Ford Roach’s Introductory Clinical Pharmacology 9th Edition by Susan M. Ford -Test Bank A+

Description

Which of the following are environmental factors that lead to errors in the calculation of drug doses? Select all that apply.
	A)	Poor lighting
	B)	Heavy workload
	C)	Noise
	D)	Temperature
	E)	Interruptions

2.	Which of the following are the three specific items found on a drug label needed to administer a drug? Select all that apply.
	A)	Monitoring parameters
	B)	Side effects
	C)	Dosage form
	D)	Drug name
	E)	Dosage strength

3.	When a nurse reviews the package labeling, which of the following names will the nurse see on the drug label?
	A)	Trade name
	B)	Scientific name
	C)	Pharmacological name
	D)	Nonproprietary name
	E)	Generic name

4.	Which of the following might help the nurse distinguish between the trade and generic names on a drug label? Select all that apply.
	A)	The trade name is written in smaller print.
	B)	The trade name is usually capitalized.
	C)	The trade name is followed by a registration symbol.
	D)	The trade name is often in parentheses.
	E)	The trade name is found under the generic name.

5.

A client has been taking Coumadin 5 mg daily. After a check of the client’s INR, the physician wants to increase the client’s Coumadin dose to 7.5 mg on Wednesdays and continue 5 mg all the other days of the week. How many Coumadin 5 mg tablets does the nurse need to give the client to achieve a dose of 7.5 mg?

6.	A nurse should recognize which of the following as a metric system unit? Select all that apply.
	A)	Inch
	B)	Milligram
	C)	Centimeter
	D)	Ounce
	E)	Pound

7.	A physician writes an order for a client to receive Levothyroxine (Synthroid) 0.2 mg, but the client has 100 mcg tablets. How many 100 mcg tablets should the nurse administer to the client?

8.	Which of the following drug doses is written correctly? Select all that apply.
	A)	Synthroid 0.175 mg
	B)	Synthroid .175 mg
	C)	Synthroid 175 mcg
	D)	Synthroid 175.0 mcg
	E)	Synthroid .1750 mg

9.	Drugs used for parenteral administration may be available in which of the following forms? Select all that apply.
	A)	Disposable syringes
	B)	Reusable cartridges
	C)	Ampules containing liquid form of the drug
	D)	Reusable vial containing liquid form of the drug
	E)	Vial containing drug powder

10.	A client weighs 56 kg. How many pounds does the client weigh?

11.	A client weighs 275 lb. How many kilograms does the client weight?

12.	A client has a temperature of 39°C. What is the client’s temperature in degrees Fahrenheit?

13.	A client has a temperature of 99°F. What is the client’s temperature in degrees Celsius?

14.	Convert the ratio 2:100 into a percentage.

15.	A client is to receive 0.5 mg of a drug. The drug is available in a 2 mg/mL vial. How many mL should the nurse administer to the client?

16.	A client is to receive a 7.5 mg/kg dose of a drug. The client weighs 155 lb, how many milligrams of the drug should the client receive per dose?

17.	The physician writes an order for a client to receive 1 mg of vitamin B12 once every month. Vitamin B12 comes in a 1000 mcg/mL vial. How many mL should the nurse administer to the client each month?

18.	A client is to receive 250 mg of penicillin VK twice daily for ten days. Penicillin VK is available in a 500 mg tablet. How many tablets should the client be instructed to take at each dose?

19.	A client weighs 200 lb. The client is to receive 5 mg/kg per dose of drug. How many mg of drug will the client receive in each dose?

20.	A client has a standing order to receive Tylenol for fevers over 100°C. A client has a temperature of 38.5°C. What is the client’s temperature in degrees Fahrenheit and should the client receive a dose of Tylenol?

21.	What is the first step in the procedure of dividing mixed numbers and fractions?
	A)	The whole number is first changed to a fraction.
	B)	The second fraction is inverted and fractions are multiplied.
	C)	Both numbers are changed to improper fractions.
	D)	Mixed numbers are changed to improper fractions.

22.	What is the first step in the procedure of dividing whole numbers and mixed numbers?
	A)	Mixed numbers are changed to improper fractions.
	B)	The whole number is changed to an improper fraction.
	C)	The whole number is placed over 1.
	D)	Both numbers are changed to improper fractions.

23.	What is the procedure for dividing fractions?
	A)	Both numbers are changed to improper fractions.
	B)	The whole number is first changed to a fraction.
	C)	Mixed numbers are changed to improper fractions.
	D)	The second fraction is inverted and the fractions are multiplied.

24.	What is the procedure to multiply a whole number and a mixed number?
	A)	Mixed numbers are changed to improper fractions.
	B)	Both numbers are changed to improper fractions.
	C)	The second fraction is inverted and fractions are multiplied.
	D)	The whole number is first changed to a fraction.

25.	What is the procedure to multiply mixed numbers?
	A)	The whole number is first changed to a fraction.
	B)	The second fraction is inverted and fractions are multiplied.
	C)	Mixed numbers are changed to improper fractions.
	D)	Both numbers are changed to improper fractions.

26.	What is the first step in the procedure of dividing a whole number by a fraction?
	A)	The whole number is placed over 1.
	B)	The whole number is first changed to a fraction.
	C)	Both numbers are changed to improper fractions.
	D)	The fraction is inverted and multiplied.

27.	Which of the following are units of the metric system?
	A) Minims B) Grains C) Drams D) Grams

28.	“Dose desired / dose on hand = dose administered” is the formula for calculating the dose to be administered. Under which of the following circumstances is this to be used?
	A)	When the physician is not available to calculate the dosage.
	B)	When the dosage is written in the apothecary system.
	C)	When the dose desired and dose on hand are in the same system.
	D)	When the label of the drug is in the metric system.

1.	Which of the following results occur when nurses teach clients effectively? Select all that apply.
	A)	Improved client outcomes.
	B)	Decreased adherence with drug regimen.
	C)	Increased ability of client to manage drug therapy.
	D)	Worsened client outcomes.
	E)	Decreased ability of client to manage drug therapy.

2.	Which of the following can the nurse do to improve a client’s motivation to learn? Select all that apply.
	A)	Educate the client about their disease process.
	B)	Do not include caregivers in the education process as it is a HIPAA violation.
	C)	Create an accepting and positive atmosphere.
	D)	Ignore client’s questions until you are finished teaching.
	E)	Encourage client participation in goal planning.

3.	Which of the following are domains of the learning process?
	A)	Cognitive domain
	B)	Affective domain
	C)	Physical domain
	D)	Psychological domain
	E)	Psycomotor domain

4.	Which of the following are included in the cognitive domain? Select all that apply.
	A)	Thought
	B)	Feelings
	C)	Beliefs
	D)	Recall
	E)	Decision making

5.	Which of the following are included in the affective domain? Select all that apply.
	A)	Thought
	B)	Feelings
	C)	Beliefs
	D)	Recall
	E)	Decision making

6.	The client uses the cognitive domain to do which of the tasks? Select all that apply.
	A)	Form new beliefs.
	B)	Process new information.
	C)	Make a decision.
	D)	Ask questions.
	E)	Demonstrate a physical skill.

7.	The nurse makes use of the cognitive domain when information is given to the client of caregiver about which or the following? Select all that apply.
	A)	Instruction on the correct administration of insulin.
	B)	Review of complications associated with diabetes.
	C)	Review of adverse reactions associated with insulin.
	D)	Review of how frequently to administer insulin.
	E)	Instruction on how to use a glucometer.

8.	The nurse makes use of the psychomotor domain when information is given to the client or caregiver about which of the following? Select all that apply.
	A)	Instruction on the correct administration of insulin.
	B)	Review of complications associated with diabetes.
	C)	Review of adverse reactions associated with insulin.
	D)	Review of how frequently to administer insulin.
	E)	Instruction on how to use a glucometer.

9.	The nursing process is a systematic method that includes which of the following steps? Select all that apply.
	A)	Identifying client health needs.
	B)	Reviewing client medications.
	C)	Devising a plan of care.
	D)	Initiating a nursing plan.
	E)	Evaluating the effectiveness of a plan.

10.	To develop an effective teaching plan, the nurse must first determine a client’s needs which can include which of the following? Select all that apply.
	A)	Information the client needs to know about a particular medication.
	B)	Client’s ability to read.
	C)	Client’s ability to learn the information presented.
	D)	Client’s ability to use the information presented.
	E)	Client’s ability to accept the information presented.

