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pharm test 8
| Question | Answer |
|---|---|
| A patient at increased risk for thromboembolic disorders will begin taking a progestin-only oral contraceptive. Which statement by the patient indicates understanding of how this oral contraceptive works? | “I will need to use backup contraception if I miss a pill.” |
| A patient calls a family planning clinic and tells the nurse that her vaginal ring, which has been in place for 2 weeks, came out sometime during the night while she was sleeping. The nurse will instruct her to: | clean the ring with warm water, reinsert it, and use condoms for 7 days. |
| A patient is taking a combination oral contraceptive (OC) and reports breast tenderness, edema, and occasional nausea. What will the nurse recommend? | The patient should request an OC containing less estrogen. |
| A nurse provides teaching to a woman who is taking tranexamic acid (Lysteda) for menorrhagia. Which statement by the patient indicates a need for further teaching? | “I should take an oral contraceptive to prevent pregnancy while taking this drug.” |
| An adolescent female pt w/ multiple sexual partners asks a nurse about birth control methods. Patient tells the nurse she tried oral contraceptives once but often forgot to take her pills. Nurse will recommend discussing which contracept with the provider | DMPA (Depo-Provera) and condoms |
| pregnant patient is being induced with oxytocin, which has been infusing for 1 hour. The initial rate was 6 milliunits/min, and the rate now is 18 milliunits/min. Nurse notes regular contractions occurring every 3 mins, each lasting 35 sec. The nurse will | increase the rate of infusion by 3 to 6 milliunits/min every 15 to 40 minutes. |
| A patient in preterm labor is receiving intravenous magnesium sulfate at a rate of 1 gm/hr. The woman reports headache and dizziness. Her blood pressure is 90/60 mm Hg. What will the nurse do? | Tell the patient not to get up without assistance. |
| Postpartum pt is receiving ergonovine maleate (Ergotrate) to prevent hemorrhage. Nurse assesses pt an notes heart rate of 76 beats/min, a respir rate of 16 breath/mi, a blood pressure of 120/80 mm Hg.pt’s uterus is firm. The pt complains of mild/moderate | Continue to monitor and tell the patient to report increased cramping. |
| A nurse is teaching a community education class on contraceptives. The nurse tells the class that if spermicides containing nonoxynol-9 are used, the patient should take special precautions, because these spermicides have been linked to: | increased transmission of the human immunodeficiency virus (HIV). |
| A nurse is teaching a community education class on contraceptives. The nurse tells the class that if spermicides containing nonoxynol-9 are used, the patient should take special precautions, because these spermicides have been linked to: | increased transmission of the human immunodeficiency virus (HIV). |
| A patient who is having her sixth child has gone beyond term, and her labor is being induced with oxytocin (Pitocin). The pt is having increased frequency, duration, and intensity of contractions. Nurse will interrupt the oxytocin infusion if what occurs | Individual contractions last 2 minutes. |
| A nurse is discussing various ways to obtain a medical abortion with a patient. Which statement by the patient best demonstrates understanding of mifepristone (RU 486) (Mifeprex)? “This drug is most effective if I use it: | within 7 weeks of conception.” |
| A pt is in preterm labor, the prescriber orders magnesium sulfate for its neuroprotective effect on the fetus. The order calls for 4 gm given as an intravenous bolus over 20 minutes, followed by a maintenance infusion of 2 gm/hr. What will the nurse do? | Question the maintenance amount. |
| A patient who is taking a combination oral contraceptive begins taking carbamazepine. After several weeks, the patient tells the nurse she has begun experiencing spotting during her cycle. What will the nurse tell her to do? | Discuss an oral contraceptive with increased estrogen. |
| A nurse is teaching an adolescent female patient about 28-day monophasic combination oral contraceptives. The provider has instructed the pt to begin taking the pills on the first Sunday after the onset of her next period. What will the nurse tell the pt? | “Use another form of contraception for the next month.” |
| A nurse working in a family planning clinic is teaching a class on intrauterine devices (IUDs). Which patient should be advised against using an IUD for contraception? | An 18-year-old woman with multiple sexual partners |
| A patient calls the nurse to report that she forgot to take a combination OC pill during the third week of her cycle. She tells the nurse that she missed another pill earlier that week. The nurse will tell her to: | take a pill now, continue the pack, skip the placebo pills, and start a new pack on week 4. |
