1 . A healthcare provider prescribes cephalexin monohydrate (Keflex) for a client with a postoperative
infection. It is most important for the nurse to assess for what additional drug allergy before
administering this prescription?
A) Penicillins.
B) Aminoglycosides.
C) Erythromycins.
D) Sulfonamides.
A) Penicillins.
Cross-allergies exist between penicillins (A) and cephalosporins, such as cephalexin monohydrate
(Keflex), so checking for penicillin allergy is a wise precaution before administering this drug.
2. Which nursing intervention is most important when caring for a client receiving the antimetabolite
cytosine arabinoside (Arc-C) for chemotherapy?
A) Hydrate the client with IV fluids before and after infusion.
B) Assess the client for numbness and tingling of extremities.
C) Inspect the client's oral mucosa for ulcerations.
D) Monitor the client's urine pH for increased acidity.
C) Inspect the client's oral mucosa for ulcerations.
Cytosine arabinoside (Arc-C) affects the rapidly growing cells of the body, therefore stomatitis and
mucosal ulcerations are key signs of antimetabolite toxicity (C). (A, B, and D) are not typical
interventions associated with the administration of antimetabolites.
, 3. When assessing an adolescent who recently overdosed on acetaminophen (Tylenol), it is most
important for the nurse to assess for pain in which area of the body?
A) Flank.
B) Abdomen.
C) Chest.
D) Head.
B) Abdomen.
Acetaminophen toxicity can result in liver damage; therefore, it is especially important for the nurse to
assess for pain in the right upper quadrant of the abdomen (B), which might indicate liver damage. (A, C,
and D) are not areas where pain would be anticipated.
4. An adult client is given a prescription for a scopolamine patch (Transderm Scop) to prevent motion
sickness while on a cruise. Which information should the nurse provide to the client?
A) Apply the patch at least 4 hours prior to departure.
B) Change the patch every other day while on the cruise.
C) Place the patch on a hairless area at the base of the skull.
D) Drink no more than 2 alcoholic drinks during the cruise.
A) Apply the patch at least 4 hours prior to departure.
Scopolamine, an anticholinergic agent, is used to prevent motion sickness and has a peak onset in 6
hours, so the client should be instructed to apply the patch at least 4 hours before departure (A) on the
cruise ship. The duration of the transdermal patch is 72 hours, so (B) is not needed. Scolopamine blocks
muscarinic receptors in the inner ear and to the vomiting center, so the best application site of the patch
is behind the ear, not at the base of the skull (C). Anticholinergic medications are CNS depressants, so
the client should be instructed to avoid alcohol (D) while using the patch.
5. The nurse is reviewing the use of the patient-controlled analgesia (PCA) pump with a client in the
immediate postoperative period. The client will receive morphine 1 mg IV per hour basal rate with 1 mg
IV every 15 minutes per PCA to total 5 mg IV maximally per hour. What assessment has the highest
priority before initiating the PCA pump?
A) The expiration date on the morphine syringe in the pump.
B) The rate and depth of the client's respirations.
C) The type of anesthesia used during the surgical procedure.
D) The client's subjective and objective signs of pain.
B) The rate and depth of the client's respirations.
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