11.	Which of the following represent inappropriate times for client teaching? Select all that apply.
	A)	When there are visitors.
	B)	Immediately prior to discharge.
	C)	The day of admission.
	D)	While the client is sedated.
	E)	While the client is in pain.

12.	The nurse can use which of the following to evaluate a client’s knowledge of the material presented? Select all that apply.
	A)	Client recitation of information
	B)	Client return demonstration
	C)	Open-ended questions
	D)	Closed-ended questions
	E)	Nurse review of information

13.	Which of the following is true of adult learning? Select all that apply.
	A)	Adults prefer a formal learning environment.
	B)	Adults draw on past experiences to facilitate learning.
	C)	Adults learn best by listening.
	D)	Adults learn best by active learning.
	E)	Adults are most often visual learners.

14.	Which of the following are ways the nurse can help the client adapt drug administration in the home? Select all that apply.
	A)	Prepare a daily calendar
	B)	Prepare a pill box
	C)	Provide written instructions
	D)	Place all medication in one bottle
	E)	Develop a clear, easy-to-read dosing schedule

15.	A nurse is formulating a teaching plan for a client receiving a new drug. Which of the following information should be included in the teaching plan? Select all that apply.
	A)	Adverse reaction to expect from the drug.
	B)	Adverse reactions to report to the physician.
	C)	Therapeutic response to expect from the drug.
	D)	The route of administration.
	E)	The dose of drug to administer.

16.	Development of a therapeutic relationship with a client is based on which of the following? Select all that apply.
	A)	Trust
	B)	Education
	C)	Commitment
	D)	Dedication
	E)	Caring

17.	Which of the following dosage forms would require relatively little client teaching? Select all that apply.
	A)	Injectables
	B)	Inhalers
	C)	Tablets
	D)	Capsules
	E)	Transdermal patches

18.	When a nurse assesses a client’s ability to learn, what should the nurse take into consideration? Select all that apply.
	A)	Literacy level
	B)	Language
	C)	Presence of a learning impairment
	D)	Visual impairment
	E)	Hearing impairment

19.	Client goals are set during the planning stage of the client’s teaching plan. When the nurse is developing client-specific goals, which of the following should the nurse keep in mind? Select all that apply.
	A)	Goals should be measurable.
	B)	Goals should be attainable.
	C)	Goals should be set by the client only.
	D)	Goals should be set by the physician only.
	E)	Goals should be set by the nurse only.

20.	Which of the following would be considered appropriate client goals for the nurse to set when teaching a client how to use a glucometer? Select all that apply.
	A)	Demonstration of appropriate testing procedure.
	B)	Understanding of steps to take in the case of low blood glucose.
	C)	Understanding of blood glucose goals.
	D)	Understanding of the pathophysiology of diabetes.
	E)	Understanding of frequency of blood glucose testing.

21.	A nurse is caring for a patient with high blood pressure. The patient has a sphygmomanometer at home. A family member wishes to learn how to measure blood pressure. The nurse demonstrates to the patient and the family member how to take blood pressure measurements using the sphygmomanometer. What kind of learning domain does this learning belong to?
	A)	Psychomotor domain	C)	Cognitive domain
	B)	Affective domain	D)	Intellectual domain

22.	A patient with seasonal allergies has been prescribed a nasal spray, which will be administered at home. The patient wants to know about the addictive nature of the nasal spray, the adverse reactions, and the harmful effects involved. Which of the following nursing diagnoses from the patient’s care plan should the nurse address while educating the patient?
	A)	Ineffective therapeutic regimen management
	B)	Discharge teaching for the patient
	C)	Deficient knowledge nursing diagnosis
	D)	Effective individual therapeutic regimen management

23.	A patient is to be discharged from a nursing home. The nurse caring for the patient has to educate the patient regarding the appropriate use of prescribed drugs. Which of the following factors is most important in helping the patient to learn faster?
	A) Attitude B) Motivation C) Interest D) Grasping power

24.	A cancer patient needs supplemental oxygen at home through an oxygen cylinder. The nurse assigned to the patient teaches the patient’s brother to administer oxygen from the cylinder at home. Which of the following is the most effective for the nurse to evaluate the patient’s brother understanding?
	A)	Ask questions such as “Do you understand?”
	B)	Ask the patient’s brother to demonstrate the procedure.
	C)	Ask the patient’s brother to document the technique.
	D)	Asking questions related to the procedure.

25.	A patient in a local health care center is presented information on drug administration by the nurse. All of the following affects the patient’s interpretation of the information except:
	A)	Patient’s financial status	C)	Prior perceptions
	B)	Prior knowledge	D)	Previous experiences

26.	A patient admitted to a hospital is not good at information recalling, decision making, and conclusion-drawing skills. The patient also lacks proper psychomotor knowledge. Which of the following types of nursing diagnosis should the nurse use for such a patient?
	A)	Knowledge deficit
	B)	Ineffective therapeutic regimen management
	C)	Effective individual therapeutic regimen management
	D)	Discharge teaching for the patient

27.	A nurse is caring for a patient with liver cirrhosis. The nurse has to collaborate on an individualized teaching plan to help the client administer the post-discharge medication. What factors should be kept in mind by the nurse when implementing such a plan? Select all that apply.
	A)	The nurse’s teaching ability
	B)	The prescribed drug
	C)	The patient’s learning skills
	D)	The patient’s need to know the drugs
	E)	The health care provider’s preference

28.	A diabetes patient is awaiting discharge from a nursing care unit. The nurse presents information to the patient regarding injections to be administered at home. Which intellectual activities does the patient involve when interpreting this information using the cognitive domain of learning? Select all that apply.
	A)	Recall
	B)	Opinions
	C)	Thought
	D)	Attitude
	E)	Decision making

29.	A patient with viral flu is prescribed drugs to be administered at home. The nurse prepares a teaching plan to help the patient learn the administration of the prescribed drugs at home. Which of the following factors could pose obstacles in the patient’s learning process?
	A)	Varied or different literacy levels	C)	Previous experience
	B)	Lack of high grasping skills	D)	Prior knowledge

30.	A nurse is caring for a 70-year-old patient diagnosed with diabetes. The patient is to be discharged soon, and the nurse needs to teach him about the administration of the oral medications. Which of the following will most likely help the nurse learn about the patient’s affective behavior? Select all that apply.
	A)	Developing a therapeutic relationship with the patient.
	B)	Overlooking the concern of the patient’s family.
	C)	Approaching the patient with respect.
	D)	Nurturing a relationship based on trust and caring.
	E)	Avoiding patient’s queries on sensitive issues.

1.	Which of the following represents mechanisms by which penicillins inhibit bacterial synthesis? Select all that apply.
	A)	Inhibition of cell wall synthesis.
	B)	Disruption of DNA synthesis.
	C)	Disruption of RNA synthesis.
	D)	Disruption of protein synthesis.
	E)	Disruption of binding to host cells.

2.	Penicillins are categorized into which of the following four groups? Select all that apply.
	A)	Synthetic penicillins
	B)	Natural penicillins
	C)	Penicillinase-resistant penicillins
	D)	Aminopenicillins
	E)	Extended-spectrum penicillins

3.	Which of the following are examples of beta-lactamase inhibitors? Select all that apply.
	A)	Methicillin
	B)	Amoxicillin
	C)	Tazobactam
	D)	Sulbactam
	E)	Clavulanic acid

4.	A nurse monitoring a client taking penicillin should be aware of the common GI tract adverse reactions, including which of the following? Select all that apply.
	A)	Glossitis
	B)	Stomatitis
	C)	Esophagitis
	D)	Diarrhea
	E)	Gastritis

5.	Which of the following is true of bacterial superinfections that occur with the administration of penicillins? Select all that apply.
	A)	Bacterial superinfections are seen with parenteral administration of penicillins.
	B)	Bacterial superinfections are seen with oral administration of penicillins.
	C)	Bacterial superinfections usually occur in the bowel.
	D)	Bacterial superinfections usually occur in the skin and soft tissue.
	E)	Bacterial superinfections usually occur in the oral mucosa.