| A patient is admitted to the obstetric unit in preterm labor at 36 weeks’ gestation. The prescriber orders a tocolytic agent. When teaching the patient about this medication, the nurse will tell her that tocolytics: | help delay delivery while glucocorticoids are given. |
| A pt has just purchased a 1-year supply of 28-day-cycle oral contraceptives. She tells the nurse she wishes she had planned things better, because she has calculated that her period will begin during her upcoming honeymoon. What will the nurse suggest? | She should discard the inert pills and start a new pack during the honeymoon. |
| A patient has been experiencing side effects with a combination oral contraceptive, and her provider has ordered a different combination product. The nurse will instruct the patient to do what? | Change products at the beginning of her next cycle. |
| A pt has 2 doses of dinoprostone (Prepidil) to initiate labor. been 6 hrs since last dose. Nurse assesses pt and notes that the cervix is ripe and dilated to 4 cm, but contractions are dimin in intensity and frequency. What will the nurse expect to do? | Administer oxytocin. |
| A 12-year-old male patient diagnosed with hypogonadism will begin testosterone injections. What will the nurse include when teaching the family about this therapy? | Injections are given every 2 to 4 weeks for 3 to 4 years. |
| A nurse is teaching a male adult patient about the use of testosterone gel. Which statement by the patient indicates an understanding of the teaching? | “I should not let my child touch the gel to prevent behavioral problems.” |
| A 68-year-old male patient receives a prescription for 25-mg tablets of sildenafil (Viagra) for erectile dysfunction. When he asks the nurse how to take the medication, the nurse will tell him to: | start with one tablet about 1 hour before anticipated sexual activity. |
| A nurse is obtaining a history and reviewing the chart of an adult male patient who has been taking oral androgens. Which assessment would warrant notifying the provider? | Nausea, anorexia, and fatigue |
| A patient who has erectile dysfunction asks a nurse whether sildenafil (Viagra) would be a good medication for him to take. Which aspect of this patient’s history would be of most concern? | Occasional use of nitroglycerin |
| A female patient who swims competitively admits to using anabolic steroids to increase her muscle mass and improve her performance. What will the nurse tell this patient? | The risk of liver disease will increase. |
| A nurse is obtaining a history from a patient who will receive tadalafil (Cialis) for erectile dysfunction. The patient reports that he expects to have sexual activity three or four times a week. What should the nurse tell the patient? | He should talk to his provider about daily dosing of tadalafil. |
| A clinic nurse is assessing an adolescent male patient who has been receiving androgen therapy for hypogonadism via a transdermal patch. The pt’s last clinic visit was 4 weeks earlier. Which part of the interval history is of most concern to the nurse? | Five pound weight gain |
| A pt w/ history of BPH admitted to the unit. pt is taking multiple medications, including terazosin (Hytrin). During evening rounds, pt begins to complain of dizziness an nasal congestion. Upon assessment, the pt is somnolent / has a bp of 101/42 mm Hg. N | adverse effects. |
| An adolescent male patient is beginning androgen therapy for delayed puberty. His parents ask the nurse when this treatment may be stopped. The nurse will offer which response? | When testicular enlargement occurs |
| 14-yr M pt who plays football is admitted to the hospital. Nurse notes the pt has short for his age according to standard growth chart. pt is muscular, has a deep voice, and needs to shave. Nurse notifies the provider of these findings. Which test will n | Liver function tests and serum cholesterol |
| male pt tells nurse he awakens 1-2x's a night to void and has difficulty starting his stream of urine. describes these symptoms as annoying. Pt’s provider examines him and notes the prostate is moderately enlarged. pt is sexually active an tells nurse tha | doxazosin (Cardura). |
| A male pt is being treated for (BPH) by another provider but cannot rem. which drug he is taking. He comes to the clinic seeking treatment for erectile dysfunction and receives a prescription for sildenafil (Viagra). What will the nurse teach this pt? | “You should not take sildenafil if you are taking silodosin (Rapaflo).” |
| A nurse is providing education to a patient who is beginning therapy with testosterone gel. What statement made by the patient demonstrates a need for further teaching? | “I should apply the entire contents of the packet to my genitals.” |
