protease inhibitors, anduse with NSAIDs may enhance bleeding

32. The prescriber has written admission orders, and thenurse is transcribing them. the nurse is having difficultytranscribing one order because of the prescribershandwriting. which is the best action for the nurse to take atthis time?A. ask a colleague what the order says.B. contact the prescriber to clarify the order.C. wait until the prescriber makes rounds again to clarify theorderD. ask the patient what medications he takes at home.

B. contact the prescriber to clarify the order.

33. A member of an investigational drug study team isworking with healthy volunteers whose participation willhelp to determine the optimal dosage range andpharmacokinetics of the drugs. the team member isparticipating in what type of study?A. phase IB. phase IIC. phase IIID. phase IV

A. phase I

34. the nurse is trying to give a liquid medication to a 2 1/2year old child and notes that the medication has a strongtaste. which technique is the best way for a nurse to give themedication to this child?A. give the medication with spoonfuls of sherbet.B.add the medication to the Childs bottleC. tell the child you have candy for him.D. add the medication to a cup of milk.

A. give the medication with spoonfuls of sherbet.

35. A patient in a rehabilitation center is beginning toexperience opioid withdrawal symptoms. the nurse shouldprepare to administer which drug as part of the treatment?A. diazepam (Valium)B. methadoneC. disulfiram (Antabuse)D. bupropion (Zyban)

B. methadone

36. which of the items listed below are usually increased inthe elderly?A. gastric phB. microsomal enzymeC. lean body massD. number of nephrons

A. gastric ph

pg. 42

37. it is not uncommon for an elderly patient to experience areduction in the stomach's ability to produce hydrochloricacid. this change may result in which effect?A. delayed gastric emptyingB. an increase in gastric acidityC. Decreased intestinal absorption of medicationsD. altered absorption of weakly acidic drugs such as aspirin

D. altered absorption of weakly acidic drugs such as aspirin

pg. 42 paragraph under absorption

38. when given an intravenous (IV) medication, the patientsays to the nurse, "I usually take pills. Why does thismedication have to be given in the arm?" what is the nursesbest answer?A. "The medication will cause fewer adverse effects whengiven intravenously."B. "The IV medication will be absorbed slowly into thetissue over time."C. "The action of the medication will begin sooner whengiven intravenously."D. "There is a lower chance of allergic reactions when drugsare given IV."

C. "The action of the medication will begin sooner whengiven intravenously."

39. The nurse is presenting a substance abuse lecture forteenage girls and is asked about "roofies." the nurserecognizes that this is the slang term for what substance?A. cocaineB. flunitrazepamC. secobarbitalD. methamphetamine.

B. flunitrazepam

pg. 97Pills that are classified as benzodiazepines. They haverecently gained popularity as a recreational drug; chemicallyknown as flunitrazepam

40. A patient who has advanced cancer is receiving opiodmedications around the clock to keep him comfortable as henears the end of his life. which term best described this typeto therapy?A. palliative therapyB. maintenance therapyC. acute therapyD. supplemental therapy

A. palliative therapy

41. For accurate medication administration to pediatricpatients, the nurse must take into account which criteria?A. weight and organ maturityB. renal output and weightC. weight, body temperature, and ageD. height and age

A. weight and organ maturity

42. Drug transfer to the fetus is more likely during the lasttrimester of pregnancy for which reason?A. decreased fetal surface areaB. increased placental surface areaC. enhanced placental blood flowD. increased amount of protein bound rug in maternalcirculation

C. enhanced placental blood flow

43. A 38 year old man stopped smoking months ago. he tellsthe nurse that he still feels strong ciggarette cravings andwonders if he is ever going to feel "normal" again. whichstatement by the nurse is correct?A. "these cravings will never stop."B. "these cravings may persist for months to years."C. "the craving tells us that you are still using nicotine."D. "the cravings indicate that you are about to experiencenicotine withdrawal."

B. "these cravings may persist for months to years."

44. the patient is asking the nurse about current U.S. lawsand regulations of herbal products. which statement is true?A. medicinal herbs are viewed as dietary supplements.B. herbal remedies are held to the same standards are drugs.C. producers of herbal products must prove therapeuticefficacy.D. herbal remedies are protected by patent laws.

A. medicinal herbs are viewed as dietary supplements.

45.the nurse is assigned to a patient who is newly diagnosedwith type 1 diabetes mellitus. which statement bestillustrates an outcome criterion for this patient?A. the patient will follow instructions.B. the patient will not experience complications.C. the patient will adhere to the new insulin treatmentregimen.D. the patient will demonstrate safe insulin selfadministration technique.

D. the patient will demonstrate safe insulin selfadministration technique.

46. nurses have the ethical responsibility to tell the truth totheir patients. what is the principle known as?a. justiceb. veracityc. beneficenced. nonmalefiecence

b. veracity

pg. 56The duty to tell the truth; related nursing actions includetelling the truth with regard to placebos, investigational newdrugs, and informed consent

47. the nurse is developing a care plan for a patient who willbe self administering insulin injections which statementreflects a measurable goal?a. the patient will know about insulin injections.b. the patient will understand the principles of insulinpreparation.c. the patient will demonstrate the proper technique ofmixing insulin.d. the patent will comprehend the proper technique ofpreparing insulin.

c. the patient will demonstrate the proper technique ofmixing insulin.

48. a patient has been taking naltrexone (ReVia) as part ofthe treatment for addiction to heroin. the nurse expects thatthe naltrexone will have which therapeutic effect for thispatient?

a. nalterxone prevents the cravings for opioid drugs.b. nalterxone works as a safer substitute for the heroin untilthe patient completes withdrawal.c. the patient will experience flushing, sweating, and severenausea if he takes heroin on naltrexone.d. if opioid drugs are used while taking naltrexone, euphoriais not produced; thus, the drug's effects are lost.

d. if opioid drugs are used while taking naltrexone, euphoriais not produced; thus, the drug's effects are lost.

pg. 165naloxone HCL (Narcan) is a pure opioid antagonist itpossesses no agonistic morphine-like properties and worksas blocking drug for opioid drugs. Does not produceanalgesia or respiratory depression. Drug of choice forreversal of opioid respiratory depression

49. when reviewing the various schedules of controlleddrugs, the nurse knows that which description correctlydescribes schedule II drugs?

a. drugs with high potential for abuse that have acceptedmedication useb. drugs with high potential for abuse that do not haveaccepted medical use.c. medically accepted drugs that may cause moderatephysical or psychological dependenced. medically accepted drugs with very limited potential forcausing mild physical or psychological dependence

a. drugs with high potential for abuse that have acceptedmedication use

pg. 53; C-II; written prescription only, no refills, containermust have warning label

50. A patient with a new prescription for diuretic has justreviewed with the nurse how to include more potassium inher diet. this reflects learning in which domain?a. physicalb. affectivec. cognitived. psychomotor

c. cognitive

51. the nurse is administering medications to a patient whois in liver failure resulting form end stage cirrhosis. the nurseis aware that patients with liver failure would most likelyhave problems with which pharmacokinetic phase?a. absorptionb. distributionc. metabolismd. excretion

c. metabolism

52.which nursing diagnosis is appropriate for a patient whohas just received a prescription for a new medication?a. noncompliance related to a new drug therapyb. ineffective health maintenance related to new drugtherapyc. lack of knowledge regarding newly prescribed drugtherapyd. deficient knowledge related to newly prescribed drugtherapy

d. deficient knowledge related to newly prescribed drugtherapy

53. an 83 year old woman has been given thiazide diuretic totreat mild heart failure. she and her daughter should be toldto watch for which problems?a. constipation and anorexiab. fatigue and dehydrationc. daytime sedation and lethargyd. edema, nausea, and blurred vision

b. fatigue and dehydration

54. the nurse is aware that confusion, forgetfulness, andincreased risk for falls are common responses of an elderlypatient who is taking which type of drug?a laxativesb. anticoagulants'. sedatives.c. daytime sedation and lethargyd. diuretics

b. anticoagulants'. sedatives.

55. when reviewing pharmacology terms for a group ofnewly graduated nurses, the nurse explains that a drugs halflife is the time to take for

a. the drug to elicit half of its therapeutic response.

b. one half of the original amount of a drug to reach thetarget cells.

c. one half of the original amount of a drug to be removedfrom the body

d. one half of the original amount of a drug to be absorbedinto the circulation.

c. one half of the original amount of a drug to be removedfrom the body

56. which one of the following statements about over thecounter drugs is not true?a. drug interactions with OTC medications are common.b. Labels on OTC medications rarely causemisunderstanding and /or misuse of the drugs.c. Use of OTC drugs may delay treatment of more seriousailmentsd. OTC drugs may relieve symptoms without addressing thecause of the problem.

b. Labels on OTC medications rarely causemisunderstanding and /or misuse of the drugs.

