18. Patient is admitted to the intensive care unit with hyperkalemia due to the use of potassium-sparing A diuretics. What assessment should the nurse prioritize?
A) Orientation to name, place, and time.
B) Cardiac monitoring.
C) Urine output.
D) Temperature.

19. Media reports in the community have focused on the risks of hepatitis B. The hepatitis B vaccine is recommended for what individuals? Select all that apply.
A) Adolescents over the age of 13.
B) Infants.
C) Anyone with acute or chronic renal failure.
D) Individuals aged 65 years or older.
E) Individuals with a known risk of hepatitis B exposure.

20. A patient presents to the emergency department (ED) having an acute asthma attack and has been prescribed epinephrine. The nurse should assess what therapeutic effect of this drug?
A) Decreased inflammatory response in the airways.
B) Reduced surface tension within the alveoli, allowing for gas exchange.
C) Inhibition of histamine and slow-reacting substance of anaphylaxis (SRSA) to prevent the allergic asthmatic response.
D) Dilation of the bronchi with increased rate and depth of respiration.

21. The clinic nurse is talking with a patient about information concerning a medication that the patient read about online. What is the nurse's best action?
A) Encourage the patient to seek information about drugs from a pharmacist.
B) Explain that information obtained from the Internet is not always accurate.
C) Offer the patient a drug reference guide to read and learn more about the drug.
D) Interpret the information and explain it in terms that the patient will understand.

22. The patient is undergoing chronic stress and is experiencing negative health effects. What type of drug could this patient receive to reduce the autonomic nervous response? Select all that apply.
A) A drug that reduces sympathetic response.
B) A drug that increases sympathetic response.
C) A drug that reduces parasympathetic response.
D) A drug that increases parasympathetic response.
E) A drug that reduces central nervous system (CNS) response

24. The nurse is caring for a patient with pneumonia. The nurse would expect to see which symptoms? Select all that apply.
A) Difficulty breathing.
B) Urinary retention.
C) Rash.
D) Fever.
E) Oxygen saturation of 88%.

25. The nurse is teaching a class about the autonomic nervous system for critical care nurses. What statements, if made by the nurse during the class, are accurate? Select all the apply
A) "Adrenergic receptors respond to norepinephrine."
B) "Adrenergic receptors are part of the sympathetic nervous system."
C) "Cholinergic receptors are part of the parasympathetic nervous system."
D) "Cholinergic receptors include alpha- and beta-receptors."
E) "Cholinergic and adrenergic receptors are part of the autonomic nervous system."

26. The nurse would assess patients with what conditions to determine whether there is a need for a saliva substitute? Select all that apply.
A) Cystic fibrosis.
B) Stroke.
C) Cancer treated with chemotherapy or radiation therapy.
D) Myocardial infarction.
E) Chronic dry mouth.

27. The nurse is caring for a patient who is exhibiting adverse medication effects. The nurse should recognize that adverse effects can be extensions of?
A) Primary action of a drug.
B) Anaphylaxis.
C) Secondary action of a drug.
D) An anticholinergic response to the drug.

28. A patient has just begun to take a prescribed diuretic and the nurse has taught the patient about the phenomenon of fluid rebound. How should the nurse teach the patient to avoid this complication?
A) Temporarily increase potassium intake.
B) Temporarily increase sodium intake.
C) Void every 2 hours when beginning the medication, if possible.
D) Ensure consistent, adequate fluid intake.

29. The nurse is caring for a resident in a long-term care facility who is African American with a history of an anxiety disorder. The patient is receiving oral lorazepam 2 mg t.i.d. What assessment should the nurse prioritize?
A) Suicidal ideation.
B) Level of consciousness.
C) Sleep quality.
D) Mucous membrane integrity.

30. A nurse is caring for a neonate born with a congenital heart anomaly. To better help the parents understand the impact of this disorder, the nurse begins by describing the usual flow of blood through the heart. What course should the nurse describe?
A) Deoxygenated blood from the lungs enters the left atrium through the pulmonary artery.
B) Oxygenated blood from the lungs enters the right atrium through the pulmonary veins.
C) Deoxygenated blood from the lungs enters the right atrium through pulmonary veins.
D) Oxygenated blood from the lungs enters the left atrium through the pulmonary veins.

