- Where would the procedures and treatments directed by the health care provider be found?
| A. | Summary sheet |
| B. | Physician’s order form |
| C. | Physician’s progress notes |
| D. | History and physical examination form |
ANS: B
| Feedback |
| A | A summary sheet provides a brief overview of the hospital course at discharge. |
| B | The physician’s order form contains all procedures and treatments ordered by the health care provider. |
| C | Physician’s progress notes provide regular observations on the patient’s course of treatment and response. |
| D | A history and physical examination form provides information about baseline information from the patient. |
DIF: Cognitive Level: Knowledge REF: 82
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Safe, Effective Care Environment
- Which action will the nurse take when it is determined that the narcotic count is incorrect while obtaining a medication from the narcotic area?
| A. | Determine the cause of the discrepancy at the end of the shift. |
| B. | Notify the health care provider stat. |
| C. | Call the nurse from the previous shift to determine if there was a discrepancy earlier. |
| D. | Report the discrepancy to the charge nurse immediately. |
ANS: D
| Feedback |
| A | The discrepancy needs to be addressed immediately, and therefore this is not the most appropriate action for the nurse to take. |
| B | It is not appropriate to contact the health care provider for an incorrect narcotic count. |
| C | The count would have been verified at shift change; this is not an appropriate action for the nurse to take. |
| D | Reporting the discrepancy to the charge nurse immediately enables the supervisory staff to narrow the time frame during which a medication was taken and not documented. |
DIF: Cognitive Level: Analysis REF: 98
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Safe, Effective Care Environment
- Which action will the nurse take if a dosage is unclear on a health care provider’s order?
| A. | Ask the patient what dosage was given in the past. |
| B. | Ask another physician to determine the correct dosage. |
| C. | Tell the patient that the medication will not be given. |
| D. | Contact the health care provider to verify the correct dosage. |
ANS: D
| Feedback |
| A | The patient is not a reliable source of verification. |
| B | The physician who wrote the order should verify it. |
| C | It would be a medication error to withhold the dose instead of verifying it. |
| D | Any questionable orders should be verified by the health care provider who wrote the orders. |
DIF: Cognitive Level: Application REF: 102
TOP: Nursing Process Step: Planning
MSC: NCLEX Client Needs Category: Physiological Integrity
- What is the most reliable method to calculate a pediatric patient’s medication dosage?
| A. | Age |
| B. | Height |
| C. | Body surface area (BSA) |
| D. | Placement on a growth scale |
ANS: C
| Feedback |
| A | Due to the differences in weight among children, age is not a reliable method. |
| B | Due to the differences in height among children, this is not a reliable method. |
| C | The most reliable method is by proportional amount of body surface area or body weight. |
| D | Placement on a growth scale identifies how the child corresponds to other children on a percentile. Although it is determined by a specific measurement, the percentile identified would not be a specific measurement; therefore, this is not a reliable method. |
DIF: Cognitive Level: Comprehension REF: 104
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
- Which medication route provides the most rapid onset of a medication, but also poses the greatest risk of adverse effects?
| A. | Intradermal |
| B. | Subcutaneous |
| C. | Intramuscular |
| D. | Intravenous |
ANS: D
| Feedback |
| A | Intradermal administration has a slower absorption rate. |
| B | Subcutaneous administration has a slower absorption rate. |
| C | Intramuscular administration has a slower absorption rate. |
| D | Intravenous medications are delivered directly into the bloodstream and avoid the “first pass” effect of the liver. |
DIF: Cognitive Level: Knowledge REF: 104-105
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
- Which is known as the “fifth vital sign”?
| A. | Temperature |
| B. | Respirations |
| C. | Pain |
| D. | Pulse |
ANS: C
| Feedback |
| A | Temperature is not known as the “fifth vital sign.” |
| B | Respirations are not known as the “fifth vital sign.” |
| C | Pain is known as the “fifth vital sign.” |
| D | Pulse is not known as the “fifth vital sign.” |
DIF: Cognitive Level: Knowledge REF: 86
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
- Which is true regarding the unit dose drug distribution system?
| A. | The inventory is delivered to each nursing unit on a regular and recurring basis. |
| B. | The system delivers one dose of each medication to be administered until the subsequent delivery of inventory. |
| C. | The use of single-dose packages of drugs dispensed to fill each dose requirement as it is ordered. |
| D. | The amount of inventory needed to dose all patients on the unit for a 24-hour interval. |
ANS: C
| Feedback |
| A | This is not the unit dose system. |
| B | This is not the unit dose system. |
| C | The unit dose drug distribution system uses single-unit packages of drugs dispensed to fill each dose requirement as it is ordered. |
| D | This is not the unit dose system. |
DIF: Cognitive Level: Comprehension REF: 94
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
- The nursing assessment identifies that the client is nauseated and cannot take acetaminophen (Tylenol) orally. Which is true regarding the substitution of this medication to suppository form?
| A. | It is standard practice when the patient is unable to take the ordered medication. |
| B. | It is acceptable if the patient agrees to the altered route form. |
| C. | It is preferable to having the patient miss a dose of the medication. |
| D. | It is contraindicated without an order from the health care provider. |
ANS: D
| Feedback |
| A | The substitution of one form for another is not standard practice. |
| B | The substitution of one form for another is not acceptable without the prescriber’s order. |
| C | The substitution of one form for another is not preferable without the prescriber’s order. |
| D | One dosage form of medication should never be substituted for another unless the prescriber is consulted; there can be a great variation in the absorption rate of the medication through different routes of administration. |
DIF: Cognitive Level: Application REF: 104
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
- Which medication order requires nursing judgment and means “administer if needed”?
| A. | Morphine 4 mg IV stat |
| B. | Morphine 4 mg IV prior to procedure |
| C. | Morphine 4 mg IV four times a day |
| D. | Morphine 4 mg IV every 4 hours PRN |
ANS: D
| Feedback |
| A | The dose of morphine would be given immediately, not as needed |
| B | The dose of morphine would be given prior to the patient’s scheduled procedure. |
| C | The dose of morphine is given four times a day, not as needed. |
| D | PRN indicates for the nurse to administer morphine every 4 hours if needed and requires nursing judgment. |
DIF: Cognitive Level: Comprehension REF: 100
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
- What is medication reconciliation?
| A. | Comparing the patient’s current medication orders to all of the medications actually being taken |
| B. | The administration of high-alert medications that have been ordered on admission to an acute care facility |
| C. | The completion of an incident report following a variance that resulted in a serious complication |
| D. | A printout of computerized patient data that identifies the times that all of the ordered medications are to be administered |
ANS: A
| Feedback |
| A | Medication reconciliation is the process of comparing a patient’s current medication orders to all of the medications that the patient is actually taking. |
| B | Administering high-alert medications is not the same as medication reconciliation. |
| C | Completing an incident report is not the same as medication reconciliation. |
| D | A printout of computerized patient data that identifies the times that all of the ordered medications are to be administered is a description of the medication administration record (MAR), not a description of medication reconciliation. |
DIF: Cognitive Level: Knowledge REF: 101
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
- Which example best demonstrates safe drug administration by the nurse?
| A. | Administering an oral medication with the patient sitting upright |
| B. | Asking children to say their name before administering the medication |
| C. | Leaving the medications on the bedside stand after verifying patient identification |
| D. | Returning unused portion of a medication to a stock supply bottle |
ANS: A
| Feedback |
| A | Sitting the patient upright for oral medications is safe medication practice. |
| B | Children should never be asked their names as a means of positive identification. |
| C | Remaining with a patient until the drug is swallowed is safe practice. |
| D | Returning an unused portion of medication to the stock supply bottle is not safe medication practice. |
DIF: Cognitive Level: Application REF: 106
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
- The nurse determines that a prescribed medication has not been administered as ordered on the previous shift. What action will the nurse take?
| A. | Administer the medication immediately. |
| B. | Complete an incident report. |
| C. | Notify the nurse responsible for the error. |
| D. | Record the occurrence in the nurse’s notes. |
ANS: B
| Feedback |
| A | Depending on the medication and frequency of administration, the medication may not be given immediately. |
| B | An incident report is completed when a medication error occurs. |
| C | It is not the nurse’s responsibility to notify another nurse of the error. |
| D | Medication errors are not recorded in the nurse’s notes. |
DIF: Cognitive Level: Application REF: 105
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
MULTIPLE RESPONSE
- Who defines the standards of care for the practice of nursing? (Select all that apply.)
| A. | State boards of nursing |
| B. | Hospital policy and procedures |
| C. | Federal laws regulating health care |
| D. | The Joint Commission |
| E. | Professional nursing associations |
ANS: A, C, D
| Feedback |
| Correct | Standards of care are defined by state boards of nursing.
Standards of care are defined by federal laws regulating health care facilities.