57. all of the following regarding pediatric patients are trueEXCEPT:

a. total body water content is much greater than in adultsb. first pass elimination is reduced because of the immaturityof the liverc. gastric emptying is more rapid because of increasedperistaltic activity.d. the level of microsomal enzymes are decreased.

c. gastric emptying is more rapid because of increasedperistaltic activity.

58. a 25 year old woman is visiting the prenatal clinic todayand shares with the nurse her desire to go "Natural" with herpregnancy. she shows the nurse a list of herbal remedies thatshe wants to buy so that she can "avoid taking any drugs."which statement by the nurse is correct?

a. "Most herbal remedies are nontoxic and safe for useduring pregnancy."b. "Please read the labels carefully before use to check forcautionary warnings."c. "Keep in mind that products from different manufacturesare required to contain consistent amounts of the herbalproducts."d. "It's important to remember that herbal remedies do nothave proven safety ratings for pregnant women."

d. "It's important to remember that herbal remedies do nothave proven safety ratings for pregnant women."

59. when discussing dosage calculation for pediatric patientswith a clinical pharmacist, the nurse notes that which type ofdosage calculation is used most commonly in pediatriccalculations?a. West nomogramb. Clark rulec. Height to weight ratiod. Mg/kg formula

a. West nomogram

60. all of the following about OTC drugs are true EXCEPT:

a. drug interactions with OTC medications are rare.b. OTC drugs are indicated for short term treatment ofconditionsc. OTC drugs may relieve symptoms without addressing thecause of the problemd. patients may misunderstand product labels and misuse thedrugs.

a. drug interactions with OTC medications are rare.

61.when monitoring a patient on an insulin drip to reduceblood glucose levels, the nurse notes that the patient'sglucose level is extremely low, and the patient is lethargicand difficult to awaken. this would be classified as whichtype of adverse drug reaction?a. an adverse effectb. an allergic reactionc. an idiosyncratic reactiond. an pharmacologic reaction

a. an adverse effect

62. the nurse is conducting a smoking cessation program.which statement regarding drugs used in cigarette smokingcessation programs is true?a. rapid chewing of the nicotine gum releases an immediatedose of nicotine.b. quick relief form withdrawal symptoms is most easilyachieved by using a transdermal patchc. treatment compliance is higher with use of the gum ratherthan the transdermal patch.d. the nicotine gum can be used only up to six times a day

d. the nicotine gum can be used only up to six times a day

63. a patient has been taking an over the counter (OTC) acidreducing drug because he has had "stomach problems" forseveral months. he tells the nurse that the medicine helps aslong as he takes it, but once he stops it, the symptoms return.which statement by the nurse is the best advice for thispatient?

a. "the over the counter drug has helped you, so you shouldcontinue to take it."b. " the over the counter dosage may not be strong enough.you should be taking prescription strength for best effects."c. for best results, you need to watch what you eat inaddition to taking this drug."d. "using this drug may relieve your symptoms, but it doesnot address the cause. you should be seen by your healthcare provider."

d. "using this drug may relieve your symptoms, but it doesnot address the cause. you should be seen by your healthcare provider."

64. A patient is receiving 2 different drugs. at currentdosages and dosage forms, both drugs are absorbed into thecirculation in identical amounts. thus, because they have thesame absorption rates, they area. in a steady stateb. synergisticc, compatible.d. bioequivalent.

d. bioequivalent.

65. a nurse is providing teaching for a patient who will betaking varenicline (chantix) as part of a smoking cessationprogram. which teaching point is appropriate for a patienttaking this medication?a. this drug is available as a chewing gum that can be takento reduce cravingsb. be careful when driving because drowsiness may be aproblemc. there have been very few adverse effects reported for thisdrug.d. avoid caffeine while on this drug.

d. avoid caffeine while on this drug.

66. the nurse is administering parenteral drugs. whichstatement is true regarding parenteral drugs?a. parenteral drugs bypass the first pass effectb. absorption of parenteral drugs is affected by reducedblood flow to the stomach.c. absorption of parenteral drugs is altered by the presence offood in the stomachd. parenteral drugs exert their effects while circulating in thebloodstream.

a. parenteral drugs bypass the first pass effect

67. the nurse is assessing a newly admitted 83 year oldpatient and determines that the patient is experiencingpolypharmacy. which statement most accurately illustratespolypharmacy?a. the patient has lower risk for drug interactions.b. the patient takes one medication for an illness severaltimes a day.c. the patient risks problems only if over the countermedications are also taken.d. the patient takes multiple medications for several differentillnesses.

d. the patient takes multiple medications for several differentillnesses.

68. when given a scheduled morning medication, the patientstates, "I haven't seen that pill before, are you sure it'scorrect?" that nurse checks the medication administrationrecord and verifies that is listed. which is the nurse's bestresponse to the patient?a. "It's listed here on the medication sheet, so you shouldtake it."b. "Go ahead and take it, and then I'll check with your doctorabout it."c. "It wouldn't be listed here if it were not ordered for you!"d. "I'll check on the order first before you take it."

d. "I'll check on the order first before you take it."

69. a patient is experiencing chest pain and needs to take asublingual form of nitroglycerin. where does the nurseinstruct the patient to place the tablet?a. under the tongueb. in the space between the cheek and the gum inside themouthc. at the back of the throat for easy swallowingd. on a nonhairy area of the chest

a. under the tongue

70. the nurse is writing a nursing diagnosis for plan of carefor a patient who has been newly diagnosed with type 2diabetes. which statement reflects the correct format fornursing diagnosis?a. anxietyb. anxiety related to new drug therapyc. anxiety related to feelings about drug therapy asevidenced by statements such as "I'm upset about having togive myself shots."d. anxiety related to new drug therapy as evidenced bystatements such as "I'm upset about having to give myselfshots."

d. anxiety related to new drug therapy as evidenced bystatements such as "I'm upset about having to give myselfshots."

71. The nurse is assessing an elderly Hispanic woman whois being treated for hypertension. during the assessment,what is important for the nurse to remember about culturalaspects?a. the patient should be discouraged from using folkremedies and rituals.b. the nurse should expect the patient to value protectivebracelets and root workers as healers.c. the nurse should remember that the balance among body,mind, and environment would be important for this patienthealth beliefs.d. the nurses assessment should include informationregarding religious practices and beliefs regardingmedications, treatment, and healing.

d. the nurses assessment should include informationregarding religious practices and beliefs regardingmedications, treatment, and healing.

72. for which cultural group must the health care teamprovider respect the value placed on harmony with natureand the belief that disease is the result ill spirits?a. Hispanicsb. Asian Americansc. native Americansd. African Americans

c. native Americans

73. all of the following regarding over the counter (OTC)drugs are true except:a. use of OTC drugs may delay treatment of seriousailments.b. drug interactions with OTC medications are rare.c. OTC drugs may relieve symptoms without addressing thecause of the problem.d. patients may misunderstand product labels and misuse thedrugs.

b. drug interactions with OTC medications are rare.

74. of the drugs listed below which would be affected by thefirst pass effect? select all that apply.a. morphine infusion through a patient controlled analgesiapumpb. nitroglycerin sublingual tabletsc. diphenhydramine (Benadryl) elixird. levothyroxine (Synthroid) tabletse. Transdermal nicotine patchesf. nifedipine (Procardia) capsulesg. penicillin given by IV piggyback infusion

c. diphenhydramine (Benadryl) elixird. levothyroxine (Synthroid) tabletsf. nifedipine (Procardia) capsules

75. which are appropriate considerations when the nurse isassessing the learning needs of a patient? select all thatapplya cultural background.b. social supportc. level of educationd. readiness to learne. health beliefs

a cultural background.c. level of educationd. readiness to learne. health beliefs

76. which factors contribute to drug polymorphism? selectall that applya. the number of drugs ordered by the physicianb inherited factorsc. the patient's diet and nutrition statusd. different dosage forms of the same druge. the patients values and beliefsf. the patients drug historyg. the various available forms of a drug

b inherited factorsc. the patient's diet and nutrition statuse. the patients values and beliefsf. the patients drug history

77. which statements are true regarding pediatric patientsand pharmacokinetics: select all that applya. the levels of misrosomal enzymes are decreasedb. perfusion to the kidneys may be decreased and may resultin reduced renal functionc. first pass elimination is increased because of higher portalcirculation.d. first pass elimination is reduced because of the immaturityof the liver.e. total body water content is much less than in adults.f. gastric emptying is slowed because of slow or irregularperistalsis.g. gastric emptying is more rapid because of increasedperistaltic activity.

a. the levels of misrosomal enzymes are decreasedd. first pass elimination is reduced because of the immaturityof the liver.f. gastric emptying is slowed because of slow or irregularperistalsis.