31. The nurse is caring for a patient who is receiving antacids to relieve GI discomfort. What nursing action is most appropriate?
A) Administer this drug with other drugs or food to prolong therapeutic effects.
B) Administer the antacid 1 hour before or 2 hours after other oral medications.
C) Limit fluid intake to decrease dilution of the medication in the stomach.
D) Have the patient swallow the antacid whole and do not crush or chew the tablet.

32. The nurse is caring for a patient who needs to know that drugs, even when taken correctly, can produce negative or unexpected effects. The nurse should address what topic during health education?
A) Teratogenic effects.
B) Toxic effects.
C) Adverse effects.
D) Paradoxical effects.

38. A patient is undergoing chemotherapy and is experiencing severe nausea. The nurse administered ondansetron intravenously, with good effect. This patient has benefited from?
A) Stimulation of antinausea receptors in the medulla.
B) Increased gastric emptying and small bowel peristalsis.
C) Blockage of receptors in the CTZ.
D) Recalibration of the vestibular apparatus.

39. A patient's abnormal immune response has been attributed to disruptions in cell histocompatibility. What physiologic process is defective in this patient?
A) Reproduction of cells when other cells die.
B) Recognition of cells as self-cells that belong in the body.
C) Production of antibodies to viral invaders.
D) Antigen stimulation of white blood cell production.

40. A nurse is teaching the patient newly prescribed sublingual nitroglycerin how to take the medication. What action should the nurse instruct the patient to do first?
A) To check radial pulse.
B) To place the tablet in the buccal cavity.
C) To take a sip of water.
D) To lie down for 15 minutes before administration.

41. The home health nurse is caring for an elderly patient in their home. Patient reports almost daily diarrhea. The nurse should assess for what common cause of diarrhea in older adults?
A) Inadequate fluid intake.
B) Antihypertensive medications.
C) Laxative overuse.
D) Inactivity.

42. A patient with a history of peptic ulcer disease has responded well to treatment with a histamine-2 antagonist. This patient is most likely experiencing?
A) Destruction of Helicobacter pylori.
B) Coating and protecting of the stomach lining.
C) Increased pH of secreted hydrochloric acid.
D) Reduction in the quantity of hydrochloric acid secreted.

49. What is the main action of antiemetics?.
A) Altering central nervous system (CNS) actions to decrease perception of nausea
B) Speeding up the gastrointestinal (GI) tract so the stomach empties rapidly.
C) Depressing hyperactive vomiting reflex.
D) Changing the perception of motion in motion sickness.

50. A patient who is using a topical antifungal agent to treat mycosis calls the clinic patient report a severe rash that is accompanied by blisters. What should the nurse instruct the patient to do?
A) "Make an appointment SO you can be tested for allergies."
B) "Scrub the rash gently with soap and water."
C) "Stop using the drug immediately."
D) "Decrease the amount of the medication used."

51. Members of states a community group are attending a first-aid class the nurse is teaching. A participant states that she is careful to a supply of syrup of ipecac just in case one of her children is accidentally poisoned. What instruction should the nurse provide?
A) "Syrup of ipecac accidentally isn't recommended anymore. You should discard it"
B) "It's important not to give it if your child's ingested anything caustic or corrosive"
C) "Make sure to bring you child to the hospital if you ever have to give him or her a dose o it"
D) "Instead of giving syrup of ipecac, it's recommended that you call the local poison center immediately."

52. A patient that has signs and symptoms of a herpes infection, and the health care provider has stated would be acyclovir would be appropriate for the patient. What routes of care administration would be possible for this patient? Select all that apply.
A) Subcutaneous.
B) Intramuscular.
C) Oral.
D) Intrathecal.
E) Intravenous.