6.	A nurse should be monitoring a client taking oral penicillins for which of the following that may indicate a bacterial superinfection? Select all that apply.
	A)	Bloody diarrhea
	B)	Fever
	C)	Pruritus
	D)	Abdominal cramping
	E)	Hives

7.	A nurse should monitor which of the following client populations more closely as they are more likely to develop a superinfection? Select all that apply.
	A)	Geriatrics
	B)	Adolescents
	C)	Chronically ill
	D)	Long-term penicillin treatment
	E)	Pediatrics

8.	Nurses should monitor blood counts of clients taking penicillins for which of the following hematopoietic changes? Select all that apply.
	A)	Pancytopenia
	B)	Anemia
	C)	Thrombocytopenia
	D)	Leukopenia
	E)	Hemoglobulinemia

9.	Penicillins should be used cautiously in clients with which of the following? Select all that apply.
	A)	History of allergies
	B)	Diabetes
	C)	Asthma
	D)	Bleeding disorders
	E)	Hypertension

10.	Which of the following should be included in the nurse’s pre-administration assessment prior to a client receiving a penicillin? Select all that apply.
	A)	Allergy history
	B)	Medical history
	C)	Medication history
	D)	Blood glucose
	E)	Current symptoms

11.	Which of the following are examples of a penicillinase-resistant penicillin? Select all that apply.
	A)	Dicloxacillin
	B)	Penicillin G
	C)	Nafcillin
	D)	Oxacillin
	E)	Ampicillin

12.	During ongoing assessment of a client receiving amoxicillin (Amoxil), the nurse should monitor the client for which of the following? Select all that apply.
	A)	Relief of symptoms
	B)	Development of a rash
	C)	Increase in appetite
	D)	Change in appearance or amount of drainage
	E)	Decrease in temperature

13.	Which of the drug-specific nursing diagnoses may be used in the administration of a penicillin? Select all that apply.
	A)	Impaired comfort
	B)	Impaired skin integrity
	C)	Diarrhea
	D)	Impaired urinary elimination
	E)	Risk of ineffective respiratory function

14.	It is best to give penicillins on an empty stomach, one hour before or two hours after a meal. Which of the following penicillins can be given without regard to meals? Select all that apply.
	A)	Amoxicillin (Amoxil)
	B)	Ampicillin (Principen)
	C)	Penicillin V (Veetids)
	D)	Amoxicillin/clavulanate (Augmentin)
	E)	Carbenicillin indanyl (Geocillin)

15.	The oral administration of penicillins can result in fungal superinfections in the oral cavity. The nurse should examine the client’s mouth daily for which of the following? Select all that apply.
	A)	Sore tongue
	B)	Ulceration
	C)	Black, furry tongue
	D)	Oral pain
	E)	Swollen gums

16.	When skin irritation is present during the administration of a penicillin, the nurse should advise the client to avoid which of the following? Select all that apply.
	A)	Harsh soaps
	B)	Perfumed lotions
	C)	Antipyretic creams
	D)	Rubbing the area
	E)	Wearing rough or irritating clothing

17.	The nurse can recommend which of the following to reduce the risk of fungal superinfections? Select all that apply.
	A)	Consumption of yogurt
	B)	Consumption of buttermilk
	C)	Consumption of Acidophilus
	D)	Rinsing daily with an alcohol-based mouthwash.
	E)	Brushing with a soft-bristle toothbrush.

18.	The physician writes an order for a pediatric client to receive ampicillin (Principen) 250 mg every six hours for seven days. The client is unable to swallow tablets, but the ampicillin is available in a 125 mg/5 ml suspension. How many teaspoonfuls will the client receive each day?

19.	The physician writes an order for a client to receive amoxicillin (Amoxil) 700 mg twice daily for 14 days. Amoxicillin is available in a 250 mg/5 mL suspension. How many mL will the client need for 14 days?

20.	The physician orders penicillin V (Veetids) 350 mg by mouth every eight hours for a client. The client is unable to swallow tablets due to swelling in the throat and mouth. Penicillin V is available in a 125 mg/5 mL suspension. How many mL will the nurse need to prepare for each dose?

21.	A patient who has been on penicillin therapy for several days has developed inflamed oral mucous membranes and swelling in the tongue and the gums. The primary health care provider has diagnosed it as a fungal superinfection of the oral cavity resulting in impaired oral mucous membranes. Which of the following interventions should the nurse perform?
	A)	Inspect mouth and gums regularly.
	B)	Instruct patient to avoid brushing teeth.
	C)	Offer patient a liquid diet.
	D)	Instruct the patient to gargle every two hours.

22.	A patient with a throat infection has been recommended penicillin therapy by the primary health care provider. Before administering the first dose of penicillin to the patient, which of the following interventions should the nurse perform as part of the pre-administration assessment?
	A)	Perform renal and hepatic function tests.
	B)	Inspect patient’s stools.
	C)	Evaluate the patient’s lifestyle and diet.
	D)	Obtain patient’s general health history.

23.	A 26-year-old female patient with a skin infection has been prescribed 400 mg bacampicillin to be taken orally. Which of the following instructions should the nurse include in the patient teaching plan?
	A)	If a dosage is missed, increase the next dosage to meet the daily quota.
	B)	Bacampicillin will reduce the effectiveness of birth control pills.
	C)	Take drug on an empty stomach, an hour before or two hours after meals.
	D)	Avoid use of skin-care products, like moisturizers, when on penicillin therapy.

24.	A patient undergoing penicillin therapy shows improvement and states that he is feeling better. Which of the following interventions is the nurse most likely to perform in such a situation?
	A)	Instruct patient to increase dietary intake.
	B)	Inform the primary health provider immediately.
	C)	Record evaluations on patient’s chart.
	D)	Inquire about any previous drug allergies.

25.	After administering penicillin as prescribed, a patient shows signs of diarrhea and informs the nurse that there is blood in his stools. Which of the following interventions should the nurse perform?
	A)	Contact primary health provider immediately.
	B)	Include yogurt or buttermilk in patient’s diet.
	C)	Decrease fiber content in diet.
	D)	Continue with prescribed regimen.

26.	A nurse is caring for a patient who is being administered penicillin. What are the common adverse reactions to penicillin a nurse should assess for?
	A)	Inflammation of the tongue and mouth	C)	Severe hypotension
	B)	Impaired oral mucous membranes	D)	Sudden loss of consciousness

27.	The primary health provider has prescribed 764 mg of carbenicillin indanyl sodium to be taken orally four times a day. The available tablet contains carbenicillin indanyl sodium equivalent to 382 mg of carbenicillin. The nurse should administer how many tablet/s to the patient four times a day?
	A) 2 B) 2.5 C) 3 D) 3.5

28.	A nurse is required to administer a parenteral form of penicillin to a patient. Which of the following interventions should a nurse perform when preparing penicillin in parenteral form?
	A)	Extract penicillin from vial and then reconstitute.
	B)	Save excess antibiotic after reconstitution for later use.
	C)	Use any available diluent for reconstitution.
	D)	Shake the vial well to distribute the drug evenly.

29.	A doctor prescribes a patient 3.375 g piperacillin sodium and tazobactam (Zosyn) every six hours. After reconstitution, the concentration of the drug is 2.25 g/50 mL. Which of the following quantity of the reconstituted solution should the nurse administer to the patient?
	A) 60 mL B) 65 mL C) 70 mL D) 75 mL

30.	A 48-year-old patient with an ear infection is being assessed for penicillin therapy. When assessing the patient’s drug history, the nurse finds that the patient is taking beta-adrenergic blocking drugs to control his blood pressure. Which of the following risks is this patient most susceptible to if penicillin is administered?
	A)	Anaphylactic shock	C)	Excess bleeding
	B)	Higher blood pressure	D)	Heart attack

1.	Which of the following are true of tetracyclines? Select all that apply.
	A)	Tetracyclines are broad spectrum antibiotics.
	B)	Tetracyclines may cause permanent discoloration of the teeth in children.
	C)	Tetracyclines can be used when penicillins are contraindicated.
	D)	Tetracyclines are contraindicated in children younger than 6 years.
	E)	Tetracyclines are used to treat Rocky Mountain spotted fever.