78. which statements are true regarding the elderly andpharmacokinetics? select all that applya. the level of microsomal enzymes are decreased.b. fat content is increased because of decreased lean bodymass.c. fat content is decreased because of increased lean bodymass.d. the number of intact nephrons is increased.e. the number of intact nephrons is decreased.f. gastric pH is less acidicg. gastric pH is more acidic

a. the level of microsomal enzymes are decreased.c. fat content is decreased because of increased lean bodymass.e. the number of intact nephrons is decreased.f. gastric pH is less acidic

79. when giving medications the nurse ill follow the rightsof medication administration. which include what rights?a. right drugb. right routec. right dosed. right timee. right patientf. right documentation

a. right drugb. right routec. right dosed. right timee. right patientf. right documentation

80. the nurse can prevent medication error by followingwhich principles? select all that applya. assess for allergies after giving medications.b. use 2 patient identifiers before giving medications.c. do not give a medication that another nurse has drawn upin a syringe.d. minimize the use of verbal and telephone orders.e. use trade names instead of generic names to avoidconfusion.

b. use 2 patient identifiers before giving medications.c. do not give a medication that another nurse has drawn upin a syringe.d. minimize the use of verbal and telephone orders.

81.the nurse is conducting a class for seniors citizens aboutthe use of over the counter (OTC) drugs. which statementsare true regarding the use of OTC drugs? select all that applya. use of OTC drugs may delay treatment of serious ailmentsb. drug interactions with OTC are rareC. OTC drugs may relieve symptoms without addressing thecause of the problemd. OTC drugs are indicated for long term treatment ofconditionse. patients may misunderstand product labels and misuse thedrugs.

a. use of OTC drugs may delay treatment of serious ailmentsC. OTC drugs may relieve symptoms without addressing thecause of the probleme. patients may misunderstand product labels and misuse thedrugs.

82. during a party a guest who is on disulfiram (Antabuse)therapy drinks a half glass of wine. the party guest willquickly experience which symptoms? select all that applya euphoriab. vomitingc. diarrhead. pallore. flushed skinf. sweating

b. vomitinge. flushed skinf. sweating

A patient about to receive his morning dose of digoxin hasan apical pulse of 70 beats per minute. What will the nursedo?A. Administer the dose.B. Administer the dose and notify the physician.C. Check the radial pulse for 1 full minute.D. Withhold the dose and notify the

A. Administer the dose.

In assessing a patient before administration of a cardiacglycoside, the nurse knows that what condition canpredispose a patient to digitalis toxicity?A. HypokalemiaB. HyperkalemiaC. HypocalcemiaD. Hypernatremia

A. Hypokalemia; control ventricular response to atrialfibrillation and a derived from foxglove. Digoxin is the onlyavailable cardiac glycoside---positive inotropic---inhibitssodium potassium pump (adenosine tripphophatase) Sodiumand calcium rise. Cholinergic stimulation via the vagusnerve of Parasympathetic nervous system. ---Negativechronotropic---Negative Dromotropic effect

While assessing a patient who is receiving intravenousdigitalis, the nurse recognizes that the drug has a negativechronotropic effect. How would this drug effect be evidentin the patient?A. Increased heart rateB. Decreased heart rateC. Decreased conductionD. Increased ectopic beats

B. Decreased heart rate

A patient has been taking digoxin at home but has taken anaccidental overdose and has developed toxicity. He has beenadmitted to the telemetry unit where the physician hasordered digoxin immune Fab (Digibind). The patient asksthe nurse why the medication is ordered. What is the nurse'sbest response?A. "It works faster than digoxin."B. "It is safer than digoxin and can be taken orally."C. "It helps to convert the irregular heart rhythm to a morenormal rhythm."D. "This drug is an antidote to digoxin and will help to lowerthe blood levels."

D. "This drug is an antidote to digoxin and will help to lowerthe blood levels." (severe bradycardia, advanced heart block,ventricularr tachycardia, fibrillation, and hyperkalemia);available in parental form. Clinical signs and symptoms aremonitored NOT serum levels----used for systolic heartfailure and atrial fibrillation.

5. A patient has been placed on a milrinone infusion as partof the therapy for end-stage heart failure. What risksinvolved with this drug will the nurse keep in mind whileassessing this patient during the infusion?A. HypertensionB. HyperkalemiaC. Nausea and vomitingD. Cardiac dysrhythmias

D. Cardiac dysrhythmias (contraindictated with ventriculartachycardia, and fibrillation) used for treatment of atrialfibrillation. Available in Oral and injection form.

6. A patient with atrial fibrillation was started on digoxin,and 1 week later a digoxin level was drawn. Which result iswithin normal therapeutic levels for digoxin?A. 0.4 ng/mLB. 0.7 ng/mLC. 2.1 ng/mLD. 2.6 ng/mL or higher

B. 0.7 ng/mL (normal 0.5 to 2.0 ng/mL

7. When reviewing the list of medications taken by a patientwho will be receiving a new prescription for digoxin, thenurse would be concerned about which medication that mayinteract with the digoxin?A. aspirinB. acetaminophen (Tylenol)C. furosemide (Lasix)D. vitamin K

C. furosemide (Lasix); (loop Diuretics); numerous ones onpage 341

8. The nurse is reviewing discharge teaching for a patientwho will be taking digoxin (Lanoxin) therapy. The patientshould be taught to avoid which foods when taking thedigoxin?A. Leafy green vegetablesB. Dairy productsC. Grapefruit juiceD. Bran muffins

D. Bran muffins

9. In assessing a patient before administration of a cardiacglycoside, the nurse knows that which lab result can increasethe toxicity of the drug?A. Potassium level 2.8 mEq/LB. Potassium level 4.9 mEq/LC. Sodium level 140 mEq/LD. Calcium level 10 mg/dL

A. Potassium level 2.8 mEq/L (low potassium normal is 3.5to 5.0)

10. The nurse administering the phosphodiesterase inhibitorinamrinone recognizes that this drug should have a positiveinotropic effect. This effect will result in increasedA. heart rate.B. blood vessel dilation.C. force of cardiac contraction.D. conduction of electrical impulses across the heart.

C. force of cardiac contraction. (increase cAMP) positiveinotropic (by more calcium available in SR)effect andvasodilation, (inodilators)---positive chornotropic effect);USED IN ICU; ADVERSE EFFECT...thrombocytopenia,dysrhythmia, ventricular, hypotension and angina,hypokalemia, tremor.

11. The nurse notes in a patient's medical record thatnesiritide has been ordered. Based on this order, the nurseinterprets that the patient has which disorder?A. Atrial fibrillationB. Acutely decompensated heart failure with dyspnea at restC. Systolic heart failureD. Long-term treatment of heart failure.

B. Acutely decompensated heart failure with dyspnea at rest

SELECT ALL THAT APPLY:

1. When a patient is experiencing digoxin toxicity, whichclinical situation would necessitate the use of digoxinimmune Fab (Digibind)? Select all that apply.A. The patient reports seeing colorful halos around lights.B. The patient's serum potassium level is above 5 mEq/L.C. The patient is experiencing nausea and anorexia.D. The patient is experiencing severe sinus bradycardia thatdoes not respond to cardiac pacing.E. The patient has taken an overdose of greater than 10 mgof digoxin.