43. A patient is being discharged home from the hospital on newly prescribed anticholinergic drugs. A referral to the home health nurse has been made. What priority teaching point will the home health nurse emphasize when discussing the patient's drugs?
A) "Do not drive until you adjust to your medication."
B) "Take hot baths or showers to relieve side effects."
C) "Keep the house warm to avoid a chill."
D) "Limit your intake of fluids to avoid urinary side effects."

44. A patient is admitted to the unit and the nurse is performing a comprehensive assessment. What findings should the nurse interpret as indicating increased risk for infection? Select all that apply.
A) The patient appears to be malnourished.
B) The patient's blood pressure is 151/94 mm Hg.
C) The patient is under intense psychosocial stress.
D) The patient is 81 years old.
E) The patient's laboratory results indicate decreased amylase levels.

45. The patient, diagnosed with angina, reports chest pain. There is an order for oral sublingual nitroglycerin as needed. What action should the nurse take?
A) Place two nitroglycerin tablets under the patient tongue and call the provider.
B) Place one tablet under the patient's tongue and repeat every 5 minutes to a maximum of three tablets until pain has been relieved.
C) Have the patient swallow a tablet with a full glass of water and repeat in 10 minutes.
D) Apply a nitroglycerin transdermal patch to the patient's back.

46. A patient presents to the clinic and is diagnosed with a vaginal fungal infection. What should the nurse teach the patient about self-administration of the prescribed vaginal antifungal medication?
A) "Insert low into the opening of the vagina."
B) "Temporarily discontinue the medication when you're menstruating."
C) "Stay lying down for at least 15 minutes after insertion."
D) "Gently rub the cream into your vaginal wall after insertion."

47. An inhaled sympathomimetic drug has been ordered for a teenage athlete who has exercise-induced asthma. What should the patient be instructed to do?
A) Use the inhaler every day at the same time each day.
B) Use the inhaler as soon as the symptoms start.
C) Use the inhaler 30 to 60 minutes before exercising.
D) Use the inhaler 2 to 3 hours before exercising to ensure peak effectiveness.

58. A nurse a work is reviewing the structure and function of the neurologic system in preparation for a work placement on a neurologic unit. What statement most accurately describes an aspect of the autonomic nervous system?
A) The autonomic nervous system spans the centras and peripheral nervous systems
B) Cholinergic receptors are exclusively located in the sympathetic nervous system
C) Nicotinic receptors are primarily associated with the parasympatheitc nervous system
D) Alpha- and beta-receptors are the two basic types of muscarinic receptors.

59. The nurse is reviewing the structure and function of the endocrine system before providing care on a medical unit. What criterion can the nurse use to describe all hormones?
A) They are produced in large amounts in response to threats to homeostasis.
B) They circulate indefinitely until they are eventually used by receptor cells.
C) They are secreted directly from a gland to the tissue that they affect.
D) They are transported through the blood to specific receptor sites.

60. A patient has been prescribed an aminoglycoside. In order to prevent accumulation of the drug, what should the nurse encourage the patient to do?
A) Take diuretics as prescribed.
B) Increase fluid intake.
C) Take the drug on an empty stomach.
D) Perform moderate exercise daily, if possible.

61. The nurse is explaining the characteristics of an appropriate donor to a patient with end-stage liver disease who requires a liver transplant. The nurse should describe?
A) Histocompatibility antigens.
B) Lipoproteins.
C) Active transport.
D) Receptor sites.

62. The nurse is teaching a patient about the administration of nasal spray. What information is most important to include in this discussion?
A) Finish the bottle of nasal spray to clear the infection effectively.
B) Nasal spray can be shared between family members only.
C) Administer the nasal spray in a prone position.
D) Overuse of nasal spray may cause rebound congestion.

63. The nurse administers typical antipsychotic medications to the patient who has taken these same drugs for many years. What signs and symptoms should the nurse attribute to secondary actions of the drug? Select all that apply.
A) Muscular tremors.
B) Drooling.
C) Changes in gait.
D) Yellow discoloration of the skin and sclera.
E) Fine red rash on the trunk.