2.	The nurse should advise clients that which of the following are adverse reactions that may occur with the administration of tetracyclines? Select all that apply.
	A)	Photosensitivity
	B)	Hypoglycemia
	C)	Hypotension
	D)	Diarrhea
	E)	Stomatitis

3.	Tetracyclines increase the risk of toxicity from which of the following drug? Select all that apply.
	A)	Digoxin (Lanoxin)
	B)	Phenytoin (Dilantin)
	C)	Vancomycin (Vancocin)
	D)	Warfarin (Coumadin)
	E)	Carbamazepine (Tegretol)

4.	Which of the following should a nurse recognize as an aminoglycoside? Select all that apply.
	A)	Amikacin (Amikin)
	B)	Amoxicillin (Amoxil)
	C)	Vancomycin (Vancocin)
	D)	Kanamycin (Kantrex)
	E)	Azithromycin (Zithromax)

5.	How do aminoglycosides elicit there bactericidal effects? Select all that apply.
	A)	Inhibit bacterial DNA gyrase.
	B)	Block a step in bacterial protein synthesis.
	C)	Disrupt the functional ability of the bacterial cell wall.
	D)	Block bacterial RNA synthesis.
	E)	Inhibit bacterial binding to the host cell.

6.	While administering aminoglycosides to clients, the nurse must be aware of which of the following toxicities that can result from their use? Select all that apply.
	A)	Nephrotoxicity
	B)	Cardiotoxicity
	C)	Ototoxicity
	D)	Hepatotoxicity
	E)	Neurotoxicity

7.	Which of the following signs should the nurse monitor a client for that would indicate nephrotoxicity from an aminoglycoside? Select all that apply.
	A)	Proteinuria
	B)	Hematuria
	C)	Decreased urine output
	D)	Increased serum creatinine
	E)	Decreased fluid intake

8.	What contraindication to aminoglycosides should a nurse be aware of to prevent complications to the client? Select all that apply.
	A)	Preexisting hearing loss
	B)	Pregnancy
	C)	Parkinsonism
	D)	Diabetes
	E)	Hyperlipidemia

9.	Which of the following is true of macrolide antibiotics? Select all that apply.
	A)	Macrolides are broad spectrum antibiotics.
	B)	Macrolides are contraindicated in clients with renal dysfunction.
	C)	Macrolides may cause visual disturbances.
	D)	Macrolides can be used in clients allergic to penicillins.
	E)	Macrolides can be used to treat acne vulgaris.

10.	Clindamycin (Cleocin) should be used with caution in clients with which of the following? Select all that apply.
	A)	Seizure disorder
	B)	GI disorders
	C)	Myasthenia gravis
	D)	Diabetes
	E)	Hepatic impairment

11.	During the nurse’s pre-administration assessment he or she should identify and record signs and symptoms of infection. Which of the following are signs or symptoms of infection that a client might display? Select all that apply.
	A)	Redness
	B)	Drainage
	C)	Pain
	D)	Fever
	E)	Swelling

12.	During ongoing assessment of a client receiving erythromycin (Ery-Tab), the nurse should notify the physician immediately if which of the following occur? Select all that apply.
	A)	Significant drop in blood pressure
	B)	Increase in heart rate
	C)	Decrease in temperature
	D)	Increase in respiratory rate
	E)	Sudden increase in temperature

13.	Which of the drug-specific nursing diagnoses may be used in the administration of a macrolide, aminoglycoside, tetracycline, or lincosamide to a client? Select all that apply.
	A)	Impaired comfort
	B)	Altered thought process
	C)	Diarrhea
	D)	Risk for injury
	E)	Ineffective tissue profusion

14.	The nurse should not administer tetracyclines with which of the following? Select all that apply.
	A)	Lantus
	B)	Cheese
	C)	Tums
	D)	Peri-Colace
	E)	Feosol

15.	Which of the following should the nurse do when giving a macrolide, tetracycline, aminoglycoside, or a lincosamide intramuscularly? Select all that apply.
	A)	Inspect previous injection sites.
	B)	Rotate the injection site.
	C)	Use the abdomen for intramuscular injections.
	D)	Note the site used for injection in the client’s chart.
	E)	Notify the physician of any persistent localized reactions.

16.	When the client has an elevated temperature, the nurse checks which of the following every hour until the temperature returns to normal? Select all that apply.
	A)	Temperature
	B)	Pulse
	C)	Blood glucose
	D)	Blood pressure
	E)	Respirations

17.	The physician orders amikacin (Amikin) 15 mg/kg IM in two divided doses. Amikacin is available in a 50 mg/mL vial. How many mL does the nurse need to prepare per dose if the client weighs 152.5 lb?

18.	The physician writes an order for a client to receive gentamicin 3 mg/kg/day given IV every eight hours. If the client weighs 225.3 lb, how many mg will be administered to the client in each dose?

19.	The physician writes an order for a client to receive neomycin 1 g/day orally for three days for preoperative prophylaxis. Neomycin is available in a 500 mg tablet. How many tablets will the client need for the three days?

20.	The physician orders clindamycin (Cleocin) 600 mg IM per day in three equal doses for a client. Clindamycin is available in a 150 mg/mL vial. How many mL will the nurse need to prepare for each dose?

21.	A nurse has administered demeclocycline to a patient. Which of the following adverse reactions should the nurse closely monitor the patient for?
	A) Photosensitivity B) Abdominal pain C) Cramping D) Blood dyscrasias

22.	A patient has been prescribed a tetracycline drug for Rocky Mountain spotted fever. The patient also takes antacids. Which of the following effects is likely to occur due to an interaction between the two drugs?
	A)	Increased risk of bleeding
	B)	Increased action of neuromuscular-blocking drugs
	C)	Increased profound respiratory depression
	D)	Decreased absorption of tetracycline

23.	In which of the following patients is lincosamide therapy contraindicated?
	A)	Children younger than 9 years	C)	Patients taking cisapride
	B)	Patients with preexisting liver disease	D)	Patients with myasthenia gravis

24.	A middle-aged patient has been prescribed tetracycline as part of his Prevpac for the treatment of H. pylori. The patient has a history of atrial fibrillation which is being treated with digitalis drugs. Given his history and current medications, the patient is at risk for which of the following conditions?
	A)	Respiratory depression	C)	Increase in serum theophylline level
	B)	Increase in serum levels	D)	Risk of toxicity

25.	A young pregnant patient with intestinal amebiasis is prescribed a tetracycline. Which of the following can be an adverse effect of the drug?
	A)	Yellow-gray-brown discoloration of the teeth
	B)	Toxic effects to the developing fetus
	C)	Increase in the blood pressure
	D)	Bacterial overgrowth of nonsusceptible organisms

26.	A patient has been prescribed oral tetracycline for the treatment of acne. Which of the following must the nurse include in the patient teaching plan?
	A)	Take the drug on an empty stomach.
	B)	Take the drug along with a meal.
	C)	Take the drug along with milk or fruit juice.
	D)	Take the drug immediately after meals.

27.	A patient is being prescribed tetracycline for the treatment of rickettsiae. The nurse learns that the patient is also taking an anticoagulant for a circulatory disorder. What is the effect of oral anticoagulant drugs interacting with tetracycline?
	A)	Increased serum theophylline level	C)	Increased risk of bleeding
	B)	Decreased effectiveness of tetracycline	D)	Increased risk for digitalis toxicity

28.	A patient with acne vulgaris was administered macrolides, after which the patient developed diarrhea. What nursing intervention should the nurse perform in this case?
	A)	Inspect stools for blood or mucus.	C)	Record symptoms of infection.
	B)	Obtain allergy history.	D)	Measure urine output.

29.	A patient has been administered Ketac as part of a dental treatment. Which of the following adverse effects should the nurse inform the patient of?
	A)	Esophagitis	C)	Photosensitivity
	B)	Difficulty in focusing eyesight	D)	Development of skin rashes

30.	A patient is admitted to a health care facility for diarrhea. The patient’s stool tested positive for blood and mucus. What immediate nursing intervention should follow after this observation?
	A)	Save urine sample for tests.
	B)	Measure and record vital signs.
	C)	Check patient’s blood pressure.
	D)	Save stool sample for occult blood test.

1.	Clients taking which of the following drugs may be at increased risk for candidal infections? Select all that apply:
	A)	Zocor
	B)	Cipro
	C)	Orapred
	D)	Diovan
	E)	Ortho Tri-Cyclen

2.	Which of the following herbs have been found to be effective against fungal skin infections? Select all that apply:
	A)	Tea tree oil
	B)	Gingko biloba
	C)	Valerian root
	D)	Fever few
	E)	Garlic

3.	Itraconazole (Sporanox) should be used with caution in clients with which of the following conditions? Select all that apply
	A)	Hypertension
	B)	Glaucoma
	C)	HIV
	D)	Hypochlorhydria
	E)	GERD

4.	Which of the following are true of amphotericin B (AmBisome)? Select all that apply:
	A)	AmBisome is light sensitive.
	B)	AmBisome is administered via IM injection.
	C)	AmBisome can cause renal damage.
	D)	AmBisome is administered in the outpatient setting.
	E)	AmBisome should be used within eight hours.