B. The patient's serum potassium level is above 5 mEq/L.

D. The patient is experiencing severe sinus bradycardia thatdoes not respond to cardiac pacing. (E) might be right aswell a person taking 10mg of digoxin is a indication oftoxicity...page 340 states life threatening digoxin overdose inadults and 4 mg in children)

2. Which drug classes are considered first-line treatment forheart failure? Select all that apply.A. Angiotensin converting enzyme (ACE) inhibitorsB. Angiotensin II receptor blockers (ARBs)C. Digoxin (cardiac glycoside)D. Beta-blockersE. Nesiritide (Natrecor), the B-type natriuretic peptide

ACEARBSBeta-blockersloop diuretics

1.When administering topical nitroglycerin ointment, thenurse should use which technique?A. The ointment should be applied on the chest over theheart.B. The ointment should be used only in the case of a mildangina episode.C. The old ointment should be removed before newointment is applied.D. The ointment should be massaged gently into the skin,then covered with plastic wrap.

C. The old ointment should be removed before newointment is applied.

2.The nurse is giving intravenous nitroglycerin to a patientwho has just been admitted because of an acute myocardialinfarction. Which statement is true regarding theadministration of the intravenous form of this medication?A. Specific nonpolyvinylchloride (non-PVC) plasticintravenous bags and tubing must be used.B. It is stable for only 24 hours after preparation.C. It can be given in infusions with other medications.D. The solution will be slightly colored green or blue.

A. Specific nonpolyvinylchloride (non-PVC) plasticintravenous bags and tubing must be used.

3.A 53-year-old man has been admitted for evaluation ofchest pain. He has been diagnosed with angina and will begiven a prescription for sublingual nitroglycerin tablets.When teaching the patient how to use sublingualnitroglycerin, what instruction should the nurse include?A. Take up to five doses at 15-minute intervals for an anginaattack.B. If the tablet does not dissolve quickly, chew the tablet formaximal effect.C. If the chest pain is not relieved after one tablet, call 911immediately to activate emergency medical services.D. Wait 1 minute between doses of sublingual tablets, up tothree doses.

C. If the chest pain is not relieved after one tablet, call 911immediately to activate emergency medical services.

4.A 74-year-old professional golfer has chest pain thatoccurs toward the end of his golfing games. He says the painusually goes away after 1 or 2 sublingual nitroglycerintablets and rest. What type of angina does he have?A. ClassicB. VariantC. UnstableD. Prinzmetal's

A. Classic also called (Chronic stable angina); chest painthat has as its primary cause arteriosclerosis, which results ina long-term but relatively stable level of obstruction in oneor more coronary arteries.

5.A patient arrives in the emergency department with severechest pain. She says she has had pain off and on for a weeknow. Which assessment finding would indicate the need forcautious use of nitrates and nitrites?A. Blood pressure of 98/68 mm HgB. History of liver diseaseC. History of heart failureD. History of a myocardial infarction 2 years ago

A. Blood pressure of 98/68 mm Hg

6.A calcium channel blocker (CCB) is prescribed for apatient, and the nurse provides instructions to the patientabout the medication. What does the nurse tell the patient?A. The tablet should be chewed for faster release of themedication.B. To increase the effect of the drug, take it with grapefruitjuice.C. If the adverse effects of chest pain, fainting, or dyspneaoccur, discontinue the medication immediately.D. A high-fiber diet with plenty of fluids will help preventthe constipation that may occur.

D. A high-fiber diet with plenty of fluids will help preventthe constipation that may occur.........CCBs:phenylalkylamins, benzothiazepines, and dihydroridines(verapril, dilitiazem, amlodipine)

7.When applying transdermal nitroglycerin patches, howwill the nurse instruct the patient?A. "Use any nonhairy area on the body."B. "Use only the chest area for application sites."C. "Temporarily remove the patch if you go swimming."D. "Apply the patch to the same site consistently."

A. "Use any nonhairy area on the body.

8.A patient has been taking a beta-blocker for 4 weeks aspart of his antianginal therapy. He also has type II diabetesand hyperthyroidism. When discussing possible adverseeffects, the nurse should include which information?A. "Watch for unusual weight loss."B. "Monitor your pulse for increased heart rate."C. "Use the hot tub and sauna at the gym as long as time islimited to 15 minutes."D. "Monitor your blood glucose levels for possiblehypoglycemia or hyperglycemia."

D. "Monitor your blood glucose levels for possiblehypoglycemia or hyperglycemia."...BBs (-LOL), atenolol,metoprolol, nadolol, and propranolol.

9.What action is recommended to help reduce the toleranceto transdermal nitroglycerin therapy that commonlydevelops?A. Omit a dose once a week.B. Leave the patch on for 2 days at a time.C. Cut the patch in half for a week until the tolerancesubsides.D. Remove the patch at bedtime, then apply a new one in themorning.

D. Remove the patch at bedtime, then apply a new one in themorning.

10.While assessing a patient who is taking a beta-blocker forangina, the nurse knows to monitor for which adverseeffect?A. NervousnessB. HypertensionC. BradycardiaD. Dry cough

C. Bradycardia (blocks beta 1 and beta 2 receptors) otheradverse effects: negative chronotropic, decrease cardiacoutput, and negative dromotropic effect, beta 2:bronchoconstriction, increased airway resistence (asthmaand COPD), cardiac rhytm, decrease renin release.

Select all that apply:1.A patient is experiencing chest pain while playing tennis.He has a bottle of sublingual nitroglycerin with him. Whichof the actions are appropriate for the patient to take at thistime? Select all that apply.A. Stop the activity and lie down or sit down.B. Call 911 immediately.C. Call 911 if the pain is not relieved after taking 1sublingual tablet.D. Call 911 if the pain is not relieved after taking 3sublingual tablets in 15 minutes.E. Place a tablet under the tongue.F. Place a tablet in the space between the gum and cheek.G. Take another sublingual tablet if chest pain is not relievedafter 5 minutes, up to three, total.

A. Stop the activity and lie down or sit downC. Call 911 if the pain is not relieved after taking 1sublingual tablet.E. Place a tablet under the tongue.F. Place a tablet in the space between the gum and cheek.G. Take another sublingual tablet if chest pain is not relievedafter 5 minutes, up to three, total.

The physician has ordered the adrenergic drug doxazosin(Cardura) for a patient. When providing education about thisdrug, the nurse should include which instructions?A. The patient should weigh herself daily and report anyweight loss to the physician.B. The patient should increase her potassium intake byeating more bananas and apricots.C. The impaired taste associated with the medication usuallygoes away in 2 to 3 weeks.D. The patient should take her first dose while lying downbecause there is a first-dose effect with prazosin.

D. The patient should take her first dose while lying downbecause there is a first-dose effect with prazosin.

2. A patient with severe liver disease is receiving theangiotensin converting enzyme (ACE) inhibitor, captopril(Capoten). The nurse is aware that the advantage of this drugfor this patient is that captoprilA. is a prodrug and is metabolized by the liver beforebecoming active.B. is not a prodrug and does not need to be metabolized bythe liver before becoming active.C. rarely causes first-dose hypotensive effects.D. has little effect on electrolyte levels.

B. is not a prodrug and does not need to be metabolized bythe liver before becoming active.

3. During a follow-up visit, the physician examines thefundus of the patient's eye. Afterward, the patient asks thenurse, "Why is he looking at my eyes when I have highblood pressure? It does not make sense to me!" What is thebest response by the nurse?A. "We need to monitor for drug toxicity."B. "We must watch for increased intraocular pressure."C. "The physician is assessing for visual changes that mayoccur with drug therapy."D. "The physician is making sure the treatment is effectiveover the long-term."

D. "The physician is making sure the treatment is effectiveover the long-term.

4. Which of the following parameters determine theregulation of arterial blood pressure?A. Cardiac output and vascular resistanceB. Heart rate and peripheral resistanceC. Blood volume and renal blood flowD. Myocardial contractility and arteriolar constriction

A. Cardiac output and vascular resistance

5. When counseling a male patient about the possibleadverse effects of antihypertensive drugs, the nurse shoulddiscuss which potential problem?A. ImpotenceB. BradycardiaC. Increased libidoD. Increased weight

A. Impotence

6. Antihypertensive drug therapy for a newly diagnosed,stage 1 hypertensive African American patient would mostlikely include which drug or drug classes?A. Vasodilators aloneB. ACE inhibitors aloneC. Calcium channel blockers with thiazide diureticD. Beta-blockers with thiazide diuretic

C. Calcium channel blockers with thiazide diuretic

7. The nurse is creating a plan of care for a patient with anew diagnosis of hypertension. Which is a potential nursingdiagnosis for the patient taking antihypertensivemedications?A. DiarrheaB. Sexual dysfunctionC. Stress urinary incontinenceD. Impaired memory

B. Sexual dysfunction

8. A patient's blood pressure elevates to 210/150 mm Hg,and a hypertensive emergency is obvious. He is transferredto the intensive care unit and started on a sodiumnitroprusside (Nipride) drip to be titrated per his response.With this medication, the nurse knows that the maximumdose of this drug should be infused for how long?A. 10 minutesB. 30 minutesC. 1 hourD. 24 hours

A. 10 minutes

9. A patient with primary hypertension is prescribed drugtherapy for the first time. The patient asks how long drugtherapy will be needed. Which answer by the nurse is themost correct response?A. "This therapy should take about 3 months."B. "This therapy should take about a year."C. "This therapy should go on until your symptomsdisappear."D. "Therapy for high blood pressure is usually life-long."