Standards of care are defined by The Joint Commission.
Standards of care are defined by professional nursing associations such as the American Nurses Association. |
| Incorrect | Individual hospital policies and procedures incorporate federal and state guidelines into their respective policy and procedures and are often more stringent than state and federal regulations. |
DIF: Cognitive Level: Knowledge REF: 81
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Safe, Effective Care Environment
- Which must the nurse have before administering any medication? (Select all that apply.)
| A. | A current license to practice |
| B. | A medication order signed by a practitioner licensed with prescription privileges |
| C. | Knowledge of the medication |
| D. | Consultation with a pharmacist |
| E. | Knowledge of the client’s diagnosis |
ANS: A, B, C
| Feedback |
| Correct | Physicians must be licensed to prescribe medications; nurses must be licensed to administer medications.
Physicians must be licensed to prescribe medications; nurses must be licensed to administer medications.
Safe medication administration includes knowledge of the medication.
Safe medication administration includes knowledge of the pathophysiology of patient diagnoses and pharmacodynamics of the ordered medication on the pathophysiology. |
| Incorrect | It is not necessary for the nurse to consult with a pharmacist each time medication is to be administered to a patient. |
DIF: Cognitive Level: Comprehension REF: 81
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Safe, Effective Care Environment
- Which advantages does the unit dose drug distribution system include? (Select all that apply.)
| A. | There is decreased participation by the pharmacy. |
| B. | The pharmacist is able to analyze prescribed medications for each client for drug interactions and contraindications. |
| C. | There is less waste of medications. |
| D. | The time spent by nursing personnel preparing these medications is increased. |
| E. | Credit is given to the patient for unused medications. |
ANS: B, C, E
| Feedback |
| Correct | Because the pharmacist has a profile of all medications for each patient, he or she is able to analyze prescribed medications for each patient for drug interactions and contraindications. This is an advantage of the unit dose drug distribution system.
Less waste of medications is an advantage of the unit dose drug distribution system.
Because each dose is individually packaged, credit can be given to the patient for unused medications. |
| Incorrect | There is increased pharmacist involvement and better use of his or her extensive drug knowledge.
Nursing personnel time is decreased with this method. |
DIF: Cognitive Level: Knowledge REF: 94 | 96
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Safe, Effective Care Environment
- Which statements are true regarding the types of medication orders? (Select all that apply.)
| A. | Stat orders are the same as single-dose orders. |
| B. | Standing orders indicate the number of specified doses a medication is to be given. |
| C. | Renewal orders facilitate physician review before continuance of high-risk medications. |
| D. | PRN medications will designate a mandatory number of times the medication is to be administered. |
| E. | Verbal orders should be used as much as possible. |
ANS: B, C
| Feedback |
| Correct | Standing orders state the frequency of medication dosages to be administered or indicate the time frame of administration.
Renewal orders require the physician to review medications that have “expired orders” as determined by facility policy. Renewal policies facilitate physician verification of the necessity to continue a medication beyond a “usual” time frame and help ensure patient safety. |
| Incorrect | Single-dose and stat orders are not the same.
PRN medications are not ordered a mandatory number of times, although a maximum number might be specified.
Verbal orders should be avoided whenever possible. |
DIF: Cognitive Level: Comprehension REF: 100
TOP: Nursing Process Step: Planning
MSC: NCLEX Client Needs Category: Physiological Integrity
- Which statements are true regarding computerized prescriber order entry (CPOE)? (Select all that apply.)
| A. | Integrates the ordering system with the pharmacy, laboratory, and nurses’ stations |
| B. | Provides instant access to online information to facilitate patient care needs |
| C. | Facilitates review of ordered medications for potential drug interactions |
| D. | Facilitates review of drugs for appropriateness of dosages |
| E. | Alleviates the need to perform mathematical computations |
ANS: A, B, C
| Feedback |
| Correct | Computerized prescriber order entry systems integrate patient information.
Computerized prescriber order entry systems provide instant access.
Computerized prescriber order entry systems facilitate this process.
Computerized prescriber order entry systems facilitate this process. |
| Incorrect | Alleviation of the need to perform mathematical computations is not a component of the computerized prescriber order entry system. |
DIF: Cognitive Level: Knowledge REF: 101
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity; Safe, Effective Care Environment
- Which lab tests are used to assess liver and/or renal function before administering medications? (Select all that apply.)
| A. | CBC |
| B. | LDH |
| C. | ALT |
| D. | Crs |
| E. | BUN |
| F. | APTT |
ANS: B, C, D, E
| Feedback |
| Correct | Liver function tests include LDH (lactic dehydrogenase).
Liver function tests include ALT (alanine aminotransferase).
Renal function tests include Crs (serum creatinine).
Renal function tests include BUN (blood urea nitrogen). |
| Incorrect | Although a CBC is useful in assessing the patient before administration of medication, it is not a renal or hepatic function test.
Although an APTT is useful in assessing the patient before administration of medication, it is not a renal or hepatic function test. |
DIF: Cognitive Level: Knowledge REF: 104
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
Clayton: Basic Pharmacology for Nurses, 15th Edition
Chapter 9: Enteral Administration
Test Bank
MULTIPLE CHOICE
- In which position would the nurse place a patient before the administration of an enteral feeding?
| A. | Supine |
| B. | Semi-Fowler’s |
| C. | Left lateral |
| D. | Prone |
ANS: B
| Feedback |
| A | Aspiration is a risk during enteral feedings in this position. |
| B | To facilitate gastric emptying, the patient should be placed in a semi-Fowler’s position (30-degree head-of-bed [HOB] elevation) for 30 minutes before the start of the feeding. |
| C | Aspiration is a risk during enteral feedings in this position. |
| D | This position would prevent gastric emptying and increase the risk of aspiration. |
DIF: Cognitive Level: Application REF: 136
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
- Which type of lubricant would the nurse use to administer a rectal suppository?
| A. | Petroleum jelly |
| B. | Mineral oil |
| C. | Water-soluble |
| D. | Anesthetic |
ANS: C
| Feedback |
| A | Petroleum-based lubricants can harbor bacteria and promote infection. |
| B | Petroleum-based lubricants can harbor bacteria and promote infection. |
| C | Water-soluble lubricants should be used with rectal suppository administration. When not available, water can be used to moisten mucosal surfaces. |
| D | Unless the patient has pain in the rectal area (in which case another route of administration should be considered), anesthetic should not be required. |
DIF: Cognitive Level: Knowledge REF: 138
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
- Which is a characteristic of medication administration via the rectal route?
| A. | Irritation of the mouth |
| B. | Nausea and vomiting |
| C. | Bypassing of the digestive enzymes |
| D. | Use of the first-pass metabolism |
ANS: C
| Feedback |
| A | Rectal administration bypasses the oral cavity. |
| B | Rectal administration does not affect the gag reflex or upset the stomach. |
| C | Rectal administration bypasses the digestive enzymes because the medication is absorbed directly into the bloodstream. |
| D | Rectal administration bypasses first-pass metabolism. |
DIF: Cognitive Level: Knowledge REF: 126
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
- Which medications are provided in dried, powdered form compressed into small disks?
| A. | Pills |
| B. | Capsules |
| C. | Tablets |
| D. | Lozenges |
ANS: C
| Feedback |
| A | Pills are an obsolete dose form that is no longer manufactured as a result of the development of capsules and compressed tablets. |
| B | Capsules are small cylindrical gelatin containers that hold dry powder or liquid medicine. |
| C | Tablets are dried, powdered drugs that have been compressed into small disks. |
| D | Lozenges are small aromatic medicated candies, such as cough drops. |
DIF: Cognitive Level: Comprehension REF: 127
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
- Which action by the nurse is appropriate when administering enteric-coated tablets?
| A. | Administer with an antacid. |
| B. | Crush the tablet and mix with applesauce. |
| C. | Encourage the patient to drink a full glass of water. |
| D. | Instruct the patient to place the medication between the cheek and teeth. |
ANS: C
| Feedback |
| A | Administering with an antacid would alter the dissolution of the enteric-coated tablet because it has a coating that resists dissolution in the acidic pH of the stomach but is dissolved in the intestines. |
| B | Enteric-coated tablets must not be crushed. |
| C | Drinking a full glass of water ensures the medication reaches the stomach and is diluted to decrease the potential for irritation. |
| D | Enteric-coated tablets must be swallowed. |
DIF: Cognitive Level: Application REF: 131
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
- Which route of administration would be ordered by the health care provider if a patient is vomiting?