5.	During IV infusion of amphotericin B (AmBisome) clients should be monitored for which of the following adverse reactions during the first 30 to 60 minutes of the infusion? Select all that apply:
	A)	Muscle pain
	B)	Hypotension
	C)	Nausea
	D)	Decreased renal function
	E)	Chills

6.	Which of the following should be part of the nurse’s teaching plan when instructing a client about the use of an antifungal cream preparation for the treatment of ringworm in the ambulatory care setting? Select all that apply:
	A)	Clean involved area before applying cream.
	B)	Increase the amount of cream used if skin infection worsens.
	C)	Decrease the frequency of applying cream if skin infection improves.
	D)	Keep towels and washcloths for bathing separate from other family members during treatment.
	E)	Keep the affected area clean and moist.

7.	Which of the following should be included in the nurse’s teaching plan when instructing a female client on the use of miconazole (Monistat) vaginal cream? Select all that apply:
	A)	Discontinue drug during the menstrual period.
	B)	Avoid nylon and tight-fitting garments to avoid reinfection.
	C)	Wear a sanitary napkin after insertion of the drug to prevent staining of clothes and bed linens.
	D)	Do not have intercourse while taking the drug to avoid reinfection.
	E)	If there is no improvement in two days, stop using the drug and consult a physician.

8.	Which of the following are considered helminths? Select all that apply:
	A)	Roundworms
	B)	Pinworms
	C)	Ringworms
	D)	Hookworms
	E)	Tapeworms

9.	Clients receiving any antihelminthic should be advised of which of the following adverse reactions? Select all that apply:
	A)	Hypotension
	B)	Drowsiness
	C)	Abdominal pain
	D)	Hypoglycemia
	E)	Nausea

10.	Antihelminthic drugs should be used cautiously in which of the following clients? Select all that apply:
	A)	Lactating clients
	B)	Hepatically impaired clients
	C)	Anemic clients
	D)	Diabetic clients
	E)	Renally impaired clients

11.	Antiprotozoal drugs are used in the treatment of which of the following infections? Select all that apply:
	A)	Toxoplasmosis
	B)	Malaria
	C)	Giardiasis
	D)	Pneumocystis carinii pneumonia
	E)	Trichomoniasis

12.	Foods that acidify the urine may interact with chloroquine and increase the drugs excretion, thereby decreasing its effectiveness in the treatment of malaria. The nurse should counsel the client to avoid which of the following foods during treatment with chloroquine? Select all that apply:
	A)	Plums
	B)	Oranges
	C)	Fish
	D)	Eggs
	E)	Cranberries

13.	Which of the following represent drug-specific nursing diagnoses when discussing the treatment of parasitic infection? Select all that apply:
	A)	Impaired comfort
	B)	Diarrhea
	C)	Risk for ineffective tissue profusion
	D)	Risk for deficient fluid volume
	E)	Risk for impaired respiratory function

14.	A client is planning to travel to an area of the world where malaria is endemic. The physician has given the client a prescription of chloroquine for malaria prophylaxis. The nurse should advise the client of which of the following in regards to beginning and ending therapy? Select all that apply:
	A)	Begin therapy one month before exposure.
	B)	Begin therapy two weeks before exposure.
	C)	Continue therapy six to eight weeks after leaving endemic area.
	D)	Continue therapy one to two weeks after leaving endemic area.
	E)	Stop therapy two days prior to leaving endemic area.

15.	During treatment of parasitic infections the physician may order daily stool specimens be sent to the lab for examination. What should the nurse record in regard to the client’s stool when implementing a plan for the nursing diagnoses of diarrhea and risk for fluid volume deficit? Select all that apply:
	A)	Number of stools produced
	B)	Odor of stool
	C)	Consistency of stool
	D)	Frequency of stool
	E)	Color of stool

16.	What nondrug methods should the nurse advise the client and their family to take to prevent the passing of infection to others or reinfection? Select all that apply:
	A)	Wash hands thoroughly before preparing or eating food.
	B)	Disinfect toilets daily.
	C)	Bathe daily.
	D)	Disinfect the bathtub or shower stall immediately after bathing.
	E)	Avoid putting fingers in the mouth or biting fingernails.

17.	The physician has ordered Abelcet for a client at a dose of 3.5 mg/kg/day to be administered in a single infusion. The client weighs 75 kg. Abelcet is available in a 5 mg/mL vial. How many mL will need to be prepared to be administered to the client in one dose?

18.	A physician has ordered a client to receive Ancobon 50 mg/kg/day every six hours. The client weighs 120 lb. Ancobon is available in 250 mg tablets. How many tablets would the client require daily?

19.	Which of the following are trade names for clotrimazole vaginal preparations? Select all that apply:
	A)	Lotrimin 3
	B)	Monistat 3
	C)	Femstat 3
	D)	Terazol 7
	E)	Mycelex-7

20.	The nurse must monitor a client carefully for signs of bleeding when which of the following antifungals is concomitantly administered with warfarin (Coumadin)? Select all that apply:
	A)	Fluconazole (Diflucan)
	B)	Itraconazole (Sporanox)
	C)	Ketoconazole (Nizoral)
	D)	Griseofulvin (Grisactin)
	E)	Voriconazole (Vfend)

21.	A patint has been prescribed chloroquine. Which of the following instructions should the nurse give to the patient regarding the dosage of the antimalarial drug?
	A)	Avoid foods that acidify the urine.
	B)	Take the drug on an empty stomach.
	C)	Increase dosage if dosage missed once.
	D)	Discontinue drug if color of urine changes.

22.	A patient has been diagnosed with an amebiasis infection, and the primary health care provider has prescribed metronidazole. The patient is also taking warfarin for blood clotting. Which of the following is a possible interaction associated with taking metronidazole with warfarin.
	A)	Increases absorption of metronidazole	C)	Increases the risk of bleeding
	B)	Increases metabolism of metronidazole	D)	Increases the risk of heart attack

23.	A patient with a severe stomach ache visits the health care facility. Which of the following interventions should the nurse perform if a pinworm infection is suspected?
	A)	Obtain stool samples.	C)	Obtain urine sample.
	B)	Obtain blood sample.	D)	Obtain sample of saliva.

24.	A patient is being administered doxycycline. Which of the following instructions should the nurse give to the patient regarding the possible side effects of the drug?
	A)	Avoid taking warfarin because it increases the risk of bleeding.
	B)	Avoid exposure to the sun by wearing protective clothing.
	C)	Take the drug with food, or immediately afterwards.
	D)	Do not drive or perform other activities requiring alertness.

25.	A patient has been diagnosed with amebiasis. Which of the following interventions should the nurse perform regularly while caring for the patient?
	A)	Take vital signs every eight hours.
	B)	Freeze any stool samples for testing.
	C)	Avoid foods that acidify the urine.
	D)	Provide the patient with small, frequent meals.

26.	A patient has been instructed to take metronidazole for intestinal amebiasis. Which of the following instructions should the nurse give to the patient regarding the drug?
	A)	Take the food on an empty stomach.
	B)	Avoid intake of alcohol.
	C)	Guard against effects of photosensitivity.
	D)	Take phenobarbital for impaired sleep.

27.	A patient has been prescribed quinine. Which of the following instructions should the nurse give to the patient regarding its use?
	A)	Cut the tablet in half and take each half one after the other.
	B)	Ensure that the drug is taken on an empty stomach.
	C)	Ignore itching, rash, fever, or vision problems—these are normal.
	D)	Do not drive if blurred vision or dizziness occurs.

28.	A patient has been prescribed albendazole on an outpatient basis for an anthelmintic infection. Which of the following instructions should the nurse give to the patient?
	A)	Easy bruising or bleeding is normal and needn’t be reported.
	B)	Disinfect the bathtub or shower stall immediately after bathing.
	C)	Avoid bathing daily if patient experiences impaired skin integrity.
	D)	Use oral contraceptives during the course of the drug therapy.