D. "Therapy for high blood pressure is usually life-long."

10. A patient who has been taking antihypertensive drugs fora few months complains of having a persistent dry cough.The nurse knows that this cough is an adverse effect ofwhich class of antihypertensive drugs?A. Beta-blockersB. Angiotensin-converting enzyme (ACE) inhibitorsC. Angiotensin-receptor blockers (ARBs)D. Calcium channel blockers

B. Angiotensin-converting enzyme (ACE) inhibitors otheradverse effects are: fatigue, dizziness, mood changes, andheadaches. Dry non productive cough which is reversiblewhen stopping ACE therapy. has a first dose hypotensioneffect

11. Which drug is commonly used for a pregnant patientwho is experiencing hypertension?A. mannitol (Osmitrol)B. enalapril (Vasotec)C. hydrochlorothiazide (HydroDIURIL)D. methyldopa (Aldomet)

D. methyldopa (Aldomet); alpha 2-adrenergic receptorstimulators (agonist); has high incidence of adverse effects:orthostatic hypotension, fatigue, and dizziness. (clondine) isanother drug but not used in pregnancy

12. A patient diagnosed with prehypertension has a bloodpressure reading of _____ mm Hg systolic _____ mm Hgdiatolic.A. less than 120; and less than 80B. 120 and 139; or 80 and 89C. 140 and 159; or 90 and 99D. 160 and 179; or 100 and 109

B. 120 and 139; or 80 and 89

13. A patient has hypertension along with type I diabetesmellitus and proteinuria. The nurse anticipates that a drugfrom which drug class will be ordered for its renal-protectiveeffects?A. Beta-blockersB. ACE inhibitorsC. DiureticsD. Calcium channel blockers

B. ACE inhibitors (non-prodrugs captopril and lisinpril)doesn't need to be turn into an active form in the liver.(protect the kidneys by reducing the GFR pressure and thenumber one choice with cardiovascular and diabetes)

14. The nurse is reviewing the orders for a patient and notesa new order for an ACE inhibitor. The nurse checks thecurrent medication orders, knowing that this drug class mayhave a serious interaction with what other drug class?A. Calcium channel blockersB. DiureticsC. Nonsteroidal antiinflammatory drugs (NSAIDs)D. Nitrates

C. Nonsteroidal antiinflammatory drugs (NSAIDs)(iburprohen can reduce the effect of ACE and predispose thept. with acute renal failure); other adverse effects: potassiumlevels above 5 mEq/L because they promote hyperkalemia,lactating women, children, bilateral renal disease); rash,pruritus, anemia, neutropenia, thrombocytosis, andagranulocytosis.

1. When teaching a patient about antihypertensive drugtherapy, which statement by the nurse is correct? Select allthat apply.A. "You should try to have your blood pressure checkedonce a week and keep track of the readings."B. "If you notice that the symptoms have gone away, youshould be able to stop taking the drug."C. "An exercise program may be helpful in treatinghypertension, but let's check with your doctor first."D. "If you experience severe side effects, stop the medicineand let us know at your next office visit."E. "Most over-the-counter decongestants are compatiblewith antihypertensive drugs."f. "please continue the medication, even if you are feelingbetter"

"You should try to have your blood pressure checked once aweek and keep track of the readings."C. "An exercise program may be helpful in treatinghypertension, but let's check with your doctor first."D. "If you experience severe side effects, stop the medicineand let us know at your next office visit."f. "please continuethe medication, even if you are feeling better"

1. When monitoring a patient who has diabetes and isreceiving a carbonic anhydrase inhibitor for edema, thenurse monitors for which possible adverse effect?A. Metabolic alkalosisB. Elevated blood glucoseC. HyperkalemiaD. Drowsiness

B. Elevated Blood glucose and glycosuria in diabetics

The nurse should monitor a patient for signs and symptomsof hyperkalemia if the patient is taking which of thefollowing diuretics?A. hydrochlorothiazide (HydroDIURIL)B. furosemide (Lasix)C. metolazone (Zaroxolyn)D. spironolactone (Aldactone)

D. spironolactone (Aldactone); synthetic steriod blocksaldosterone receptors...hyperkalemia common complication,it is a potassium sparing diuretic. Most commonlyprescribed for children. only oral form and a pregnancy Ddrug.

Mannitol (Osmitrol) has been ordered for a patient withacute renal failure. The nurse knows to administer this drugusing which procedure?A. Intravenously, through a filterB. By rapid intravenous bolusC. By mouth in a single morning doseD. Through a gravity intravenous drip with standard tubing

A. Intravenously, through a filter; Osmotic diuretic; cancrystalized in cold temperatures and IV only, and it is storedin a warmer in pharmacy. Pregnancy C drug

Furosemide (Lasix) is prescribed for a patient who is aboutto be discharged, and the nurse provides instructions to thepatient about the medication. Which statement by the nurseis correct?A. "Keep a weekly journal or log of your weight."B. "Avoid foods high in potassium, such as bananas,oranges, fresh vegetables, and dates."C. "If you experience weight gain, such as five or morepounds a week, be sure to tell your physician during yournext routine visit."D. "Be sure to change your position slowly and rise slowlyafter sitting or lying so as to prevent dizziness and possiblefainting because of blood pressure changes."

D. "Be sure to change your position slowly and rise slowlyafter sitting or lying so as to prevent dizziness and possiblefainting because of blood pressure changes."

5. When reviewing the mechanisms of action of diuretics,the nurse knows that which statement is true about the loopdiuretics?A. They work by inhibiting aldosterone.B. They are very potent, having a diuretic effect that lasts atleast 6 hours.C. They are particularly useful when rapid diuresis is desiredbecause their onset of action is rapid.D. They have the disadvantage of ceasing to be effectivewhen the creatinine clearance decreases below 25 mL/min.

C. They are particularly useful when rapid diuresis is desiredbecause their onset of action is rapid.

6. When teaching about hydrochlorothiazide, the nurseshould be sure the patient knows to be cautious in takingwhich medications with hydrochlorothiazide?A. DigitalisB. PenicillinC. Potassium supplementsD. Over-the-counter vitamins

A. Digitalis, corticosteriods, diazoxide, and oralhypoglycemics

7. When a patient is receiving diuretic therapy, which of thefollowing would best reflect the patient's fluid volumestatus?A. Blood pressure and pulseB. Serum potassium and sodium levelsC. Intake, output, and daily weightD. Measurements of abdominal girth and calf circumference

C. Intake, output, and daily weight

8. A patient is being discharged to home on a single dailydose of a diuretic. The health care provider instructs thepatient to take the dose at which time so it will be leastdisruptive to the patient's daily routine?A. In the morningB. At noonC. With supperD. At bedtime

A. In the morning

9. A patient is started on a diuretic for antihypertensivetherapy. The nurse expects that a drug in which of thefollowing classes is likely to be used initially?A. Loop diureticsB. Osmotic diureticsC. Thiazide diureticsD. Vasodilators

C. Thiazide diuretics (chlorohiazide,hydrochlorohiazide, andbendroflumthiazide, chlorthalidone, indapamide, andmetolazone)

10. A patient in the neurologic intensive care unit is beingtreated for cerebral edema and is given which type of drug toreduce intracranial pressure?A. Loop diureticsB. Osmotic diureticsC. Thiazide diureticsD. Vasodilators

B. Osmotic diuretics

11. A 79-year-old patient is taking a diuretic for treatment ofhypertension. This patient is very independent and wants tocontinue to live at home, despite his diagnosis of mild heartfailure. The nurse will know that which teaching point isimportant for this patient?A. He should take the diuretic with his evening meal.B. He should skip the diuretic dose if he plans to leave thehouse.C. If he feels dizzy while on this medication, he should stoptaking it and take potassium supplements instead.D. He should take extra precautions when standing upbecause of possible orthostatic hypotension and resultinginjury from falls.