| A. | Gastrostomy tube |
| B. | Intradermal |
| C. | Ophthalmic |
| D. | Rectal |
ANS: D
| Feedback |
| A | Gastrostomy is used for patients who cannot swallow or have had oral surgery; drugs administered by this route would be placed in the gastrointestinal tract and are inappropriate for the patient with vomiting. |
| B | Intradermal routes are used for allergy testing. |
| C | Ophthalmic medications are for use in the eye. |
| D | The rectal route is a good alternative when nausea or vomiting is present. |
DIF: Cognitive Level: Application REF: 126
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
- After entering the patient’s room to administer oral medications, which action will the nurse take first?
| A. | Assist the patient to sit upright. |
| B. | Check the patient’s identification. |
| C. | Inform the patient about the medications. |
| D. | Offer the patient something to drink. |
ANS: B
| Feedback |
| A | Assisting the patient to sit upright is appropriate when administering oral medications, but this is not the first thing the nurse would do. |
| B | Checking the patient’s identification is the first nursing action once at the bedside. |
| C | Providing information about medications is appropriate, but it is not the first thing the nurse would do. |
| D | Offering the patient something to drink to facilitate swallowing of medications is appropriate, but it is not the first thing the nurse would do. |
DIF: Cognitive Level: Application REF: 130
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
MULTIPLE RESPONSE
- Oral drug administration includes which principles? (Select all that apply.)
| A. | Dependable rate of absorption |
| B. | Most economical |
| C. | Insulin can be administered via this route. |
| D. | Drugs are delivered directly by the oral, rectal, or NG methods. |
| E. | Dosage forms are convenient and readily available. |
ANS: B, E
| Feedback |
| Correct | Oral administration is the most economical.
Oral administration is convenient and readily available.
|
| Incorrect | Absorption from oral medications can vary depending on many factors.
Insulin cannot be administered via the oral route.
In oral drug administration, drugs are only delivered via the oral route. |
DIF: Cognitive Level: Comprehension REF: 126
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
- The nurse is administering an oral medication to a 90-year-old patient who has difficulty swallowing pills. One of the medications to be administered is a spansule-type capsule. What nursing considerations are important in this case? (Select all that apply.)
| A. | Wash hands before preparing medications and before administration. |
| B. | Crush medications and administer with a soft food such as applesauce. |
| C. | Check the patient’s ID band with the MAR to ensure patient rights are followed. |
| D. | Have an 8-ounce glass of water available. |
| E. | Check with the pharmacist to see if the spansule medication comes in a liquid form. |
ANS: A, C, D, E
| Feedback |
| Correct | Hands should be washed before and after medication preparation.
Always check the patient’s identification before administering medication.
Have water available to the patient when administering this medication.
Giving the medication in liquid form, if available, would be much more comfortable for the patient. |
| Incorrect | Spansule medications are time-released and should not be crushed. |
DIF: Cognitive Level: Application REF: 127-130
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
- Which are common receptacles used in the hospital with pediatric oral medications? (Select all that apply.)
| A. | Oral syringe |
| B. | Baby bottle full of formula |
| C. | Infant feeding nipple |
| D. | Teaspoon |
| E. | Medicine dropper |
ANS: A, C, E
| Feedback |
| Correct | An oral syringe or plastic medicine cup would be most accurate.
An infant feeding nipple is commonly used for pediatric patients.
A medicine dropper may be used to administer medications to pediatric patients. |
| Incorrect | A full bottle of formula is too large a volume in which to administer medication.
A teaspoon does not minimize the risk of spilling when administering medication to a pediatric patient. |
DIF: Cognitive Level: Comprehension REF: 133-134
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
- Which data will the nurse document when administering a PRN oral pain medication to a patient? (Select all that apply.)
| A. | Date, time, drug name, dosage, and route of administration |
| B. | Essential patient education about the drug completed |
| C. | Administration receptacle used |
| D. | Signs and symptoms of adverse drug effects |
| E. | Evaluation of therapeutic effectiveness |
ANS: A, B, D, E
| Feedback |
| Correct | These items are included in the six rights of medication administration.
The patient should be educated about the drug being administered.
The nurse should observe for adverse drug effects.
Evaluating the drug’s therapeutic effectiveness is important. |
| Incorrect | Unless the receptacle used is unusual, it does not need to be noted. |
DIF: Cognitive Level: Comprehension REF: 134
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
- Nasogastric medication administration includes which principles? (Select all that apply.)
| A. | The tube must be assessed for correct placement. |
| B. | All medications can be combined into one syringe. |
| C. | Tablets and capsules should be dissolved in water. |
| D. | The suction source should be immediately reconnected. |
| E. | Flush the tube with 30 mL of water after drug administration. |
ANS: A, C, E
| Feedback |
| Correct | It is essential to verify correct placement of a nasogastric tube.
Solid medications must be crushed and dissolved in water before administration (with the exception of enteric-coated tablets). Capsules should be opened and granules or powder sprinkled into 30 mL of water to dissolve (with the exception of timed-released capsules).
Flushing the tube serves to clear the tube and ensure that the drug has been transported to the intestine. |
| Incorrect | Incompatible medications should not be combined.
Suction will evacuate the medication from the patient. |
DIF: Cognitive Level: Application REF: 134
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
- Which nursing actions are correct when administering a disposable enema? (Select all that apply.)
| A. | Position the patient on the left side. |
| B. | Allow the solution to flow in by gravity. |
| C. | Instruct the patient to hold the solution 30 minutes before defecating. |
| D. | Maintain the six rights of medication administration. |
| E. | Lubricate the rectal tube. |
ANS: A, C, D, E
| Feedback |
| Correct | To facilitate flow into the large intestine, patients should be positioned on the left side.
The solution should be held for 30 minutes before defecating.
Enemas are medications, so the six rights of medication administration should be followed.
Lubrication of the rectal tube will facilitate insertion into the rectum. |
| Incorrect | Gravity will not facilitate the administration of a small volume of enema solution administered from a bottle. |
DIF: Cognitive Level: Knowledge REF: 139-140
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
- In preparing to administer medications to a patient with a nasogastric tube, which would be appropriate to give through that route? (Select all that apply.)
| A. | Liquid medication |
| B. | Tablets crushed and diluted in 30 mL of water |
| C. | Enteric-coated tablets crushed and diluted in 30 mL of water |
| D. | Capsules emptied into 30 mL of water |
| E. | Timed-release capsules emptied into 30 mL of water |
| F. | Suppositories |
ANS: A, B, D
| Feedback |
| Correct | Liquid forms of medications are preferable.
Tablets may be crushed and diluted in water.
Capsules may be opened and the contents added to approximately 1 ounce of water. |
| Incorrect | Enteric-coated medications should never be broken for administration.
Timed-release capsules should never be broken for administration.
Suppositories are not given via nasogastric route. |
DIF: Cognitive Level: Application REF: 134
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
Clayton: Basic Pharmacology for Nurses, 15th Edition
Chapter 17: Drugs Used for Mood Disorders
Test Bank
MULTIPLE CHOICE
- Which occurs with mania associated with bipolar disorder?
| A. | Varying degrees of sadness |
| B. | Distinct episodes of elation |
| C. | Suicide |
| D. | Psychomotor retardation |
ANS: B
| Feedback |
| A | Sadness is characteristic of depression. |
| B | Mania is characterized by distinct episodes of euphoria and elation. |
| C | Suicide is not generally associated with mania; it is more commonly associated with depression. |
| D | Psychomotor retardation is not associated with mania. |
DIF: Cognitive Level: Comprehension REF: 251
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Psychosocial Integrity
- Which postoperative narcotic analgesic will most likely be prescribed to a patient whose current medications include a monoamine oxidase inhibitor (MAOI), a thyroid hormone, and a multivitamin?
| A. | Meperidine (Demerol) |
| B. | Morphine |
| C. | Ibuprofen (Advil) |
| D. | Acetaminophen (Tylenol) |
ANS: B
| Feedback |
| A | Meperidine will interact with the patient’s medication. |
| B | Morphine is the narcotic analgesic of choice because it will not interact with the patient’s MAOI. |
| C | Advil is not a narcotic analgesic. |
| D | Acetaminophen is not a narcotic analgesic. |
DIF: Cognitive Level: Application REF: 260
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
- What is the major advantage of selective serotonin reuptake inhibitors (SSRIs) over other types of antidepressant therapy?
| A. | They are less expensive than the other classes of antidepressants. |
| B. | They cure major depressive illnesses. |
| C. | They do not cause the anticholinergic and cardiovascular adverse effects. |
| D. | Therapeutic relief is immediate. |
ANS: C
| Feedback |
| A | SSRIs tend to be more expensive than other available antidepressants. |
| B | SSRIs do not cure major depressive illnesses. |
| C | SSRIs are the most widely used class of antidepressants. Although they are as effective in treating depression as the tricyclic antidepressants, they do not cause the anticholinergic and cardiovascular adverse effects that often limit the use of tricyclic antidepressants. |
| D | As with other antidepressants, it takes 2 to 4 weeks to obtain the full therapeutic benefit when taking SSRIs. |
DIF: Cognitive Level: Knowledge REF: 260
TOP: Nursing Process Step: Planning
MSC: NCLEX Client Needs Category: Physiological Integrity
- Lithium (Eskalith) is the drug of choice for which of the following disorders?
