-pg1 Test Bank Davis’s Drug Guide for Nurses, 18e Test Bank Davis's Drug Guide for Nurses 18th Edition , Vallerand & Sanoski MULTIPLE CHOICE 1. The nurse is providing care for a patient scheduled to take acarbose ( Precose ) 25 mg 3 times daily with meals. The patient reports feeling sweaty, weak , and tremulous. Which of the following actions by the nurse is best? A. Reassure the patient that these are common side effects with the medication. B. Call the pharmacy to report an adverse drug reaction. C. Check the patient ’s blood glucose level. D. Determine if the patient has a history of anemia. ANS: C See Assessment for acarbose : Observe the patient for signs and symptoms of hypoglycemia. Acarbose alone does not cause hypoglycemia; however, other concurrently administered hypoglycemic agents may produce hypoglycemia , requiring treatment. Ignoring these sy mptoms would be dangerous, but it is not considered an adverse drug reaction requiring an official report. The patient is experiencing symptoms of hypoglycemia not anemia. KEY: Cognitive Level : Analysis DIF: Medium TOP: Therapeutic Classification : Antid iabetic s REF: Drugguide.com 2. While responding to a rapid response called on the cardiac step -down unit, the nurse from intensive care observes the unit nurse massaging a patient ’s neck and instructing the patient to bear down. Which of the following medications will most likely be used if the patient ’s pulse does not return to normal? A. Adenosine ( Adenocard ) B. Epinephrine ( Adrenaline ) C. Atenolol ( Tenormi n) D. Asenapine ( Saphri s) ANS : A See Indications for adenosine : Adenosine is used for the conve rsion of paroxysmal supraventricular tachycardia (PVST) to normal sinus rhythm when vagal maneuvers are unsuccess ful. Epinephrine is a bronchodilator used in the management of re versible airway disease . Atenolol is a beta blocker used in the man agement of hypertension . Asenapine is an antipsychotic mood stabilizer used in the acute treatment of schizophrenia or manic/mixed episodes associated with bipolar I disorder. KEY: Cognitive Level: Application DIF: Medium TOP: Therapeutic Classification: Antiarrhyt hmic s REF: Page 112 | Page 505 | Page 191 | Page 188 TEST BANK -pg2 Test Bank Davis’s Drug Guide for Nurses, 18e 3. The nurse is instructing the parent of a 6-year-old patient recently started on an albuterol ( ProAir HFA ) inhaler for exercise -induced asthma. The nurse recognizes that further teaching is necessa ry by which of the following client statements? A. “He may feel like his heart is racing after he takes his inhaler. ” B. “He can use the inhaler as many times during football practice as he needs it. ” C. “He should avoid cola and other caffeinated drinks s ince they may increase his heart rate. ” D. “He should take 2 puffs about 15 min before gym class. ” ANS : B See Contraindications/Precautions, Interactions, and Dosage for albuterol . Excess inhaler use may lead to tolerance and paradoxical bronchospasm. Use with caffeine -containing herbs (cola nut, guarana, tea, coffee) increases stimulant effect. Two inhalations every 4 –6 hr or 2 inhalations 15 min prior to exercise). Tachycardia is an expected side effect with this medication. KEY: Cognitive Level: Analys is DIF: Easy TOP: Therapeutic Classification: Bronchodilator s REF: Page 117 4. While providing care for an adolescent patient newly prescribed amitriptyline (Elavil ), the nurse should be most concerned by which of the following patient statements? A. “My mouth seems really dry and I ’m thirsty all the time. ” B. “I take a nap most afternoons now because I feel sleepy sometimes. ” C. “I’m not sure why we should even bother anymore; everything seems so pointless. ” D. “I drink a cup of coffee most days with br eakfast. ” ANS : C See Contraindications/ Precautions for amitriptyline: the use of this medication may increase the risk of suicide attempt/ideation especially during early treatment or dose adjustment; risk may be greater in children or adolescents. Sedati on is an expected side effect. Dry mouth is an expected side effect. There is no directive to avoid caffeine with this medication. KEY: Cognitive Level: Analysis DIF: Medium TOP: Therapeutic Classification: Antidepressant s REF: Page 145 5. The nurse is caring for a patient with otitis media who reports an allergy to penicillin. Orders are received for amoxicillin 500 mg every 8 hr. Which of the following actions by the nurse is best? A. Provide the medication