D. He should take extra precautions when standing upbecause of possible orthostatic hypotension and resultinginjury from falls.

12. A patient on diuretic therapy calls the clinic because he'shad the flu, with "terrible vomiting and diarrhea," and he hasnot kept anything down for 2 days. He feels weak andextremely tired. What will the nurse advise this patient?A. "It's important to try to stay on your prescribedmedication. Try to take it with sips of water."B. "Stop taking the diuretic for a few days, then restart itwhen you feel better."C. "You will need an increased dosage of the diureticbecause of your illness. Let me speak to the physician."D. "Please come into the clinic for an evaluation to makesure there are no complications."

D. "Please come into the clinic for an evaluation to makesure there are no complications."

Select all that apply:

1. When assessing a patient who is receiving a loop diuretic,the nurse looks for the manifestations of potassiumdeficiency, which would include which symptoms? Select allthat apply.A. DyspneaB. ConstipationC. TinnitusD. Muscle weaknessE. Leg crampsF. Lethargy

D. Muscle weaknessE. Leg crampsF. Lethargy

1. A patient has a deficiency in clotting factors. The nursewill prepare to administer which blood product?A. CryoprecipitateB. Fresh frozen plasmaC. Packed red blood cells (PRBCs)D. Plasma protein fractions

B. Fresh frozen plasma

2. When reviewing the health history of a patient, the nurserecalls that potassium supplements are contraindicated inpatients with a history of which problem?A. BurnsB. DiarrheaC. Renal diseaseD. Cardiac tachydysrhythmias

C. Renal disease

During a blood transfusion, a patient begins to have chillsand back pain. What action will the nurse take first?A. Observe for other symptoms.B. Slow the infusion rate and monitor vital signs.C. Discontinue the infusion immediately and notify thephysician.D. Tell the patient that her symptoms are a normal reactionto the blood product.

C. Discontinue the infusion immediately and notify thephysician.

4. The nurse is preparing to administer intravenouspotassium. Which administration technique is correct?A. The intravenous rate should not exceed 30 mEq/hr.B. Oral forms should be given on an empty stomach tomaximize absorption.C. Intravenous solutions should not contain more than 60mEq/L of potassium.D. When given intravenously, potassium must always begiven in diluted form.

D. When given intravenously, potassium must always begiven in diluted form.

A patient is in an urgent care center and is receivingtreatment for mild hyponatremia after spending a long timedoing gardening work in the heat of the day. The nurseexpects which drug therapy will be used to treat hercondition?A. Oral supplementation of fluidsB. Intravenous bolus of lactated Ringer's solutionC. Normal saline infusion, administered slowlyD. Oral administration of sodium chloride tablets

D. Oral administration of sodium chloride tablets

6. When monitoring a patient for signs of hypokalemia, thenurse looks for what early sign?A. SeizuresB. Cardiac dysrhythmiasC. Stomach crampsD. Muscle weakness

D. Muscle weakness

. During the infusion of albumin, the nurse monitors thepatient closely for the development of which adverse effect?A. HypernatremiaB. Fluid volume deficitC. Fluid volume overloadD. Transfusion reaction

C. Fluid volume overload

8. A patient is receiving an infusion of fresh frozen plasma.The nurse interprets that this patient has which disorder?A. Hypovolemic shockB. AnemiaC. Coagulation disorderD. Previous transfusion reaction

C. Coagulation disorder

The nurse is preparing to transfuse a patient with a unit ofpacked red blood cells (PRBCs). Which intravenous solutionshould be used along with the PRBC transfusion?A. 5% dextrose in water (D5W)B. 0.9% sodium chloride (NS)C. 5% dextrose in 0.9% sodium chloride (D5NS)D. 5% dextrose in lactated Ringer's (D5LR)

B. 0.9% sodium chloride (NS)

The nurse is planning to transfuse a patient with a unit ofpacked red blood cells (PRBCs). Which patient would bebest treated with this transfusion?A. A patient with a coagulation disorderB. A patient with severe anemiaC. A patient who has lost a massive amount of blood afteremergency surgeryD. A patient who has a clotting-factor deficiency

B. A patient with severe anemia

11. After a severe auto accident, a patient has been taken tothe trauma unit and has an estimated blood loss of more than30% of his blood volume. The nurse prepares to administerwhich product?A. Fresh frozen plasmaB. AlbuminC. Packed red blood cellsD. Whole blood

D. Whole blood

12. A patient who is severely anemic also has acute heartfailure with severe edema due to fluid overload. Thephysician wants to improve the patient's anemia. The nurseanticipates that the patient will receive which blood product?A. Fresh frozen plasmaB. AlbuminC. Packed red blood cells (PRBCs)D. Whole blood

C. Packed red blood cells (PRBCs)

Select all that apply:

1. During diuretic therapy, the nurse monitors the fluid andelectrolyte status of the patient. Which are symptoms ofhyponatremia? Select all that apply.A. Red, flushed skinB. LethargyC. Decreased urinationD. HypotensionE. Stomach crampsF. Elevated temperature

B. LethargyD. HypotensionE. Stomach cramps

1. A patient has been prescribed warfarin (Coumadin) inaddition to a heparin infusion. The nurse recognizes that thereason for the two anticoagulants is which of the following?A. The oral and injection forms work synergistically.B. The combination of heparin and an oral anticoagulantresults in fewer adverse effects than heparin used alone.C. Oral anticoagulants are used to reach an adequate level ofanticoagulation when heparin alone is unable to do so.D. Heparin is used to start anticoagulation so as to allowtime for the blood levels of warfarin to reach adequatelevels.

D. Heparin is used to start anticoagulation so as to allowtime for the blood levels of warfarin to reach adequate levels

2. The nurse is preparing to administer dipyridamole(Persantine). Which statement about this drug is true?A. It has antiinflammatory and antipyretic properties.B. It has analgesic properties as well as antithromboticeffects.C. It is useful in reducing the risk for fatal and nonfatalthrombotic stroke.D. It is used with warfarin to prevent postoperativethromboembolic complications.

D. It is used with warfarin to prevent postoperativethromboembolic complications

3. During thrombolytic therapy, the nurse monitors thepatient for adverse effects. What is the most commonundesirable effect of thrombolytic therapy?A. DysrhythmiasB. Nausea and vomitingC. Anaphylactic reactionsD. Internal and superficial bleeding

D. Internal and superficial bleeding

4. A patient has received too much warfarin. The nurse willprepare to give which antidote for warfarin toxicity?A. vitamin EB. vitamin KC. protamine sulfateD. potassium phosphate

B. vitamin K

5. When administering heparin subcutaneously, the nurseshould follow which procedure?A. Aspirating before injecting the medicationB. Massaging the site after injectionC. Applying heat to the injection siteD. Using a 1/2 to 5/8 inch 25- to 28-gauge needle

D. Using a -1/2 to 5/8-inch 25- to 28-gauge needle

6. A patient has been instructed to take one low-dose aspirina day as part of therapy to prevent strokes. The nurse willprovide which instruction when providing patient teachingabout this medication?A. Aspirin should be taken on an empty stomach to ensuremaximal absorption.B. Low-dose aspirin therapy rarely causes problems withbleeding.C. Laboratory studies should be done to monitor liver, renal,and clotting functions.D. Coated tablets may be crushed if necessary.

C. Laboratory studies should be done to monitor liver, renal,and clotting functions.

7. A patient will be receiving a thrombolytic drug as part ofhis treatment for acute myocardial infarction. The nurseexplains to him that this drug is used toA. relieve chest pain.B. prevent further clot formation.C. dissolve the clot in his coronary artery.D. control bleeding in the coronary microcirculation.

C. dissolve the clot in his coronary artery

A patient is receiving an intravenous infusion of heparin.The nurse will monitor which laboratory studies to adjustand monitor the dose of the heparin?A. Bleeding timesB. Activated partial thromboplastin time (aPTT)C. Prothrombin time-international normalized ratio(PT-INR)D. Vitamin K levels

B. Activated partial thromboplastin time (aPTT)

9. The nurse notes in the patient's medication history that thepatient will be starting anticoagulant therapy. Based on thisfinding, the nurse recognizes that the primary goal ofanticoagulant therapy is toA. prevent thrombus formation.B. dissolve an existing thrombus.C. stabilize an existing thrombus.D. prevent the thrombus from becoming an embolus.