| A. | Psychotic episodes |
| B. | Obsessive-compulsive disorders (OCDs) |
| C. | Bipolar disorders |
| D. | Depressive disorders |
ANS: C
| Feedback |
| A | Psychotic episodes are treated with major tranquilizers that have an antipsychotic effect. |
| B | The drugs of choice for treating OCD are SSRIs. |
| C | Lithium is used to treat acute mania and for prophylactic treatment of recurrent manic and depressive episodes in bipolar disorders. |
| D | Depressive disorders are not primarily treated with lithium. |
DIF: Cognitive Level: Comprehension REF: 269
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
- Which psychological manifestation of depression will improve in response to antidepressant therapy?
| A. | Loss of energy |
| B. | Palpitations |
| C. | Sleep disturbances |
| D. | Social withdrawal |
ANS: D
| Feedback |
| A | An increase in energy is a physiological response. |
| B | Palpitations are a physiological response. |
| C | Improvement in sleep patterns is a physiological response. |
| D | Social withdrawal and lack of interest in surroundings are psychological responses that will improve within 2 to 4 weeks of the patient receiving an effective dosage of antidepressant therapy. |
DIF: Cognitive Level: Comprehension REF: 253
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Psychological Integrity
- On what is the choice of tricyclic antidepressants based?
| A. | The need to decrease the action of norepinephrine, dopamine, or serotonin |
| B. | Patient age and gender |
| C. | An absence of adverse effects such as orthostatic hypotension |
| D. | The need for stimulation and increased mental alertness |
ANS: B
| Feedback |
| A | Tricyclics prolong the action of norepinephrine, dopamine, and serotonin. |
| B | The choice of tricyclic antidepressants is based on their individual therapeutic characteristics. |
| C | All tricyclics produce orthostatic hypotension to some degree. |
| D | All tricyclics produce sedation, not stimulation. |
DIF: Cognitive Level: Comprehension REF: 263
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Psychosocial Integrity
- The nurse is teaching a patient about medication treatment for depression. The patient asks how long it will take before sleep and appetite will begin to improve. Which response by the nurse is most accurate?
| A. | 3 days |
| B. | 1 week |
| C. | 4 weeks |
| D. | 2 months |
ANS: B
| Feedback |
| A | It takes longer than 3 days for the symptoms to improve. |
| B | The physiological manifestations of depression (sleep disturbance, change in appetite, loss of energy, fatigue, palpitations) begin to be alleviated within the first week of therapy. |
| C | Four weeks is longer than it takes for the symptoms to improve. |
| D | Two months is longer than it takes for symptoms to improve. |
DIF: Cognitive Level: Comprehension REF: 253
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
- What is the action of MAOIs on neurotransmitters?
| A. | Blocking their reuptake |
| B. | Increasing their production |
| C. | Blocking their destruction |
| D. | Increasing their reuptake |
ANS: C
| Feedback |
| A | MAOIs do not block the reuptake of neurotransmitters. |
| B | MAOIs do not increase production of neurotransmitters. |
| C | MAOIs act by blocking the metabolic destruction of epinephrine, norepinephrine, dopamine, and serotonin neurotransmitters by the enzyme monoamine oxidase in the presynaptic neurons of the brain. They prevent the degradation of these central nervous system (CNS) neurotransmitters so that their concentration is increased. |
| D | MAOIs do not increase the reuptake of neurotransmitters. |
DIF: Cognitive Level: Comprehension REF: 257
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
- A patient who is taking an MAOI to treat depression admits to eating pickled herring and cheese and drinking red wine. Which assessment finding alerts the nurse to a potential complication?
| A. | Constipation |
| B. | Hypotension |
| C. | Neck stiffness |
| D. | Urinary retention |
ANS: C
| Feedback |
| A | Constipation is not indicative of a major potential complication when patients consume foods high in tyramine. |
| B | Hypotension is not indicative of a major potential complication when patients consume foods high in tyramine. |
| C | Hypertensive crisis is a major potential complication. Common prodromal symptoms of hypertensive crisis include severe occipital headache, stiff neck, sweating, nausea, vomiting, and sharply elevated blood pressure. |
| D | Urinary retention is not indicative of a major potential complication when patients consume foods high in tyramine. |
DIF: Cognitive Level: Application REF: 260
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
- Which assessment would the nurse expect to observe in a patient who has been prescribed trazodone for treatment anxiety?
| A. | Excessive thirst |
| B. | Hand tremor |
| C. | Drowsiness |
| D. | Diarrhea |
ANS: C
| Feedback |
| A | Excessive thirst is not an adverse effect associated with trazodone. |
| B | Hand tremor is not an adverse effect associated with trazodone. |
| C | Drowsiness is a common adverse effect, and people who work with machinery, drive a car, administer medicines, or perform other duties in which they must remain mentally alert should not take trazodone while working. |
| D | Diarrhea is not an adverse effect associated with trazodone. |
DIF: Cognitive Level: Comprehension REF: 268
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological integrity
- The nurse is caring for a patient who is taking a newly prescribed drug, nefazodone, for treatment of depression. Which physical assessment finding is most important for the nurse to report to the health care provider immediately?
| A. | Bradycardia |
| B. | Dizziness |
| C. | Drowsiness |
| D. | Urinary retention |
ANS: A
| Feedback |
| A | Bradycardia with a drop in 15 beats/min is to be reported to the health care provider immediately; withholding the dose is warranted until approved. |
| B | Dizziness is a common adverse effect that would not need to be reported to the health care provider. |
| C | Drowsiness is a common adverse effect that would not need to be reported to the health care provider. |
| D | Urinary retention is a common adverse effect that would not need to be reported to the health care provider. |
DIF: Cognitive Level: Comprehension REF: 267
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological integrity
- The nurse is providing education to a patient who has been prescribed bupropion (Wellbutrin) for smoking cessation. Which statement by the patient would indicate the need for further teaching?
| A. | “My dose will increase after 3 days.” |
| B. | “I should swallow this medication whole.” |
| C. | “If I have the urge to smoke, I will take more medication.” |
| D. | “I do not need to taper my dose when the drug is discontinued.” |
ANS: C
| Feedback |
| A | Dosage will begin at 150 mg/day for the first 3 days and then, for most patients, be increased to 300 mg/day. |
| B | Bupropion should be swallowed whole, not crushed, divided, or chewed. |
| C | The patient is maintained on doses of 300 mg/day for 7 to 12 weeks and is not based on a desire to smoke. |
| D | Dose tapering is not required when discontinuing bupropion. |
DIF: Cognitive Level: Application REF: 265
TOP: Nursing Process Step: Evaluation
MSC: NCLEX Client Needs Category: Physiological integrity
- Which nursing action is most important when providing care to a patient diagnosed with a mood disorder?
| A. | Assess the patient for thoughts of suicide. |
| B. | Provide supplemental feedings as needed. |
| C. | Assist with activities of daily living. |
| D. | Offer opportunities for interaction with other patients. |
ANS: A
| Feedback |
| A | Determining if there is a risk for suicide, monitoring at specified intervals, and providing patient safety and supervision are the highest priorities with severe mood disorders. |
| B | Providing supplemental feedings is not a priority. |
| C | Assisting with activities of daily living is not the main priority. |
| D | Offering opportunities for interaction with other patients is not the main priority. |
DIF: Cognitive Level: Application REF: 252
TOP: Nursing Process Step: Intervention
MSC: NCLEX Client Needs Category: Physiological integrity
MULTIPLE RESPONSE
- Which areas are addressed by the nurse when obtaining a history of a patient admitted with depression? (Select all that apply.)
| A. | Current medications and medical history |
| B. | Recent stressors and support system |
| C. | Family history of mood disorder |
| D. | Dietary patterns |
| E. | Insurance coverage |
ANS: A, B, C, D
| Feedback |
| Correct | It is important to obtain a thorough history when assessing the patient with depression, including current medical status and medications.
It is important to obtain a thorough history when assessing the patient with depression, including recent stressors and support system.
It is important to obtain a thorough history when assessing the patient with depression, including family history of mood disorder.