29.	Pyrantel has been prescribed for a patient with roundworm. Which of the following common adverse reactions of pyrantel should the patient report immediately to the primary care provider?
	A) Abdominal cramping B) Headache C) Nausea D) Rashes

30.	In which of the following patients are anthelmintic drugs contraindicated?
	A)	Patients who are pregnant	C)	Patients with clinical depression
	B)	Patients with myasthenia gravis	D)	Children younger than 15 years

1.	Opioid analgesics can be classified as which of the following? Select all that apply:
	A)	An agonist
	B)	A partial agonist
	C)	A partial antagonist
	D)	An antagonist
	E)	A mixed agonist-antagonist

2.	A nurse should recognize the common adverse effects of opioids. Which of the following are examples of common adverse effects seen with the use of opioids? Select all that apply:
	A)	Respiratory depression
	B)	Diarrhea
	C)	Mydriasis
	D)	Constipation
	E)	Miosis

3.	Opioid analgesics are used primarily for the treatment of which of the following? Select all that apply:
	A)	Severe acute pain
	B)	Mild acute pain
	C)	Moderate chronic pain
	D)	Mild chronic pain
	E)	Opioid dependence

4.	A nurse should be aware of contraindications to the use of opioids to help decrease the likelihood of adverse events. Which of the following is an example of a client with a contraindication to the use of opioids? Select all that apply:
	A)	A client with acute bronchial asthma
	B)	A client with an acute myocardial infarction
	C)	A client with a head injury
	D)	A client with grand mal seizures
	E)	A client with mild renal impairment

5.	A homecare nurse is asked to give a client 2 teaspoonfuls of passion flower tincture three times daily. If the tincture is 2 g/5 mL, how many grams of passion flower will the client receive in one day?

6.	Prior to the administration of an opioid analgesic, the nurse should gather which of the following information from the client? Select all that apply:
	A)	Pain assessment
	B)	Allergy history
	C)	Health history
	D)	Past medication history
	E)	Current medication therapy

7.	The nurse should take care to closely monitor which of the following when an oxymorphone (Roxicodone) is administered with promethazine (Phenergan)? Select all that apply:
	A)	Temperature
	B)	Blood pressure
	C)	Pulse
	D)	Respiratory rate
	E)	Blood glucose

8.	A nurse monitoring a client taking an opiate for diarrhea should notify the physician immediately if which of the following occurs? Select all that apply:
	A)	Constipation occurs.
	B)	Blood is noted in the stool.
	C)	Diarrhea worsens.
	D)	Client reports severe abdominal pain.
	E)	Diarrhea is not relieved.

9.	The rate of tolerance to an opioid analgesic’s effects varies from client to client. Which of the following affects the rate at which tolerance develops? Select all that apply:
	A)	Body weight
	B)	Gender
	C)	Dosage
	D)	Route of administration
	E)	Age

10.	Which of the following are methods used to treat a drop in respiratory rate in a client receiving an opioid analgesic? Select all that apply:
	A)	Administering oxygen.
	B)	Coaching the client to breathe.
	C)	Stopping the opioid analgesic.
	D)	Administering naloxone (Narcan).
	E)	Administering albuterol (Proventil).

11.	Epidural administration of opioid analgesics is reserved for which of the following cases? Select all that apply:
	A)	Labor pain
	B)	Support of anesthesia
	C)	Postoperative pain
	D)	Moderate acute pain
	E)	Intractable chronic pain

12.	Which of the following are advantages of the epidural route of administration for opioid analgesics over other routes of administration? Select all that apply:
	A)	Longer time to tolerance development
	B)	Lower total dose of opioid
	C)	Fewer adverse reactions
	D)	Greater client comfort
	E)	Decreased demand on nursing staff

13.	The nurse should contact the physician immediately if a client taking an opioid analgesic experiences which of the following? Select all that apply:
	A)	Respiratory rate of less than 10 breaths/min
	B)	Decrease in pulse
	C)	Increase in pulse
	D)	Increase in blood pressure
	E)	Blood pressure of 95/65 mmHg

14.	Clients taking opioids may be fearful that movement may result in more pain. To help the client overcome this fear, a nurse should do which of the following? Select all that apply:
	A)	Get the client out of bed.
	B)	Get the client to do deep breathing.
	C)	Get the client to lie still in bed.
	D)	Get the client to cough every two hours.
	E)	Get the client more pain medication.

15.	To decrease the risk of injury to a client taking an opioid, the nurse should do which of the following? Select all that apply:
	A)	Keep the lights in the client’s room turned down.
	B)	Assist client from their bed to the toilet.
	C)	Assist client with rising from a lying position.
	D)	Assist client with hall-walking activities.
	E)	Advise the client to stay in bed all night.

16.	A nurse working with newborns should be cognizant of which of the following symptoms that may indicate withdrawal in a child born to an opiate-dependent mother? Select all that apply:
	A)	Jaundice
	B)	Increased respiratory rate
	C)	Decreased respiratory rate
	D)	Sneezing
	E)	Fever

17.	A nurse is working at a substance abuse clinic. Which of the following opioids are used in the treatment and management of opiate dependence? Select all that apply:
	A)	Fentanyl (Duragesic)
	B)	Methadone (Dolophine)
	C)	Propoxyphene (Darvon)
	D)	Levomethadyl (Orlaam)
	E)	Oxycodone (OxyContin)

18.	It is important for the nurse to recognize the symptoms of the abstinence syndrome in clients taking opioids. Which of the following are intermediate symptoms of the abstinence syndrome? Select all that apply:
	A)	Rhinorrhea
	B)	Increased blood pressure
	C)	Tachycardia
	D)	Mydriasis
	E)	Miosis

19.	A nurse should recognize the difference between opioid agonists and the mixed opioid agonists-antagonists. Which of the following are examples of mixed opioid agonist-antagonists? Select all that apply:
	A)	Alfentanil (Alfenta)
	B)	Buprenorphine (Buprenex)
	C)	Meperidine (Demerol)
	D)	Nalbuphine (Nubain)
	E)	Pentazocine (Talwin)

20.	A nurse should take care not to administer extra Tylenol to clients taking which of the following medications? Select all that apply:
	A)	Lortab
	B)	Darvocet
	C)	Percocet
	D)	Dilaudid
	E)	Ultram

21.	A nurse is caring for a patient who is prescribed an opioid analgesic by her health care provider. The nurse should monitor for which of the following adverse reactions of opioid analgesics when caring for this patient?
	A)	Decreased intercranial pressure	C)	Peripheral circulatory collapse
	B)	Increased breathing rate	D)	Urinary frequency

22.	A nurse is required to administer an opioid to a patient. Which of the following conditions should the nurse confirm in the patient to ensure that opioid therapy is not contraindicated in this patient?
	A)	Patient does not have acute bronchial asthma.
	B)	Patient does not have acute diabetic retinopathy.
	C)	Patient does not have acute pre-existing liver disease.
	D)	Patient does not have decreased intracranial pressure.

23.	A patient is prescribed opioid analgesic. During the initial interview with the patient, the nurse understands that the patient chronically drinks alcohol. Which of the following effect of the interaction between opioid analgesic and alcohol should the nurse monitor for in the patient?
	A)	Respiratory depression	C)	Hypotension
	B)	Central nervous system depression	D)	Sedation

24.	A nurse is assigned to care for a patient who has been prescribed an opioid analgesic. Which of the following activities should the nurse perform as a part of the pre-administration assessment?
	A)	Document description of pain and an estimate of when the pain began.
	B)	Obtain patient’s blood pressure and pulse within 5 to 10 minutes.
	C)	Monitor the patient for symptoms of respiratory depression.
	D)	Record each bowel movement, its appearance, color, and consistency.

25.	A nurse is caring for a patient with pain caused by terminal illness. The physician has prescribed an opioid for the patient. Which of the following effects of the drug administration should the nurse monitor for in the patient?
	A) Emphysema B) Alopecia C) Dehydration D) Severe anorexia

26.	A nurse has administered an opioid to a patient. What nursing interventions should the nurse perform if the patient shows a decrease in respirations?
	A)	Monitor and encourage patient to cough and breathe deeply every two hours.
	B)	Instruct the patient to restrict his consumption of liquids.
	C)	Instruct the patient to take complete bed rest.
	D)	Instruct the patient to avoid any kind of exercise.

27.	A nurse is caring for a patient who has been prescribed an opiate. What nursing intervention should the nurse perform as a part of the ongoing assessment?
	A)	Review the patient’s health history.
	B)	Review the patient’s allergy history.
	C)	Inquire about the pain experienced by patient.
	D)	Review patient’s past and current drug therapies.