A. prevent thrombus formation.

10. A patient is being discharged on anticoagulant therapy.The nurse will include in the patient-education conversationthat it is important to avoid herbal products that containwhich substance?A. ValerianB. GinkgoC. St. John's wortD. Saw palmetto

B. Ginkgo

11. A patient who is taking warfarin (Coumadin) therapy hasa headache and calls the prescriber's office to ask abouttaking a pain reliever. The nurse expects to receive an orderfor which type of medication?A. aspirin tabletsB. ibuprofen (Advil)C. acetaminophen (Tylenol)D. An opioid

C. acetaminophen (Tylenol)

. Nicotinic acid is prescribed for a patient with elevated lipidlevels. The nurse informs the patient that which adverseeffects may occur with this medication?A. Pruritus, cutaneous flushingB. Tinnitus, urine with a burnt odorC. Myalgia, fatigueD. Blurred vision, headaches

Pruritus, cutaneous flushing

2. A patient reports having adverse effects with nicotinicacid. The nurse can suggest that the patient do which of thefollowing to minimize these undesirable effects?A. Take the drug on an empty stomach.B. Take the medication every other day until these effectssubside.C. Take small doses of aspirin 30 minutes before taking thenicotinic acid.D. Take the drug with large amounts of fiber.

C. Take small doses of aspirin 30 minutes before taking thenicotinic acid.

3. A patient calls the clinic office saying that thecholestyramine powder he started yesterday clumps andsticks to the glass when he tries to mix it. The nurse shouldsuggest what method for mixing this medication foradministration?A. The powder dissolves faster in a carbonated soda drink.B. Add it to any liquid and stir vigorously to dissolve itquickly.C. Mix it with food or fruit such as crushed pineapple, or atleast 4 to 6 ounces of fluid.D. Sprinkle the powder into a spoon and take it dry,followed by a glass of water.

C. Mix it with food or fruit such as crushed pineapple, or atleast 4 to 6 ounces of fluid.

4. A patient is concerned about the adverse effects of themedication she is taking to lower her cholesterol level, afibric acid derivative. The adverse effects of this class ofmedication include which of the following?A. ConstipationB. DiarrheaC. Joint painD. Dry mouth

B. Diarrhea

While a patient is receiving antilipemic therapy, the nurseknows to monitor the patient closely for the development ofwhich problem?A. PhotosensitivityB. Pulmonary problemsC. Vitamin C deficiencyD. Liver dysfunction

D. Liver dysfunction

6. When reviewing patients' histories, the nurse recognizesthat which of the following patients would be likelycandidates for drug therapy for cholesterol reduction?A. A patient who has two risk factors and a low-densitylipoprotein (LDL) level of 100 mg/dL, without coronaryheart diseaseB. A patient who has coronary heart disease and an LDLlevel of 100 mg/dLC. A patient who has one risk factor, an LDL level of 170mg/dL, and no history of coronary heart diseaseD. A patient who has coronary heart disease and an LDLlevel of 165 mg/dL

B. A patient who has coronary heart disease and an LDLlevel of 100 mg/dL

A patient tells the nurse that he likes to eat large amounts ofgarlic for its cardiovascular benefits. The nurse reviews hismedication history, and notes that which drug would have apotential interaction with the garlic?A. acetaminophen (Tylenol)B. warfarin (Coumadin)C. digoxin (Lanoxin)D. phenytoin (Dilantin)

B. warfarin (Coumadin)

8. A patient with risk factors for coronary artery disease asksthe nurse about the "good cholesterol" laboratory values.The nurse knows that this term refers to which of thefollowing?A. ChylomicronsB. Low-density lipoproteins (LDLs)C. High-density lipoproteins (HDLs)D. Very-low-density lipoproteins (VLDLs)

C. High-density lipoproteins (HDLs)

9. A patient who has recently started therapy on a statin drugasks the nurse how long it will take until he sees an effect onhis serum cholesterol. Which of the following would be thenurse's best response?A. "Blood levels return to normal within a week ofbeginning therapy."B. "It takes several weeks to see a change in cholesterollevels."C. "It takes at least 6 months to see a change in cholesterollevels."D. "You will need to take this medication for almost a yearto see significant results."

B. "It takes several weeks to see a change in cholesterollevels."

10. The nurse should monitor for muscle pain and possiblemyopathy when a patient is taking which class ofantilipemic drugs?A. Bile acid sequestrantsB. HMG-CoA reductase inhibitorsC. Fibric acid derivativesD. Niacin

B. HMG-CoA reductase inhibitors

11. When teaching a patient who is beginning antilipemictherapy about possible drug-food interactions, the nurseshould discuss which food?A. OatmealB. Grapefruit juiceC. LicoriceD. Dairy products

B. Grapefruit juice

12. The nurse is conducting a class about antilipemic drugs.The newer antilipemic drug ezetimibe (Zetia) works bywhich mechanism?A. Preventing resorption of bile acids from the smallintestinesB. Inhibiting HMG-CoA reductaseC. Activating lipase, which breaks down cholesterolD. Inhibiting cholesterol absorption in the small intestine

D. Inhibiting cholesterol absorption in the small intestine

1. The nurse notes in a patient's medication history that thepatient will be taking desmopressin. Based on this finding,the nurse interprets that the patient has which disorder?A. Diabetes mellitusB. Diabetes insipidusC. Adrenocortical insufficiencyD. Carcinoid tumor

B. Diabetes insipidus (ADH hyposecretion disables thewater-conserving capability of the kidneys; a condition ofchronic polyuria without glucose) Insipidus means withouttaste.

2. A 16-year-old boy who is taking somatropin comes intothe office because he has had an asthma attack during a raceat school. Because of this new development, the nurseexpects which intervention to occur next?A. He should stop participation in school physical educationclasses.B. The somatropin must be discontinued immediately.C. The somatropin dosage may be adjusted.D. His growth should be documented and monitored forchanges.

C. The somatropin dosage may be adjusted

3. When a patient is receiving vasopressin, whichtherapeutic responses would the nurse expect to see?A. Improved appetiteB. Increased serum albumin levelsC. Increased serum potassium levelsD. Decreased urinary output

D. Decreased urinary output

4. A pituitary drug is prescribed for a patient with a hormonedeficiency, and the nurse provides instructions about themedication. Which statement by the patient indicates a needfor further instructions?A. "I will not stop the drug unless my doctor tells me to stopit."B. "I will call my doctor if I have a fever or sore throat."C. "I will have to stop drinking my nightly glass of wine."D. "I am looking forward to a cure for my condition withthis hormone replacement."

D. "I am looking forward to a cure for my condition withthis hormone replacement."

5. An 8-year-old girl has been diagnosed with true pituitarydwarfism. She is being treated with somatropin. Infollow-up visits, the nurse will monitor for which expectedoutcome?A. Increased growthB. Decreased urinary outputC. Increased muscle strengthD. Increased height when she reaches puberty

A. Increased growth

6. When reviewing the medication profile of a patient with anew order for desmopressin, the nurse is aware that whichdrugs may have an interaction with desmopressin?A. AspirinB. DigoxinC. LithiumD. Penicillin

C. Lithium

7. A patient's medication order indicates that he is to receivea dose of cosyntropin. The nurse is aware that this drug isused for what problem?A. Adrenocortical insufficiencyB. Diabetes insipidusC. Myasthenia gravisD. Pituitary dwarfism

A. Adrenocortical insufficiency; life threatening staterequiring immediate medical management. Glucocorticoiddeficiency, a drop in extracellular fluid volume,hyponatremia, and hyperkalemia. "Addisonian crisis"

SELECT ALL THAT APPLY

1. A patient is about to receive a dose of octreotide. Thenurse should assess for which of the followingcontraindications or cautions? Select all that apply.A. Carcinoid crisisB. DiarrheaC. Type 1 diabetes mellitusD. Type 2 diabetes mellitusE. Chronic renal failureF. Esophageal varices

C. Type 1 diabetes mellitusD. Type 2 diabetes mellitusE. Chronic renal failure

1. A patient, newly diagnosed with hypothyroidism,received a prescription for a thyroid hormone replacementdrug. The nurse assesses for which potentialcontraindication to this drug?A. InfectionsB. Diabetes mellitusC. Lupus erythematosusD. Recent myocardial infarction

D. Recent myocardial infarction

2. A patient with hypothyroidism is given a prescription forlevothyroxine. When the nurse explains that this is asynthetic form of the thyroid hormone, he states that heprefers to receive more "natural" forms of drugs. What willthe nurse explain to him about the advantages oflevothyroxine?A. It has a stronger effect than the natural forms.B. Levothyroxine is less expensive than the natural forms.C. The synthetic form has fewer adverse effects on thegastrointestinal tract.D. The half-life of levothyroxine is long enough to permitonce-daily dosing.