It is important to obtain a thorough history when assessing the patient with depression, including nutritional patterns. |
| Incorrect | Financial matters should not be part of the nursing assessment. |
DIF: Cognitive Level: Application REF: 254
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Psychosocial Integrity
- Which instructions are most pertinent to include in the discharge teaching of a patient on lithium (Eskalith) who is being discharged? (Select all that apply.)
| A. | “Persistent vomiting and profuse diarrhea are signs of toxicity and must be reported to the health care provider immediately.” |
| B. | “It is important to comply with schedules for blood tests to assess therapeutic levels.” |
| C. | “You should avoid food such as Chianti wine and aged cheeses.” |
| D. | “The common adverse effects to expect, which are excessive nausea, anorexia, and abdominal cramps, tend to resolve.” |
| E. | “You will be gradually weaned off this medication.” |
| F. | “Take the medication with food or milk.” |
ANS: A, B, D, F
| Feedback |
| Correct | Patients should be informed of the importance of toxic symptoms to report.
Patients should be informed of the importance of monitoring therapeutic lithium levels.
Nausea, vomiting, and abdominal cramps are common adverse effects and tend to resolve.
Lithium should be administered with food or milk. |
| Incorrect | Chianti wine and aged cheeses are to be avoided during MAOI therapy.
The bipolar patient may be on lithium treatment for the rest of his or her life and will not be weaned from the medication. |
DIF: Cognitive Level: Application REF: 269
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Psychosocial Integrity
- Which will the nurse include in a teaching plan for a patient with depression being treated with amitriptyline (Elavil)? (Select all that apply.)
| A. | Dryness of the mouth is normal; sucking on sugar-free hard candy and ice chips or chewing gum may help alleviate this problem. |
| B. | Rise slowly from a supine or sitting position to avoid dizziness and orthostatic hypotension. |
| C. | Avoid alcohol and barbiturates. |
| D. | If adverse effects occur, discontinue the medication. |
| E. | An immediate elevation in mood will be noted. |
ANS: A, B, C
| Feedback |
| Correct | A common adverse effect associated with tricyclic antidepressants is dry mouth.
A common adverse effect associated with tricyclic antidepressants is orthostatic hypotension.
Alcohol and barbiturates should be avoided while taking tricyclic antidepressants because they enhance sedation. |
| Incorrect | Adverse effects are likely to occur, and the medication should not be discontinued without the direction of the health care provider.
Tricyclic antidepressants typically take several weeks to produce a therapeutic effect. |
DIF: Cognitive Level: Application REF: 263-264
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
- Which foods containing significant amounts of tyramine are contraindicated when a patient is on MAOI therapy? (Select all that apply.)
| A. | Beer |
| B. | Red meat |
| C. | Aged cheeses |
| D. | Green vegetables |
| E. | Bananas |
ANS: A, C, E
| Feedback |
| Correct | Beer and red wines contain tyramine.
Well-ripened cheeses, such as camembert, edam, roquefort, parmesan, mozzarella, and cheddar, contain tyramine.
Overripe bananas contain tyramine. |
| Incorrect | Red meat does not contain tyramine.
Green vegetables do not contain tyramine. |
DIF: Cognitive Level: Knowledge REF: 260
TOP: Nursing Process Step: Planning
MSC: NCLEX Client Needs Category: Physiological Integrity
- Which nursing assessments are important before the initiation of antidepressant therapy? (Select all that apply.)
| A. | Compliancy with medication therapy within the last 2 months |
| B. | Nonverbal interactions among patient and significant others present |
| C. | Evaluation of the coherency, relevancy, and organization of thoughts in responses |
| D. | Appearance and posture |
| E. | Elimination pattern |
ANS: A, B, C, D
| Feedback |
| Correct | Compliancy with prescribed medications over the last 2 months provides the health care provider with information regarding the patient’s state of mind and ability to follow through with medication administration independently.
Patients with altered thought processes often display inconsistencies between statements of feelings and behavior norms in social settings.
Coherency, relevancy, and organization of thoughts are often affected by thought disorders. This assessment also provides information regarding the accuracy of other information that the patient has offered.
Note general appearance and appropriateness of attire and posture because these are often affected by mood disorders. |
| Incorrect | Elimination pattern is not a priority premedication assessment. |
DIF: Cognitive Level: Analysis REF: 254
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
- Which statements are true regarding the pharmacologic actions of certain antidepressant drugs? (Select all that apply.)
| A. | MAOIs block the effects of dopamine in the central nervous system. |
| B. | SSRIs inhibit the destruction and reuptake of serotonin at the synaptic cleft. |
| C. | Tricyclic antidepressants block the action of norepinephrine and epinephrine in the SNS. |
| D. | Monocyclic antidepressants such as bupropion (Wellbutrin) have an unknown mechanism of action. |
| E. | SNRIs prolong the action of neurotransmitters by decreasing the destruction of serotonin and norepinephrine. |
ANS: B, D, E
| Feedback |
| Correct | SSRIs block the destruction and storage of serotonin at the synaptic cleft, therefore increasing the amount of serotonin available.
Monocyclic antidepressants have an unknown mechanism of action. They are weaker inhibitors of the reuptake and inactivation of the neurotransmitters serotonin norepinephrine and dopamine.
SNRIs act by inhibiting the reuptake and destruction of serotonin and norepinephrine and, to a lesser extent, dopamine, from the synaptic cleft, thereby prolonging the action of the neurotransmitters. |
| Incorrect | MAOIs act by blocking the metabolic destruction of dopamine, so concentration is increased.
Tricyclics block the reuptake of neurotransmitters, not their effects. |
DIF: Cognitive Level: Comprehension REF: 260-264
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
- Which drugs interact with SSRI agents? (Select all that apply.)
| A. | Tranylcypromine (Parnate) |
| B. | Lithium (Eskalith) |
| C. | Warfarin (Coumadin) |
| D. | Furosemide (Lasix) |
| E. | Propranolol (Inderal) |
ANS: A, B, C, E
| Feedback |
| Correct | A 14-day lapse is recommended between MAOIs, such as Parnate, and SSRI agents.
The incidence of lithium toxicity is increased with SSRI agents.
The anticoagulant effects of warfarin may be enhanced with SSRIs.
The SSRIs fluvoxamine and citalopram inhibit the metabolism of beta-adrenergic blocking agents such as propranolol. |
| Incorrect | Lasix does not interact with SSRI agents. |
DIF: Cognitive Level: Comprehension REF: 261
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
- The nurse must be sure to instruct the patient about which potential adverse effects of tricyclic antidepressants? (Select all that apply.)
| A. | Diarrhea |
| B. | Dryness of mouth, nose, and throat |
| C. | Constipation |
| D. | Nocturia |
| E. | Urinary retention |
| F. | Blurred vision |
ANS: B, C, E, F
| Feedback |
| Correct | The patient may experience difficulty with dryness of the mouth, nose, and throat.
The patient may experience difficulty with smooth muscle contraction, resulting in constipation.
The patient may experience difficulty with smooth muscle contraction, resulting in urinary retention.
The patient may experience difficulty with smooth muscle contraction, resulting in blurred vision. |
| Incorrect | Diarrhea is not an adverse effect of tricyclic antidepressants.
Nocturia is not an adverse effect of tricyclic antidepressants. |
DIF: Cognitive Level: Knowledge REF: 263
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
Clayton: Basic Pharmacology for Nurses, 15th Edition
Chapter 21: Introduction to Cardiovascular Disease and Metabolic Syndrome
Test Bank
MULTIPLE CHOICE
- A patient with a body mass index (BMI) of 25 would be considered to be in which weight category?
| A. | Underweight |
| B. | Normal weight |
| C. | Overweight |
| D. | Obese |
ANS: C
| Feedback |
| A | A BMI of less than 18.5 is considered underweight. |
| B | A BMI of 18.5 to 24.9 is considered normal weight. |
| C | A BMI of 25 to 29.9 is considered overweight. |
| D | A BMI of 30 to 34.9 is considered obesity, class I, 35 to 39.9 is considered obesity, class II, and more than 40 is considered extreme obesity. |
DIF: Cognitive Level: Knowledge REF: 336
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
- What is the most critical approach to the treatment of metabolic syndrome?
| A. | Psychotherapy |
| B. | Pharmacotherapy |
| C. | Lifestyle management |
| D. | Patient education |
ANS: C
| Feedback |
| A | Psychotherapy is not the most critical approach to treating metabolic syndrome. |
| B | Pharmacotherapy is not the most critical approach to treating metabolic syndrome. |
| C | Lifestyle management is critical for managing metabolic syndrome; other approaches will not be effective without it. |
| D | Patient education is not the most critical approach to treating metabolic syndrome. |
DIF: Cognitive Level: Comprehension REF: 338
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
- Healthy diets should include no more than which percentage of saturated fat based on total calories?