28.	A nurse is caring for a patient with chronic pain who has been prescribed epidural analgesia. The nurse should monitor the patient for which of the following conditions after insertion of the epidural catheter and throughout the therapy?
	A) Abdominal pain B) Respiratory depression C) Fever D) Nervousness

29.	A patient is receiving drugs through a PCA infusion pump. Which of the following information should a nurse offer to the patient for proper administration of the drug through the infusion pump?
	A)	Pain relief should occur one hour after pushing the control button.
	B)	Control button and the button to call the nurse are the same.
	C)	Control button activates administration of the drug.
	D)	Machine delivers drug every time the control button is used.

30.	A nurse is caring for a patient who is addicted to opioids. The physician has prescribed maintenance therapy using methadone for detoxification. Which of the following should the nurse keep in mind when caring for the patient undergoing detoxification and maintenance treatment with methadone?
	A)	Dosages vary according to length of patients’ addictions.
	B)	Methadone is discontinued on an outpatient basis.
	C)	Dosages vary according to patients’ weight.
	D)	Male patients are prescribed higher doses than female patients.

1.	Which of the following are true in regards to the effect of caffeine on the body? Select all that apply:
	A)	Skeletal muscle relaxation
	B)	Respiratory stimulation
	C)	Central nervous system (CNS) stimulation
	D)	Cardiac relaxation
	E)	Diuresis

2.	Analeptics increase the depth of respirations by stimulating chemoreceptors located in which part of the body? Select all that apply:
	A)	Upper aorta
	B)	Left ventricle
	C)	Jugular vein
	D)	Carotid artery
	E)	Pulmonary vein

3.	Which of the following signs would a client taking amphetamines exhibit? Select all that apply:
	A)	Decrease in blood pressure
	B)	Sleepiness
	C)	Increased pulse
	D)	Euphoria
	E)	Decreased pulse

4.	Central nervous system stimulants may used to treat which of the following conditions? Select all that apply:
	A)	Sleep apnea
	B)	Hypertension
	C)	Attention deficit hyperactivity disorder (ADHD)
	D)	Drug-induced respiratory depression
	E)	Hyperglycemia

5.	The physician writes an order for a client to receive doxapram (Dopram) 0.5 mg/kg IV. If the client weighs 250 lb., how many milligrams will the client require in one dose?

6.	A nurse caring for a client taking a CNS stimulant should monitor the client for which of the following side effects? Select all that apply:
	A)	Disorientation
	B)	Dyspnea
	C)	Bradycardia
	D)	Urinary retention
	E)	Headache

7.	The nurse should take care not to administer CNS stimulants to clients with which of the following medical conditions? Select all that apply:
	A)	Severe hypotension
	B)	Hyperthyroidism
	C)	Diabetes
	D)	Cardiac disease
	E)	Seasonal allergies

8.	The use of CNS stimulants is contraindicated in clients with which of the following conditions? Select all that apply:
	A)	Epilepsy
	B)	COPD
	C)	Glaucoma
	D)	Diabetes
	E)	GERD

9.	The nurse’s pre-administration assessment of a client receiving a CNS stimulant for respiratory depression should include which of the following? Select all that apply:
	A)	Blood pressure
	B)	Pulse
	C)	Respiratory rate
	D)	Respiratory pattern
	E)	Review recent lab work

10.	The nurse’s pre-administration assessment of a client receiving a CNS stimulant for attention deficit hyperactivity disorder should include which of the following? Select all that apply:
	A)	Blood pressure
	B)	Pulse
	C)	Respiratory rate
	D)	Behavior pattern
	E)	Review recent lab work

11.	The nurse’s pre-administration assessment of a client receiving a CNS stimulant for the treatment of obesity should include which of the following? Select all that apply:
	A)	Blood pressure
	B)	Pulse
	C)	Weight
	D)	Respiratory rate
	E)	Review recent lab work

12.	The nurse’s ongoing assessment of a client receiving a CNS stimulant for respiratory depression should include which of the following? Select all that apply:
	A)	Blood pressure
	B)	Pulse
	C)	Respiratory rate
	D)	Respiratory pattern
	E)	Level of consciousness

13.	A client taking a CNS stimulant may experience altered sleep patterns. What can the nurse instruct the client to do to help with altered sleep patterns? Select all that apply:
	A)	Administer the drug early in the day.
	B)	Take frequent naps throughout the day.
	C)	Avoid other caffeine.
	D)	Stop taking the medication.
	E)	Be active during the day.

14.	A nurse recommends a client avoid other CNS stimulants while taking dexmethylphenidate (Focalin) which include which of the following? Select all that apply:
	A)	Tea
	B)	Chocolate
	C)	Coffee
	D)	Cola drinks
	E)	Milk

15.	A nurse caring for an elderly client should monitor the client for which of the following as older clients are more sensitive to the side effects of CNS depressants? Select all that apply:
	A)	Anxiety
	B)	Insomnia
	C)	Bradycardia
	D)	Confusion
	E)	Hypotension

16.	When should the nurse instruct a client’s parents to administer dexmethylphenidate (Focalin) to the client? Select all that apply:
	A)	After breakfast
	B)	Before breakfast
	C)	After lunch
	D)	Before lunch
	E)	At bedtime

17.	A nurse should instruct clients with which of the following conditions to avoid over-the-counter caffeine preparation? Select all that apply:
	A)	Hyperlipidemia
	B)	Peptic ulcer disease
	C)	GERD
	D)	Hypertension
	E)	Heart disease

18.	A nurse caring for a client with attention deficit hyperactivity disorder (ADHD) may administer which of the following CNS stimulants? Select all that apply:
	A)	Methylphenidate (Concerta)
	B)	Phenteramine (Adipex-P)
	C)	Modafinil (Provigil)
	D)	Doxapram (Dopram)
	E)	Dextroamphetamine (Dexedrine)

19.	A nurse caring for a client with narcolepsy may administer which of the following CNS stimulants? Select all that apply:
	A)	Methylphenidate (Concerta)
	B)	Phenteramine (Adipex-P)
	C)	Modafinil (Provigil)
	D)	Armodafinil (Nuvigil)
	E)	Dextroamphetamine (Dexedrine)

20.	A nurse caring for a client with obesity may administer which of the following CNS stimulants? Select all that apply:
	A)	Benzphetamine (Didex)
	B)	Phenteramine (Adipex-P)
	C)	Modafinil (Provigil)
	D)	Sibutramine (Meridia)
	E)	Dextroamphetamine (Dexedrine)

21.	Which of the following effects can be noticed in a patient who has been administered amphetamines?
	A) Decreased appetite B) Low blood pressure C) Drowsiness D) Depression

22.	Which of the following reactions can occur in a patient who has been administered caffeine?
	A)	Decease in heart rate	C)	Feeling of euphoria and well-being
	B)	Decrease in urinary output	D)	Skeletal muscle stimulation

23.	A patient has been prescribed an amphetamine as part of obesity treatment. Which of the following interventions should the nurse perform before the dosage regimen starts?
	A)	Record the patient’s temperature.
	B)	Record the patient’s weight.
	C)	Record the patient’s blood glucose level.
	D)	Review arterial blood gas studies.

24.	A patient has been prescribed Didrex. Which of the following precautions should the nurse take while administering the drug?
	A)	Provide tea, coffee, and other stimulants.
	B)	Administer the drug around dinner time.
	C)	Avoid administering antidepressants.
	D)	Provide carbonated beverages.

25.	A 10-year-old child is being administered CNS stimulants for ADHD. Which of the following should the nurse instruct the parents to record periodically?
	A)	Social interaction	C)	Voiding pattern
	B)	Weight and growth	D)	Sleeping pattern

26.	A patient has been prescribed Modafinil for the treatment of narcolepsy. Which of the following is a possible reaction that the nurse should monitor for?
	A) Insomnia B) Nausea C) Urinary retention D) Tremors

27.	For which of the following patients are CNS stimulants contraindicated?
	A)	Patients with Parkinson’s disease	C)	Patients younger than 20
	B)	Patients with severe hypertension	D)	Patients with renal dysfunction

28.	Which of the following reactions should a nurse monitor for in a patient who has been administered doxapram?
	A) Impaired vision B) Increased heart rate C) Urinary pattern D) Tinnitus

29.	A patient is being administered Modafinil for narcolepsy. Which of the following instructions should the nurse give to the patient?
	A)	Record any changes in weight.
	B)	Avoid coffee or tea.
	C)	Record number of periods of sleepiness.
	D)	Take OTC antidepressants for depression.