64. A patient has begun taking an antihistamine for the treatment of seasonal allergies. What
A) dietary guidelines should the nurse provide to the patient?
B) Avoid drinking alcohol while taking antihistamines.
C) intake of foods that are high in vitamin C.
Increase Avoid grapefruit juice until at least 48 hours after treatment is complete.
D) Eat several small meals instead of three larger meals in case of GI upset.

65. the A young patient is diagnosed with hypothyroidism. The nurse anticipates an order for drug of choice when treating children, which is what?
A) Liothyronine.
B) Liotrix.
C) Levothyroxine.
D) Methimazole.

66. The nurse the administers an exogenous hormone to the patient. How does the nurse's action impact the endocrine system? Select all that apply.
A) May disrupt the normal functioning of the hypothalamus.
B) May May increase the hormone levels in the body.
C) May stop production of releasing and stimulating hormones.
D) May lead to a decrease in the normal production of the hormone.
E) May make the pituitary gland unresponsive to stimuli.

67. A patient has been diagnosed with an autoimmune disease that causes numerous distressing symptoms. What pathophysiologic process is causing this patient's symptoms?
A) The patient's body is producing antibodies against the patient's own self-antigens.
B) Viruses have taken over the patient's B cells, causing them to attack the patient's own cells.
C) Cytotoxic T cells have begun to phagocytize one another, rather than pathogens.
D) B cells are producing antibodies that promote cell malignancy.

68. A patient who In lives reviewing alone and has occasional memory lapses, is being seen by the home health nurse. In reviewing the patient's medication, the nurse discovers the patient was recently prescribed azithromycin for urethritis. What characteristic of this drug makes it an appropriate choice for this patient?
A) The half-life of the drug is 3 to 7 hours.
B) It is taken only once a day.
C) The drug usually achieves results in only a 3-day
D) Azithromycin is associated with very few drug-drug interactions.

69. What concept is prioritized when a provider is considering the substitution of brand name drug with a generic drug?
A) Bioavailability.
B) Critical concentration.
C) Distribution.
D) Half-life

70. When The nurse is providing care for a patient whose type 2 diabetes is treated with glipizide. When monitoring the patient for potential adverse effects, the nurse should assess for?
A) Increased urine output.
B) Deep Kussmaul's respirations.
C) Thirst and hot or flushed skin.
D) Confusion and lack of coordination.

71. The nurse is providing care for a patient with a recent cardiac diagnosis and is explaining the structure and function of the heart. Place the events of circulation in the correct sequence, beginning with the entry of blood into the right atrium.
A) Oxygenated blood enters the left atrium.
B) Blood passes through the tricuspid valve.
C) Blood is pumped from the right ventricle to the lungs.
D) Blood passes through the mitral valve.
E) Deoxygenated blood returns to the heart from the venous system.
F) Oxygenated blood is pumped into circulation.

72. The chemoreceptor trigger zone in a patient's medulla has been stimulated. What will most likely occur following repeated stimulation?
A) Repeated swallowing.
B) Decreased respiratory rate.
C) Vomiting.
D) Increased peristalsis.

73. The nurse is reviewing the function of receptor sites in cell physiology. What role of receptor sites should the nurse understand?
A) Maintaining contact with outside proteins to prevent lysis of the cell wall.
B) Maintaining contact with inside proteins to prevent lysis of the cell wall.
C) Reacting with specific chemicals outside the cell to change the function of that chemical.
D) Reacting with specific chemicals outside the cell to stimulate a reaction within the cell.

74. Nursing care for the postoperative patient requiring long-term glucocorticoid therapy will be directed at overcoming what adverse effect of the drug?
A) Impaired wound healing.
B) Inflammation.
C) Autoimmune response.
D) Lack of mobility.

75. A patient is in the clinic to have blood drawn to assess theophylline levels. The patient appears to being responding well to the medication and is not experiencing any adverse effects. What serum level will the nurse expect the patient to have?
A) Between 0.5 and 5 mcg/mL.
B) Between 10 and 20 mcg/mL.
C) Between 25 and 35 mcg/mL.
D) Between 40 and 50 mcg/mL.