ANS: C
| Feedback |
| A | A diet with 30% saturated fat would not be considered a healthy diet. |
| B | A diet with 10% saturated fat would not be considered a healthy diet. |
| C | A healthy diet should have no more than 7% of calories from saturated fat. |
| D | A diet can have up to 7% saturated fat before it is considered unhealthy. |
DIF: Cognitive Level: Knowledge REF: 338
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
- Which ethnic group or gender is at greatest risk for developing metabolic syndrome?
| A. | Hispanic women |
| B. | Asian men |
| C. | African American men |
| D. | White women |
ANS: A
| Feedback |
| A | Hispanic women have the highest incidence rate of metabolic syndrome at 27%. |
| B | Asian men are not at the highest risk for metabolic syndrome. |
| C | African American men are not at the highest risk for metabolic syndrome. |
| D | White women are not at the highest risk for metabolic syndrome. |
DIF: Cognitive Level: Knowledge REF: 336
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
- What is the incidence of metabolic syndrome in the United States?
| A. | 1 in 4000 |
| B. | 1 in 400 |
| C. | 1 in 40 |
| D. | 1 in 4 |
ANS: D
| Feedback |
| A | One in 4000 is less than the incidence of metabolic syndrome in the United States. |
| B | One in 400 is less than the incidence of metabolic syndrome in the United States. |
| C | One in 40 is less than the incidence of metabolic syndrome in the United States. |
| D | The incidence of metabolic syndrome in the United States is 1 in 4, or about 50 million adults. |
DIF: Cognitive Level: Comprehension REF: 336
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
- Which is the mechanism of action demonstrated by exercise in managing blood glucose levels?
| A. | Exercise causes release of glucose and promotes a reduced blood glucose level. |
| B. | Exercise on a regular basis causes a reduction in lean body mass, which helps regulate blood glucose levels. |
| C. | Increased muscle mass and less fat tends to normalize blood glucose levels because glucose is used by muscle cells when exercising. |
| D. | Exercise stimulates the liver, the primary storage and utilization site of glucose, to release glucose. |
ANS: C
| Feedback |
| A | Exercise increases the rate of glucose uptake in the contracting skeletal muscles. |
| B | Exercise on a regular basis prevents reduction in lean body mass and protein wasting. |
| C | Exercise leads to more muscle and less fat, so blood glucose levels tend to return to normal. |
| D | The liver is not the primary storage and utilization site of glucose. |
DIF: Cognitive Level: Comprehension REF: 338
TOP: Nursing Process Step: Planning
MSC: NCLEX Client Needs Category: Physiological Integrity
- Which instruction by the nurse is accurate to include in a patient’s care to manage metabolic syndrome?
| A. | Encourage the client to exercise 20 minutes every day. |
| B. | Eliminate alcohol intake. |
| C. | Increase simple carbohydrates in the diet. |
| D. | Reduce stress. |
ANS: D
| Feedback |
| A | Twenty minutes of exercise is not adequate. |
| B | Alcohol intake needs to be restricted but does not have to be eliminated. |
| C | Complex carbohydrates are appropriate in the management of metabolic syndrome. |
| D | Stress reduction is important in the management of metabolic syndrome |
DIF: Cognitive Level: Application REF: 338
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
MULTIPLE RESPONSE
- What lifestyle choices may aggravate metabolic syndrome? (Select all that apply.)
| A. | Excessive tobacco smoking |
| B. | Inadequate hydration |
| C. | Excessive exercise |
| D. | Inadequate caloric intake |
| E. | Excessive consumption of alcohol |
ANS: A, E
| Feedback |
| Correct | Smoking may aggravate metabolic syndrome.
Excessive consumption of alcohol may aggravate metabolic syndrome. |
| Incorrect | Metabolic syndrome is not directly affected by inadequate hydration.
Metabolic syndrome is directly affected by a sedentary lifestyle, not excessive exercise.
Metabolic syndrome is directly affected by increased, not inadequate, caloric intake. |
DIF: Cognitive Level: Knowledge REF: 337
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
- In addition to type 2 diabetes and heart disease, which conditions are associated with metabolic syndrome? (Select all that apply.)
| A. | Dementia |
| B. | Insomnia |
| C. | Renal disease |
| D. | Obstructive sleep apnea |
| E. | Orthostatic hypotension |
| F. | Polycystic ovary syndrome |
ANS: A, C, D, F
| Feedback |
| Correct | Dementia is associated with metabolic syndrome.
Renal disease is associated with metabolic syndrome.
Obstructive sleep apnea is associated with metabolic syndrome.
Polycystic ovary syndrome is associated with metabolic syndrome. |
| Incorrect | Insomnia is not associated with metabolic syndrome.
Orthostatic hypotension is not associated with metabolic syndrome. |
DIF: Cognitive Level: Knowledge REF: 337
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
- Drug therapy for initial treatment of metabolic syndrome is targeted at controlling which conditions? (Select all that apply.)
| A. | Obstructive sleep apnea |
| B. | Diabetes mellitus |
| C. | Hypertension |
| D. | Obesity |
| E. | Dyslipidemia |
| F. | Insulin resistance |
ANS: B, C, E
| Feedback |
| Correct | Pharmacologic approaches to managing metabolic syndrome are targeted toward controlling diabetes.
Pharmacologic approaches to managing metabolic syndrome are targeted toward controlling hypertension.
Pharmacologic approaches to managing metabolic syndrome are targeted toward controlling dyslipidemia. |
| Incorrect | There is no pharmacologic intervention for obstructive sleep apnea.
Obesity should be addressed before pharmacologic therapy begins.
Insulin resistance is not dealt with pharmacologically in the early management of metabolic syndrome. |
DIF: Cognitive Level: Comprehension REF: 339
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
- Which cardiovascular conditions are related to coronary artery diseases? (Select all that apply.)
| A. | Angina pectoris |
| B. | Pulmonary stenosis |
| C. | Acute myocardial infarction |
| D. | Pericarditis |
| E. | Venous stasis ulcers |
ANS: A, C
| Feedback |
| Correct | Angina pectoris is considered a coronary artery disease.
Acute myocardial infarction is considered a coronary artery disease. |
| Incorrect | Pulmonary stenosis is a congenital heart disease.
Pericarditis is inflammation of the tissue surrounding the heart.
Venous stasis ulcers are not related to coronary artery disease. |
DIF: Cognitive Level: Comprehension REF: 335
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
- Metabolic syndrome includes which key characteristics? (Select all that apply.)
| A. | Hyperglycemia |
| B. | Abdominal obesity |
| C. | Low high-density lipoproteins |
| D. | Hypertension |
| E. | Osteoporosis |
ANS: A, B, C, D
| Feedback |
| Correct | Metabolic syndrome is characterized by hyperglycemia.
Metabolic syndrome is characterized by abdominal obesity.
Metabolic syndrome is characterized by low high-density lipoproteins.
Metabolic syndrome is characterized by hypertension. |
| Incorrect | Osteoporosis is not a characteristic of metabolic syndrome. |
DIF: Cognitive Level: Analysis REF: 336
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
Clayton: Basic Pharmacology for Nurses, 15th Edition
Chapter 31: Drugs Used to Treat Lower Respiratory Disease
Test Bank
MULTIPLE CHOICE
- A patient has questions regarding a recently prescribed antitussive agent. Which response by the nurse is the best?
| A. | “It will eliminate your cough at night.” |
| B. | “It will reduce the frequency of your cough.” |
| C. | “It should be used in the morning.” |
| D. | “It should be taken before sleep.” |
ANS: B
| Feedback |
| A | Antitussives are not likely to eliminate a cough. |
| B | Antitussive agents act by suppressing the cough center in the brain. The expected therapeutic outcome is reduced frequency of nonproductive cough to promote rest. Antitussive agents should be taken as prescribed by the health care provider. |
| C | Antitussives should be taken throughout the day. |
| D | Antitussives should be taken throughout the day. |
DIF: Cognitive Level: Comprehension REF: 487
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
- Which is a common expectorant in over-the-counter medications?
| A. | Dextromethorphan |
| B. | Diphenhydramine |
| C. | Guaifenesin |
| D. | Codeine |
ANS: C
| Feedback |
| A | Dextromethorphan is an antitussive. |
| B | Diphenhydramine is an anticholinergic agent with antihistaminic and antitussive properties. |
| C | Guaifenesin is used for symptomatic relief of conditions characterized by a dry, nonproductive cough such as the common cold, bronchitis, laryngitis, pharyngitis, and sinusitis. Guaifenesin is also used to remove mucous plugs from the respiratory tract. |
| D | Codeine is an antitussive. |
DIF: Cognitive Level: Knowledge REF: 486
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
- What is the reason for administering potassium iodide to a patient with emphysema?