1.	A client treated with an antipsychotic medication might demonstrate which of the following behaviors if the antipsychotic medication was stopped? Select all that apply:
	A)	Hallucinations
	B)	Anhedonia
	C)	Delusions
	D)	Dystonia
	E)	Flatten affect

2.	Aripiprazole (Abilify) is thought to exert its effect on which of the following receptor in the brain? Select all that apply:
	A)	Serotonin
	B)	Dopamine
	C)	Norepinephrine
	D)	Muscarinic
	E)	Nicotinic

3.	Which of the following antipsychotic medications have antiemetic effects? Select all that apply:
	A)	Lithium (Eskalith)
	B)	Aripiprazole (Abilify)
	C)	Chlorpromazine (Thorazine)
	D)	Prochlorperazine (Compazine)
	E)	Clozapine (Clozaril)

4.	A nurse should be able to differentiate between the typical and atypical antipsychotic. Which of the following are classified as atypical antipsychotics? Select all that apply:
	A)	Lithium (Eskalith)
	B)	Aripiprazole (Abilify)
	C)	Chlorpromazine (Thorazine)
	D)	Prochlorperazine (Compazine)
	E)	Clozapine (Clozaril)

5.	A 10-year-old client is being treated with haloperidol (Haldol) for Tourette’s syndrome. If the client weighs 55 lb and the physician orders for the client to have 0.05 mg/kg/day orally, what is the client’s daily dose in milligrams?

6.	A client is admitted to a psychiatric hospital for treatment of schizophrenia and the physician orders prochlorpromazine (Compazine) 15 mg IM. Prochlopromazine comes in a 5 mg/mL vial. How many milliliters does the nurse need to prepare to administer to the client?

7.	A nurse should be able to differentiate between the typical and atypical antipsychotic. Which of the following are classified as typical antipsychotics? Select all that apply:
	A)	Lithium (Eskalith)
	B)	Aripiprazole (Abilify)
	C)	Chlorpromazine (Thorazine)
	D)	Haloperidol (Haldol)
	E)	Fluphenazine (Prolixin)

8.	Which of the following are common skin reactions that a nurse should warn a client about when they are initiated on antipsychotic therapy? Select all that apply:
	A)	Urticaria
	B)	Stevens Johnson syndrome
	C)	Photosensitivity
	D)	Hyperpigmentation
	E)	Toxic epidermal necrolysis

9.	A nurse educating a client starting lithium (Eskalith) should educate the client about which of the following side effects? Select all that apply:
	A)	Extrapyramidal symptoms
	B)	Tremors
	C)	Tardive dyskinesia
	D)	Polyuria
	E)	Dystonia

10.	Which of the following is true regarding tardive dyskinesia (TD) associated with the use of antipsychotic medication? Select all that apply:
	A)	TD is an early appearing adverse reaction.
	B)	TD involves rhythmic, involuntary movements of the facial structures.
	C)	TD is a reversible adverse effect of antipsychotic drugs.
	D)	TD is less likely to occur with the use of atypical psychotics.
	E)	TD can occur after discontinuation of antipsychotic drug therapy.

11.	Which of the following clients are at increased risk for the development of lithium toxicity? Select all that apply:
	A)	Clients receiving furosemide (Lasix)
	B)	Clients experiencing diarrhea
	C)	Clients with renal insufficiency
	D)	Clients with liver cirrhosis
	E)	Clients experiencing vomiting

12.	During the pre-administration assessment of clients being given an antipsychotic drug, the nurse observes the client for any behavior patterns that appear to be deviations from normal. What behaviors should a nurse note as being a deviation from normal? Select all that apply:
	A)	Poor eye contact
	B)	Monotone speech pattern
	C)	Inappropriate laughter
	D)	Failure to answer questions completely
	E)	Inappropriate crying

13.	Which of the following are reasons a nurse may need to contact the client’s physician to administer an antipsychotic drug intramuscularly instead of orally? Select all that apply:
	A)	Client is combative.
	B)	Client refuses the medication.
	C)	Client won’t allow the nurse to inspect the oral cavity.
	D)	Client has difficulty swallowing.
	E)	Client is elderly.

14.	A nurse caring for a client receiving clozapine (Clozaril) needs to be mindful of the symptoms that indicate bone marrow suppression as agranulocytosis has been associated with the use of clozapine. Which of the following are symptoms of bone marrow suppression? Select all that apply:
	A)	Hypertension
	B)	Sore throat
	C)	Fever
	D)	Chills
	E)	Weakness

15.	The nurse should suspect lithium toxicity in a client that experiences which of the following symptoms? Select all that apply
	A)	Diarrhea
	B)	Lack of coordination
	C)	Hypertensive crisis
	D)	Muscle weakness
	E)	Decreased urine output

16.	The nurse should be able to distinguish signs of extrapyramidal syndrome (EPS) in clients taking antipsychotics so they can be quickly reported to the client’s physician. Which of the following are signs of EPS? Select all that apply:
	A)	Fine tremor
	B)	Hypotension
	C)	Akathisia
	D)	Anhedonia
	E)	Dystonia

17.	Which of the following atypical antipsychotics are associated with weight gain? Select all that apply:
	A)	Olanzapine (Zyprexa)
	B)	Risperidone (Risperdal)
	C)	Ziprasidone (Geodon)
	D)	Quetiapine (Seroquel)
	E)	Clozapine (Clozaril)

18.

A client is admitted to the psychiatric floor of a hospital for treatment of a schizophrenic episode. The physician order is for the client to receive fluphenazine (Prolixin) 3 mg IM TID. If fluphenazine is available in a 2.5 mg/mL vial, how many milliliters does the nurse need to prepare for each dose?

19.	Clients taking clozapine (Clozaril) are at risk for developing bone marrow suppression. Which of the following drugs can increase a client’s risk for bone marrow suppression when used concomitantly? Select all that apply:
	A)	Cellcept
	B)	Remicade
	C)	Prograf
	D)	Prednisone
	E)	Zocor

20.	A client is being treated for schizophrenia with thiothixene (Navane). The maximum dose of thiothixene (Navane) is 60 mg. If thiothixene is available in 5 mg tablets, how many tablets can a client receive per day?

21.	A patient is undergoing lithium therapy at a health care facility. The patient informs the nurse that he is taking antacids for heartburn. Which of the following is a possible effect of the interaction of lithium with antacids?
	A)	Decreased effectiveness of lithium	C)	Increased risk for bipolar disorder
	B)	Increased risk of lithium toxicity	D)	Increased psychotic symptoms

22.	For which of the following adverse reactions should the nurse monitor the patient who has been administered antipsychotic drugs?
	A) Hypertension B) Skin eruptions C) Dry mouth D) Bradycardia

23.	A nurse observes rhythmic, involuntary facial movements in a patient who has been administered antipsychotic drugs. The patient also makes chewing movements and, at times, his tongue protrudes. Which of the following is the most likely reason for the patient’s behavior?
	A)	Stevens-Johnson syndrome	C)	Tardive dyskinesia
	B)	Neuroleptic malignant syndrome	D)	Extrapyramidal syndrome

24.	Which of the following interventions should the nurse perform regarding the diet of a patient who is being administered lithium?
	A)	Take the drug on an empty stomach.
	B)	Ensure that extra salt is added to foods.
	C)	Drink at least five large glasses of fluid each day.
	D)	Increase food intake during drug regimen.

25.	A nurse is caring for a patient with schizophrenia. The physician has prescribed Olanzapine to the patient. Which of the following points should the nurse include in the teaching plan for the patient?
	A)	Remove the tablet with dry hands.	C)	Add extra salt to food.
	B)	Take the tablet with full glass of water.	D)	Avoid tea or coffee.

26.	A patient has been administered an antipsychotic. Which of the following reactions should be reported immediately?
	A) Orthostatic hypotension B) Dry mouth C) Rigidity D) Drowsiness

27.	Which of the following instructions should a nurse give to a patient who is being administered lithium?
	A)	Consume 2,000 ml/day of water.	C)	Take frequent sips of water.
	B)	Limit consumption of alcohol.	D)	Take diuretics regularly.

28.	Which of the following tests should be scheduled every week for a patient taking clozapine?
	A) Serum lithium B) WBC count C) Blood glucose D) pH level