| An adult male patient will begin androgen therapy for testicular failure. Which statement by the patient indicates understanding of the treatment regimen? | “My libido may improve while I am taking this medication.” |
| 14-yr male pt has not begun puberty. His parents tella nurse that their son does not want to go to school, because he gets teased. nurse learns that the boy’s dad did not begin puberty until 16 years. Lab tests on child do not reveal true hypogonadism. Wh | “A limited course of androgen therapy may be prescribed, but it is not necessary.” |
| A nurse provides teaching for a female patient with anemia who has had cancer chemotherapy and who will begin treatment with testosterone. Which statement by the patient indicates understanding of the teaching? | “Testosterone treats anemia by stimulating the synthesis of a renal hormone.” |
| Tadalafil (Cialis) was prescribed 4 weeks ago for a patient with erectile dysfunction. The patient also takes prazosin (Minipress) for hypertension. Which statement by the patient best demonstrates understanding of the use of tadalafil (Cialis)? | “I should take this medication no more than once a day.” |
| A nurse is teaching a patient about the use of sildenafil (Viagra) for erectile dysfunction. Which statement by the patient indicates understanding of the teaching? | “If my erection lasts longer than 4 hours, I should contact my provider.” |
| A provider has ordered intravenous promethazine (Phenergan) for an adult patient postoperatively to prevent nausea and vomiting (N/V). What will the nurse do? | Ensure that the IV is infusing freely through a large-bore needle. |
| A patient who takes aspirin for rheumatoid arthritis is admitted to the hospital complaining of headache and ringing in the ears. The plasma salicylate level is 300 mcg/mL, and the urine pH is 6.0. What will the nurse do? | Withhold the aspirin until the patient’s symptoms have subsided. |
| A prescriber orders hydroxyzine (Vistaril) for a patient with acute urticaria. The nurse will include which information when teaching the patient about this drug? | The patient should avoid drinking alcohol while taking the drug. |
| A patient tells the nurse that she takes aspirin for menstrual cramps, but she does not feel that it works well. What will the nurse suggest? | The patient should use a first-generation nonsteroidal anti-inflammatory medication instead. |
| A patient who takes daily doses of aspirin is scheduled for surgery next week. The nurse should advise the patient to: | stop using aspirin immediately. |
| A patient who has chronic allergies takes loratadine (Claritin) and develops a severe reaction to bee stings. The patient asks the nurse why the antihistamine did not prevent the reaction. What will the nurse say? | “Allergy symptoms that are severe are caused by mediators other than histamine.” |
| A nurse is providing teaching for an adult patient with arthritis who has been instructed to take ibuprofen (Motrin) for discomfort. Which statement by the patient indicates a need for further teaching? | “I may experience tinnitus with higher doses of this medication.” |
| An adolescent is brought to the emergency department by a parent who reports that the patient took a whole bottle of extended-release acetaminophen tablets somewhere between 8-10 hours ago. The nurse will anticipate administering which of the following? | Acetylcysteine (Mucomyst) |
| A nurse is teaching a nursing student who wants to know how aspirin and nonaspirin first-generation NSAIDs differ. Which statement by the student indicates a need for further teaching? | “Unlike aspirin, first-generation NSAIDs do not carry a risk of hypersensitivity reactions.” |
| An 18-month-old child develops an urticarial reaction after a transfusion. The prescriber orders intravenous promethazine (Phenergan). What will the nurse do? | Question the order. |
| A 5-yr child is brought to the emergency department after ingesting diphenhydramine (Benadryl). The child is uncoordinated and agitated. The nurse observes that the child’s face is flushed and that the hr is 110 beat per minute. The nurse will expect to: | give activated charcoal to absorb the drug. |
| A nurse is teaching a group of nursing students about cyclooxygenase inhibitors. Which statement by a student indicates understanding of the teaching? | “Cyclooxygenase-2 is considered the ‘bad COX.’” |
| A nurse is teaching a group of nursing students about antihistamines. Which statement by a student indicates an understanding of the mechanism of action of the antihistamines? | “Antihistamines block H1 receptors to prevent actions of histamine at these sites.” |
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