| A. | To increase blood iodide levels |
| B. | To decrease mucus viscosity |
| C. | To reduce metabolic needs of the body |
| D. | To decrease bronchial irritation |
ANS: B
| Feedback |
| A | Potassium iodide is not given to increase serum potassium iodide levels. |
| B | Potassium iodide acts as an expectorant by stimulating the bronchial glands to secrete. This will decrease the viscosity of mucous plugs, which makes it easier for patients to cough up the dry hardened plugs blocking the bronchial tubes. |
| C | Potassium does not reduce metabolic needs of the body. |
| D | Potassium does not reduce bronchial irritation. |
DIF: Cognitive Level: Application REF: 486
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
- Within minutes of the initiation of a nebulizer treatment with a sympathomimetic bronchodilator, the patient turns on his call light and states that he feels “panicky” and his heart is racing. Which action will the nurse take?
| A. | Reassure the patient this is expected. |
| B. | Add more diluents to the nebulizer. |
| C. | Administer a sedative. |
| D. | Stop treatment and notify the health care provider. |
ANS: D
| Feedback |
| A | Although this may be a common result, it is not an expected outcome. |
| B | Diluting the medication would not decrease the dose. |
| C | Although a sedative might be appropriate for the patient, this is not the intervention of choice. |
| D | Sympathomimetic drugs increase sympathetic nervous stimulation. Symptoms such as nervousness, palpitations, tremors, tachycardia, and anxiety typically are dose-related. These symptoms should be reported to the health care provider immediately because the patient may require a decreased dosage. These symptoms could lead to further complications if allowed to persist and are not common adverse effects. |
DIF: Cognitive Level: Analysis REF: 490
TOP: Nursing Process Step: Planning
MSC: NCLEX Client Needs Category: Safe, Effective Care Environment
- Premedication assessments before the use of anticholinergic bronchodilating agents should verify that the patient has no history of which condition?
| A. | Diabetes |
| B. | Hypertension |
| C. | Liver disease |
| D. | Glaucoma |
ANS: D
| Feedback |
| A | Diabetes is not affected by the use of anticholinergic bronchodilating agents. |
| B | Hypertension is not affected by the use of anticholinergic bronchodilating agents. |
| C | Liver disease is not affected by the use of anticholinergic bronchodilating agents. |
| D | Anticholinergic bronchodilating agents cause mydriasis (dilation of the pupils) and cycloplegia (loss of power in the ciliary muscle); therefore, they should not be used in patients with a history of closed-angle glaucoma. |
DIF: Cognitive Level: Comprehension REF: 492
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Safe, Effective Care Environment
- A patient is seen in the emergency department. The patient had been maintained on theophylline (Theo-Dur), and a blood sample reveals the serum theophylline level is subtherapeutic. Which may cause a subtherapeutic serum level?
| A. | Cimetidine use |
| B. | Drug tolerance |
| C. | Smoking |
| D. | Overuse of the inhaler |
ANS: C
| Feedback |
| A | Cimetidine would enhance the effects of theophylline, not decrease the effects. |
| B | Smoking reduces the therapeutic effects of xanthine derivatives, including theophylline. |
| C | The patient is not tolerant to the drug if the serum theophylline levels are too low. |
| D | Overuse of the inhaler would cause a high level of serum theophylline. |
DIF: Cognitive Level: Application REF: 494
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Health Promotion and Maintenance
- What is the action of zafirlukast (Accolate), a leukotriene receptor antagonist?
| A. | Dilates the alveolar sacs |
| B. | Decreases leukotriene release |
| C. | Inhibits histamine release |
| D. | Increases viscosity of secretions |
ANS: B
| Feedback |
| A | Leukotrienes work to reduce bronchoconstriction. |
| B | Leukotrienes are a class of anti-inflammatory agents that block leukotriene formation. Leukotrienes are part of the inflammatory pathway that causes bronchoconstriction. |
| C | Leukotrienes do not inhibit histamine release. |
| D | Leukotrienes do not affect viscosity of secretions. |
DIF: Cognitive Level: Knowledge REF: 496
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
- What is albuterol (Proventil) used to treat?
| A. | Acute bronchospasm |
| B. | Acute allergies |
| C. | Nasal congestion |
| D. | Dyspnea on exertion |
ANS: A
| Feedback |
| A | The short-acting beta agonists have a rapid onset (few minutes) and are used to treat acute bronchospasm. |
| B | Beta agonists are not used to treat allergies. |
| C | Decongestants are used for nasal congestion. |
| D | Long-acting beta agonists are used for exertional dyspnea. |
DIF: Cognitive Level: Knowledge REF: 489
TOP: Nursing Process Step: Planning
MSC: NCLEX Client Needs Category: Physiological Integrity
- From where do the fluids of the respiratory tract originate?
| A. | Specialized mucous glands called goblet cells |
| B. | Lymph fluid drawn across nasal membranes by osmosis |
| C. | Specialized beta cells in the islets of Langerhans |
| D. | Cells that produce aqueous humor |
ANS: A
| Feedback |
| A | The fluids of the respiratory tract originate from specialized mucous glands (goblet cells) and serous glands that line the respiratory tract. The goblet cells produce gelatinous mucus that forms a thin layer over the interior surfaces of the trachea, bronchi, and bronchioles. |
| B | Lymph does not make up fluid in the respiratory tract. |
| C | The beta cells in the islets of Langerhans are located in the pancreas. |
| D | Cells that produce aqueous humor are located in the interior of the eye. |
DIF: Cognitive Level: Knowledge REF: 476
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
- What structures in the respiratory tract assist in removing foreign bodies such as smoke and bacteria?
| A. | Villi |
| B. | Golgi bodies |
| C. | Ciliary hairs |
| D. | Erector pili |
ANS: C
| Feedback |
| A | The villi are hair-like protrusions into the intestine emanating from the wall of the intestine. The purpose of the villi is to slow the passage of food and allow food particles to be captured among these finger-like villi, so that the blood inside the villi can absorb the nutrients in the food. |
| B | The primary function of the Golgi apparatus, an organelle found in most eukaryotic cells, is to process proteins targeted to the plasma membrane, lysosomes, or endosomes and those that will be formed from the cell and to sort them within vesicles. Thus, it functions as a central delivery system for the cell. |
| C | Normally, respiratory tract fluid forms a protective layer over the trachea, bronchi, and bronchioles. Foreign bodies, such as smoke particles and bacteria, are caught in the respiratory tract fluid and are swept upward by ciliary hairs that line the bronchi and trachea to the larynx, where they are removed by the cough reflex. |
| D | Erector pili are small muscles that cause hairs on the skin to rise when contracted. |
DIF: Cognitive Level: Knowledge REF: 476
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
- The nurse is providing instruction about ipratropium (Atrovent) to a patient with COPD. Which is a common adverse effect that tends to resolve with therapy?
| A. | Anxiety |
| B. | Dry mouth |
| C. | Tachycardia |
| D. | Urine retention |
ANS: B
| Feedback |
| A | Anxiety is not a common adverse effect. |
| B | Dry mouth is usually mild and tends to resolve with continued therapy. |
| C | Tachycardia is not a common adverse effect. |
| D | Urine retention is not a common adverse effect. |
DIF: Cognitive Level: Knowledge REF: 492
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
- An adult patient is admitted for an asthma attack. Which assessment obtained by the nurse would support that albuterol (Proventil) was effective?
| A. | Decrease in wheezing present on auscultation |
| B. | Less dyspnea while positioned in a high Fowler’s position |
| C. | Sputum production is clear and watery |
| D. | Respiratory rate decreased to 38 breaths/min |
ANS: A
| Feedback |
| A | A bronchodilator would open the airways and result in a reduction of wheezing. |
| B | Less dyspnea while positioned in a high Fowler’s position would not indicate that the medication was effective. |
| C | Clear and watery sputum would not indicate that the medication was effective. |
| D | The respiratory rate decreased to 38 breaths/min would not indicate that the medication was effective. |
DIF: Cognitive Level: Application REF: 490
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological integrity
- A child has been diagnosed with asthma and the nurse is providing education to the family. Which statement by the mother indicates a need for further teaching?
| A. | “I will place the stuffed animals in the freezer overnight.” |
| B. | “We will confine our dog to the kitchen area.” |
| C. | “I should wash bedding in hot water.” |
| D. | “A damp cloth should be used when I dust.” |
ANS: B
| Feedback |
| A | This is an accurate statement. |
| B | Pets should be removed from the home or kept outside if at all possible. |
| C | This is an accurate statement. |
| D | This is an accurate statement. |
DIF: Cognitive Level: Application REF: 485
TOP: Nursing Process Step: Evaluation
MSC: NCLEX Client Needs Category: Physiological Integrity
- The nurse is providing nutrition information to a patient diagnosed with a lower respiratory tract disease. What is the rationale for limiting caffeine?