D. The half-life of levothyroxine is long enough to permitonce-daily dosing.

3. Levothyroxine has been prescribed for a patient withhypothyroidism. The nurse provides information to thepatient about the medication and tells the patient to contactthe prescriber if which potential adverse effect occurs?A. FatigueB. ConstipationC. PalpitationsD. Drowsiness

C. Palpitations

4. During a teaching session for a patient on antithyroiddrugs, the nurse should discuss which dietary instructions?A. Using iodized salt when cookingB. Avoiding foods containing iodineC. Increasing fluid intake to 2500 mL per dayD. Increasing intake of sodium- and potassium-containingfoods

B. Avoiding foods containing iodine

A patient who is taking propylthiouracil for hyperthyroidismwants to know how this medicine works. What should thenurse explain to her?A. It blocks the action of thyroid hormone.B. It impedes the formation of thyroid hormone.C. It destroys overactive cells in the thyroid gland.D. It inactivates already existing thyroid hormone in thebloodstream.

B. It impedes the formation of thyroid hormone.

6. A 19-year-old college student has been diagnosed withhypothyroidism and has started thyroid replacement therapywith levothyroxine (Synthroid). After 1 week, she calls theclinic to report that she feels no better. The nurse's responseis based on the fact thatA. she will probably require surgery for a cure.B. full therapeutic effects may not occur for 3 to 4 weeks.C. she probably did not take her medication as instructed.D. her diet may be causing absorption problems.

B. full therapeutic effects may not occur for 3 to 4 weeks.

7. When reviewing the drugs taken by a patient who will bestarting thyroid replacement preparations, the nurse notesthat an interaction may occur with which of the followingdrugs?A. Vitamin supplementsB. AntibioticsC. AnticoagulantsD. Beta-blockers

C. Anticoagulants

When monitoring a patient who is taking a thyroidreplacement hormone, which of the following are signs of anexcessively high dose of this drug?A. Bradycardia, somnolence, and ataxiaB. Nervousness, irritability, and palpitationsC. Dry skin, weakness, and weight gainD. Drowsiness, coughing, and neck pain

B. Nervousness, irritability, and palpitations

A patient, newly diagnosed with hypothyroidism, hasreceived a prescription for thyroid replacement therapy. Thenurse should instruct the patient to take this medication atwhich time of day?A. In the morningB. With the evening mealC. At bedtimeD. Whenever the patient experiences symptoms

A. In the morning

10. The nurse is teaching a class about thyroid disease.Which condition is caused by low levels of thyroid hormoneduring youth?A. GoiterB. MyxedemaC. CretinismD. Graves' disease

C. Cretinism

11. A patient has been taking levothyroxine (Synthroid) formore than a decade for primary hypothyroidism. Today shecalls because she has a cousin who can get her the samemedication in a generic form from a pharmaceutical supplycompany. The nurse's best advice would be:A. "This would be a great way to save money."B. "There's no difference in brands of this medication."C. "This should never be done; once you start with a certainbrand, you must stay with it."D. "It's better not to switch brands unless we check withyour doctor."

D. "It's better not to switch brands unless we check withyour doctor."

. A patient has a diagnosis of primary hypothyroidism.Which statement accurately describes this problem?A. The hypothalamus is not secreting thyrotropin-releasinghormone (TRH), therefore thyroid-stimulating hormone(TSH) is not released from the pituitary gland.B. The pituitary gland is dysfunctional and is not secretingTSH.C. The abnormality is in the thyroid gland itself.D. The abnormality is caused by an excess intake of iodine.

C. The abnormality is in the thyroid gland itself.

13. A 19-year-old college student has been diagnosed withhypothyroidism and has started thyroid replacement therapywith levothyroxine (Synthroid). After 6 months, she calls thenurse to say that she feels better and wants to stop themedication. What is the nurse's best response?A. "You can stop the medication if your symptoms haveimproved."B. "You need to stay on the medication for at least a yearbefore a decision about stopping it can be made."C. "You need to stay on this medication until you becomepregnant."D. "Medication therapy for hypothyroidism is necessary forlife, and you should not stop taking the medication."

D. "Medication therapy for hypothyroidism is necessary forlife, and you should not stop taking the medication."

The nurse is administering lispro insulin and should keep inmind that this insulin will start to have an effect withinwhich time frame?A. 15 minutesB. 1 to 2 hoursC. 80 minutesD. 3 to 5 hours

A. 15 minutes

2. When teaching about hypoglycemia, the nurse shouldmake sure that the patient is aware of the early signs ofhypoglycemia, includingA. hypothermia and seizures.B. nausea and diarrhea.C. irritability and confusion.D. fruity, acetone odor to the breath.

C. irritability and confusion.

3. The nurse is teaching a group of patients aboutself-administration of insulin. What teaching is important toinclude?A. Patients should use the injection site that is the mostaccessible.B. During times of illness, patients should increase theirinsulin dosage by 25%.C. When mixing insulins, the cloudy (such as NPH) insulinshould be drawn up into the syringe first.D. When mixing insulins, the clear (such as Regular) insulinshould be drawn up into the syringe first.

D. When mixing insulins, the clear (such as Regular) insulinshould be drawn up into the syringe first.

When monitoring a patient's response to oral antidiabeticdrugs, the nurse knows that the laboratory results that wouldindicate a therapeutic response would be a(n)A. random blood glucose level above 170 mg/dL.B. blood glucose level of less than 50 mg/dL after meals.C. fasting blood glucose level between 70 and 100 mg/dL.D. evening blood glucose level below 70 mg/dL.

C. fasting blood glucose level between 70 and 100 mg/dL.

5. A 75-year-old woman with type 2 diabetes has recentlybeen placed on glyburide, 10 mg daily. She asks the nursewhen the best time would be to take this medication. What isthe nurse's best response?A. "Take this medication in the evening, with a snack."B. "Take this medication in the morning, 30 minutes beforebreakfast."C. "This medication should be taken after the midday meal."D. "It does not matter what time of day you take thismedication."

B. "Take this medication in the morning, 30 minutes beforebreakfast."

A patient who has type 2 diabetes is scheduled for acolonoscopy and has been NPO (nothing by mouth) sincemidnight. She is concerned because her medications arebeing held. What is the best action regarding theadministration of her oral antidiabetic drugs?A. Giving her half the original doseB. Withholding all medications as orderedC. Contacting the prescriber for further ordersD. Giving her the medication with a sip of water

C. Contacting the prescriber for further orders

7. The nurse is reviewing instructions for a patient with type2 diabetes who also gives herself insulin injections as part ofthe therapy. The nurse asks the patient, "What should you doif your fasting blood glucose is 47 mg/dL?" Which responseby the patient is correct?A. "I will call my doctor right away."B. "I will give myself the Regular insulin."C. "I will take an oral form of glucose."D. "I will rest until the symptoms pass."

C. "I will take an oral form of glucose."

The nurse is teaching patients about self-injection of insulin.Which statement is true regarding injection sites?A. Avoid the abdomen because absorption there is irregular.B. Choose a different site at random for each injection.C. Give the injection in the same area each time to promoteconsistent absorption.D. Rotate sites within the same location for about 1 weekbefore rotating to a new location.

D. Rotate sites within the same location for about 1 weekbefore rotating to a new location.

9. The nurse is administering rapid-acting insulin. Whichstatement is true regarding its administration?A. It should be given within 15 minutes of the patientbeginning a meal.B. It should be given after the meal has been completed.C. It is administered once daily at the time of the middaymeal.D. It is taken only in the evenings with a snack beforebedtime.

A. It should be given within 15 minutes of the patientbeginning a meal.

10. After starting treatment for type 2 diabetes mellitus 6months earlier, a patient is in the office for a follow-upexamination. Which laboratory test will best reflect thepatient's adherence to the antidiabetic therapy over the pastfew months?A. Hemoglobin levelsB. Hemoglobin A1C levelC. Fingerstick fasting blood glucose levelD. Serum insulin levels

B. Hemoglobin A1C level

11. A patient in the emergency department was showingsigns of hypoglycemia and had a fingerstick glucose level of34 mg/dL. He has