76. The nurse admitted the patient diagnosed with a systemic fungal infection. Before administering ketoconazole as prescribed, what should the nurse confirm?
A) The patient's complete blood count (CBC) and white cell differential.
B) The patient's blood type.
C) The patient's height and weight.
D) The patient's hepatic function.

77. What symptoms would the nurse find to be consistent with a diagnosis of a peptic ulcer?
A) Pain a few hours after eating.
B) Pain described as sharp and stabbing.
C) Explosive diarrhea within 1 hour of eating.
D) Unable to stand comfortably due to abdominal pain.

78. A patient in distress is brought to the emergency department by ambulance. Emergency medical technicians state that an anaphylactic reaction from oral penicillin is suspected. Which of the nurse's assessment findings best supports this diagnosis?
A)' Blood pressure: 186/100 mm Hg, shortness of breath.
B) Hematocrit (Hct): 32%, decreased urine output.
C) Temperature: 102Â°F (38.9Â°C), swollen joints.
D) Profuse sweating, oxygen saturation: 92%.

79. The nurse assesses the patient before administering digoxin and withholds the drug and notifies the physician with what finding?
A) Respiratory rate falls below 14.
B) History reveals liver failure.
C)' Pulse is 44 beats/minute.
D) Blood pressure is 102/66 mm Hg.

80. A patient's blood pressure is 161/106 mm Hg. How will this blood pressure affect the patient's cardiac workload?
A) Increased systolic pressure will increase the patient's heart rate.
B) The patient's increased blood pressure causes an increase in preload and cardiac workload.
C) Increased afterload creates increased oxygen consumption.
D), The patient's heart will have to pump harder to overcome the mitral and tricuspid valves.

81. The nurse, who works in the emergency department, is aware that the renin-angiotensin-aldosterone system works to maintain blood flow in the kidneys. What vital sign would signify the initiation of this system in a trauma patient?
A) Increased temperature.
B) Decreased pulse.
C) Decreased blood pressure.
D) Pain level of 3 on a scale of 1 to 10.

82. The nurse is caring for a patient with renal failure whose hemoglobin level is 7.9 mg/dL. What is the nurse's best action?
A) Administer erythropoietin as prescribed.
B) Encourage the patient's fluid intake.
C) Monitor the patient's intake and output closely.
D) Collaborate with the provider to arrange dialysis.

83. The nurse is caring for a patient who does not have a respiratory disorder but has been prescribed acetylcysteine. What is an additional indication for acetylcysteine?
A) Conversion of cardiac dysrhythmias.
B) Treatment of peptic ulcer disease.
C) Antidote for acetaminophen poisoning.
D) Treatment of bronchospasm.

84. The nurse is caring for a patient who is receiving ondansetron for nausea associated with with chemotherapy. The nurse would teach the patient that what adverse effect may occur this medication?
A) Weakness and rash.
C) Headache and dizziness.
B) Urinary incontinence and photosensitivity.
D) Fever and diarrhea.

85. headache The patient is receiving digoxin and furosemide. In the morning, the patient reports
B) Contact the patient's physician immediately.
A) and nausea. What will the nurse do first?
C) Administer acetaminophen and Maalox.
Check patient's laboratory values and vital signs.
D) Give patient clear liquids and have them lie down.

86. A nurse is reviewing the function of the renin-angiotensin-aldosterone system before assessing a patient with hypertension. Place these events in the function of the renin-angiotensin-aldosterone system in the order that they occur.
A) Renin is released by juxtaglomerular cells.
B) Blood pressure increases due to vasoconstriction.
C) Angiotensinogen is converted to angiotensin I.
D) Low blood pressure is detected.
E) Angiotensin II reacts with blood vessel receptors.

87. The nurse is assessing a patient who has recently become pregnant. What hormone activity is most likely to maintain the pregnancy until birth of the fetus?
A) High levels of estrogen for the first trimester, gradually declining throughout pregnancy.
B) Temporary cessation of gonadotropin-releasing hormone (GnRH).
C) High levels of luteinizing hormone (LH) and follicle-stimulating hormone (FSH).
D) High levels of estrogen and progesterone throughout pregnancy.

18. Patient is admitted to the intensive care unit with hyperkalemi...