| A. | Caffeine increases the respiratory rate. |
| B. | Caffeine can result in thicker lung secretions. |
| C. | Caffeine will increase the anxiety response associated with dyspnea. |
| D. | Caffeine can cause bronchospasm. |
ANS: B
| Feedback |
| A | This is not an accurate statement. |
| B | Avoid caffeine-containing beverages because caffeine is a weak diuretic. Diuresis promotes thickening of lung secretions, making it more difficult to expectorate them. |
| C | This is not an accurate statement. |
| D | This is not an accurate statement. |
DIF: Cognitive Level: Application REF: 486
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
- The nurse is teaching a patient with a history of COPD to self-administer tiotropium (Spiriva) by dry powder inhalation. Which information provided by the nurse is accurate?
| A. | The medication capsules can be used multiple times. |
| B. | Press on the canister while inhaling. |
| C. | Avoid breathing into the mouthpiece. |
| D. | Wash the device with cold water. |
ANS: C
| Feedback |
| A | Capsules are meant to be used as a single dose and should be disposed of after taking the daily dose. |
| B | The HandiHaler uses capsules of medication that should be pierced before the patient inhales. |
| C | The patient should not breathe into the mouthpiece at any time. |
| D | The inhaler should be washed with hot water. |
DIF: Cognitive Level: Application REF: 493
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
- The health care provider in an outpatient clinic has prescribed omalizumab (Xolair) to a patient. Which primary outcome will the nurse teach the patient to expect?
| A. | Easier expectoration of phlegm |
| B. | Less frequent asthma exacerbations |
| C. | Increased moisture of the mucous membranes |
| D. | Liquefaction of thick secretions |
ANS: B
| Feedback |
| A | Easier expectoration of phlegm is not the outcome of omalizumab. |
| B | The primary therapeutic outcome associated with omalizumab therapy is reduced frequency of acute asthmatic exacerbations. |
| C | Increased moisture of the mucous membranes is not the outcome of omalizumab. |
| D | Liquefaction of thick secretions is not the outcome of omalizumab. |
DIF: Cognitive Level: Application REF: 497
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity
MULTIPLE RESPONSE
- Which statements are true regarding the nursing assessment of a patient with a respiratory disorder? (Select all that apply).
| A. | Central cyanosis typically is observed on the fingers and earlobes. |
| B. | Clubbing of the fingernails is a sign of hypoxia. |
| C. | As oxygen levels diminish, mental alertness will progressively deteriorate. |
| D. | The normal respiratory rate in an adult is 10 breaths/min. |
| E. | Episodes of apnea are present in Cheyne-Stokes. |
ANS: B, C, E
| Feedback |
| Correct | Fingernail clubbing is a sign of hypoxia.
Mental status will deteriorate as the oxygen level in the body diminishes.
Apnea is present in Cheyne-Stokes respirations. |
| Incorrect | Central cyanosis is not observed on the fingers and earlobes.
The normal respiratory rate in an adult is more than 10 breaths/min. |
DIF: Cognitive Level: Application REF: 482-483
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
- Which is true about arterial blood gases (ABGs)? (Select all that apply.)
| A. | They are measured from an arterial sample. |
| B. | They measure partial pressures of carbon dioxide. |
| C. | They measure blood pH. |
| D. | They measure partial pressures of sodium |
| E. | They measure partial pressures of oxygen. |
ANS: A, B, C, E
| Feedback |
| Correct | ABGs are taken from samples from arterial blood, which must be drawn and analyzed immediately.
ABGs measure partial pressures of carbon dioxide and bicarbonate.
ABGs measure pH.
ABGs measure partial pressures of oxygen. |
| Incorrect | ABGs do not measure partial pressures of sodium. |
DIF: Cognitive Level: Comprehension REF: 477
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
- The nurse is completing the admission of an older adult patient with a history of COPD whose diagnosis is pneumonia. Which assessments would be most important to include in obtaining the history? (Select all that apply.)
| A. | Smoking history and exposure to secondhand smoke |
| B. | Current medications |
| C. | Chief complaint and onset of symptoms |
| D. | Support system |
| E. | Home oxygen use |
| F. | Liver function |
ANS: A, B, C, D, E
| Feedback |
| Correct | It is important to assess present and past respiratory history, including smoking history and exposure to secondhand smoke, when obtaining information from a patient with acute and chronic lung disease.
It is important to obtain a thorough medication history when obtaining information from a patient with acute and chronic lung disease
It is important to assess the chief complaint and current pulmonary symptoms, including cough and sputum color, when obtaining information from a patient with acute and chronic lung disease.
It is important to assess the patient’s support system when obtaining information from a patient with acute and chronic lung disease.
It is important to ask about any home treatments that the patient may be using when obtaining information from a patient with acute and chronic lung disease. |
| Incorrect | Liver function testing is not necessary for the assessment of this patient. |
DIF: Cognitive Level: Application REF: 482-483
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
- Which physical assessments are pertinent to the patient with asthma? (Select all that apply.)
| A. | Lung sounds |
| B. | Patient color |
| C. | Respiratory rate and effort |
| D. | PEF |
| E. | Pulse oximetry reading |
| F. | Bowel sounds |
ANS: A, B, C, D, E
| Feedback |
| Correct | Lung sounds should be assessed in the patient with asthma.
Pallor and color should be assessed in the patient with asthma.
Respiratory rate and effort should be assessed in the patient with asthma.
PEF should be assessed in the patient with asthma.
Pulse oximetry should be assessed in the patient with asthma. |
| Incorrect | Assessment of bowel sounds is not pertinent. |
DIF: Cognitive Level: Application REF: 482-483
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Physiological Integrity
- Which principles are included when teaching a patient to use a steroid inhaler? (Select all that apply.)
| A. | Frequent oral hygiene is necessary. |
| B. | The inhaler should be used on a PRN basis only. |
| C. | Rinse and spit after inhalation of the medication. |
| D. | When taking a steroid drug as well as a bronchodilator, the bronchodilator should be administered first. |
| E. | Hold the breath for 10 seconds during inhalation of the medication. |
ANS: A, C, D, E
| Feedback |
| Correct | Steroid medications may predispose patients to secondary fungal infections in the mouth. To prevent this, patients should be instructed on good oral hygiene technique and told to gargle and rinse the mouth after each aerosol treatment with a hydrogen peroxide mouthwash.
In addition to good oral hygiene, patients should rinse and spit after inhalation of the medication.
When a bronchodilator and steroid are prescribed, the bronchodilator should be administered as the first puff of medication and, after waiting a few minutes, the steroid medication should be administered. This procedure facilitates bronchodilation so that the second medication will have a better chance of reaching lower parts of the lungs.
Patients should hold their breath for 10 seconds during inhalation of the medication so that the medication is fully inhaled. |
| Incorrect | Steroid inhalers should be used on a regular basis to prevent symptoms. |
DIF: Cognitive Level: Application REF: 484-485
TOP: Nursing Process Step: Implementation
MSC: NCLEX Client Needs Category: Health Promotion and Maintenance
- Which statements about acetylcysteine are true? (Select all that apply.)
| A. | It reduces viscosity of secretions. |
| B. | It treats acetaminophen toxicity. |
| C. | It is stored at room temperature. |
| D. | It is given to improve airway flow. |
| E. | It is odorless. |
| F. | It is administered by inhalation. |
ANS: A, B, D, F
| Feedback |
| Correct | Acetylcysteine is given to reduce the viscosity of secretions.
Acetylcysteine is used to treat acetaminophen toxicity.
Acetylcysteine is used to improve airway flow.
Acetylcysteine is a mucolytic given by inhalation. |
| Incorrect | Acetylcysteine should be refrigerated after opening.
Acetylcysteine has an odor similar to that of rotten eggs. |
DIF: Cognitive Level: Comprehension REF: 488-489
TOP: Nursing Process Step: Planning
MSC: NCLEX Client Needs Category: Physiological Integrity
- Which statements about ipratropium (Atrovent) are true? (Select all that apply.)
| A. | It is administered by aerosol inhalation. |
| B. | It relieves nasal congestion. |
| C. | It decreases mucus secretion. |
| D. | It has minimal effect on ciliary activity. |
| E. | It is used for short-term treatment of bronchospasm. |
| F. | It may cause tachycardia or urinary retention. |
ANS: A, D, F
| Feedback |
| Correct | Ipratropium bromide is administered by aerosol inhalation.
Ipratropium has minimal effect on ciliary activity.
Ipratropium may cause tachycardia, urinary retention, or exacerbation of pulmonary symptoms. |
| Incorrect | Ipratropium bromide does not relieve nasal congestion.
Ipratropium has minimal effect on mucous secretion, sputum volume, and viscosity.
Ipratropium is used as a bronchodilator for long-term treatment of reversible bronchospasm associated with COPD. |
DIF: Cognitive Level: Comprehension REF: 490 | 492
TOP: Nursing Process Step: Planning
MSC: NCLEX Client Needs Category: Physiological Integrity