as ordered. B. Call the pharmacist to reques t a substitution. C. Ask the patient if he or she has taken a moxi cillin in the past. D. Hold the medication. -pg3 Test Bank Davis’s Drug Guide for Nurses, 18e ANS : D See contraindications/ precautions for amoxicillin. Contraindicated in hypersensitivity to penicillin. This medication should be held due to the stated allergy to penicillin. KEY: Cognitive Level: Application DIF: Easy TOP: Therap eutic Classification: Anti-infectives REF: Page 1 48 6. While caring for a patient in hospice who is actively dying, the nurse notes moderate respiratory distress, copious oral secretion , and a frequent moist cough. Which of the following prn medications would most promote comfort for the patient? A. Morphine sulfate (Morphine) 2 mg IV bolus B. Atropine ( AtroPen ) 0.4 mg IV bolus C. Lorazepam (Ativan) 0.5 mg IV bolus D. Diphenhydramine (Benadryl) 25 mg IV bolus ANS : B See Action for atropine : Low doses decrease sweating, salivation, and respiratory secretions. Morphine is used for pain control. Lorazepam is used for anxiety. Benadryl is used for itching. KEY: Cognit ive Level: Analysis DIF: Medium TOP: Therapeutic Classification: Antiarrhythmic s | Therapeutic Classification: Antichol inergic s REF: Page 198 7. The nurse is counseling a patient started on azithromycin (Zithromax ) for the treatment of an upper respirat ory infection. The nurse recognizes that teaching has been effective by which of the following patient statements? A. “The med pack will have 5 pills, 1 for each of the next 5 days. ” B. “If I don ’t feel better next week, I can get a refill from the pharmac ist.” C. “I only need to take 1 pill, but my symptoms may not clear for 3 days. ” D. “I can take this medication safely even though I ’m allergic to erythromycin. ” ANS : A See Route /Dosage for azithromycin: 500 mg on 1 st day, then 250 mg/day for 4 more days. Instruct the patent to notify health care professional if symptoms do not improve. Teach the patient to take medication as directed and to finish the drug completely. Azithromycin is contraindicated in patients with an allergy to erythromycin. KEY: Cogni tive Level: Analysis DIF: Easy TOP: Therap eutic Classification: Anti-infectives REF: Page 202 Ultimatestudyguide2021@gmail.com -pg4 Test Bank Davis’s Drug Guide for Nurses, 18e 8. The home -care nurse is preparing to see a patient being treated for diabetic foot ulcerations with becaplermin (Regranex ). Which of the following instructi ons will the nurse include in the patient teaching? A. “Apply the wound gel 3 times daily to promote healing. ” B. “Store the gel in the refrigerator. ” C. “Complete healing is expected within 3 days. ” D. “After applying the wound gel, cover with a transpare nt adhesive dressing. ” ANS : B See Implementation for b ecaplermin : Calculated amount is applied as a thin layer and covered with a moist saline dressing for 12 hr; dressing is removed, ulcer rinsed , and redressed with moist dressing without becaplermin for rest of day. Process is repeated daily. Store gel in refrigerator; do not freeze. If ulcer does not decrease in size by 30% within 10 wk, continuation of therapy should be reassessed. Cover with a moist saline dressing for 12 hr. Then, remove dressing, ri nse ulcer , and redress with moist dressing without becaplermin for rest of day. KEY: Cognitive Level: Analysis DIF: Hard TOP: Therapeutic Classification: Wound/Ulcer/Decubiti healing agents REF: Page 214 9. The nurse is tracking patient symptoms relate d to acute alcohol intoxication and withdraw al. Which of the following medications would the nurse expect to provide in the management of these symptoms? A. Clopidogrel (Plavix) B. Bupropion (Zyban) C. Omeprazole (Prilosec) D. Clorazepate (Tranxene T -Tab) ANS : D See Indications for clorazepate: C lorazepate is used in the management of simple partial seizures, anxiety disorder, symptoms of anxiety , and acute alcohol withdrawal. Clopidogrel is an antiplatelet agent. Bupropion is an antidepressant. Omeprazole is an antiulcer agent. KEY: Cognitive Level: Application DIF: Medium TOP: Therapeutic Classification: Anticonvulsant s REF: Drugguide.com 10. The nurse prepares to provide colchicine (Colcrvs) to a patient. The nurse should asses s which of the followin g prior to administration of the medication? A. Blood pressure B. Complete blood count C. Triglyceride level D. Oxygen saturation ANS : B
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