NURS 6521 Walden University Quiz
NURS 6521 Walden University Quiz
1 out of 1 points
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A male patient with a diagnosis of relapsing-remitting multiple sclerosis is in the clinic to discuss with the nurse the possibility of self-administration of glatiramer. During the patient education session for self-administration, the nurse will emphasize |
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| Response Feedback: |
Since administration of glatiramer is by subcutaneous injection only, the nurse will teach the patient to rotate injection sites. Appropriate sites for the patient would include the thigh, stomach, and upper arm. |
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NURS 6521 Walden University Quiz |
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A nurse is developing a care plan for a patient who has multiple sclerosis. An expected outcome for the patient who is receiving glatiramer would be a decrease in |
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| Response Feedback: |
Glatiramer should reduce the frequency of multiple sclerosis–related attacks and therefore decrease fatigue. Fatigue, weakness, spasticity, balance problems, bladder and bowel problems, numbness, vision loss, tremor, and vertigo are the most common symptoms of multiple sclerosis. Chest pain, breathing difficulties, and heart palpitations are all identified side effects of glatiramer and are not common manifestations of MS. |
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A nurse is teaching a patient about his newly prescribed drug, colchicine, for gout. The nurse will instruct the patient to avoid which of the following foods? |
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| Response Feedback: |
High consumption of meat products and seafood increases the risk of hyperuricemia, which is the root cause of gout. Purine-rich vegetables do not increase the risk of hyperuricemia, and a high dairy intake is actually protective. |
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NURS 6521 Walden University Quiz |
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A patient with diabetes has had a cough for 1 week and has been prescribed a cough syrup (an expectorant). What special instructions should the nurse include in the patient teaching for this situation? |
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| Response Feedback: |
Special instructions need to be given to patients with diabetes when they are prescribed syrups. A diabetic patient needs to monitor glucose levels closely because syrups contain high levels of sugars, which can cause elevated glucose levels. Increased gastrointestinal tract infections are not directly related to diabetic patients taking cough syrups. Noting the time that a medication is taken and good hand-washing are always important, but are not specific considerations for a diabetic patient taking cough syrup. |
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A nurse is instructing a patient in the administration of regular insulin by the subcutaneous route. Which of the following strategies would the nurse suggest if the goal is to promote absorption of the regular insulin? |
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| Response Feedback: |
To promote the absorption of regular insulin, one anatomic area should be selected for subcutaneous injections. Serial locations within that anatomic area are then chosen to rotate the exact injection site. Injection sites should not be rotated by using different anatomic areas each day, because this would substantially change the absorption of the insulin and the patient’s blood glucose levels. Using one injection site regularly may lead to lipodystrophy. Regular insulin is administered about 30 to 60 minutes before eating a meal, not after. NURS 6521 Walden University Quiz |
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A 66-year-old woman has experienced a significant decline in her quality of life as a result of worsening rheumatoid arthritis. Her physician has prescribed etanercept and the nurse is responsible for facilitating this new aspect of the patient’s drug regimen. This will involve the administration of |
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| Response Feedback: |
Etanercept is a weekly subcutaneous injection. |
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A patient is taking gabapentin (Neurontin) for spasticity associated with multiple sclerosis. Which of the following should be the priority for monitoring? |
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| Response Feedback: |
Gabapentin is not metabolized and is excreted unchanged in the urine. Therefore, it is important to monitor renal function. Hepatic, cardiac, and respiratory functions are not compromised with this drug. |
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A nurse is working with a 57-year-old man who is a former intravenous drug abuser. He has been prescribed a weekly dosage of methotrexate for his rheumatoid arthritis. Which of the following will the nurse include in her teaching plan for this patient? |
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| Response Feedback: |
Use of illicit drugs as well as an age-related decrease in renal function may have predisposed the patient to nephrotoxicity. Therefore, it is most important for the nurse to advise the patient to drink enough water to decrease the risk for nephrotoxicity when taking methotrexate. Avoiding red meat or taking the tablets before bedtime does not help reduce the risk of nephrotoxicity. |
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A 70-year-old woman who is on long-term ibuprofen therapy for osteoarthritis has returned to the clinic for her regular 6-month visit. In the last couple of months, she has been having increasing periods of abdominal pain. The nurse suspects that this pain may be related to |
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| Response Feedback: |
During long-term ibuprofen therapy, especially in patients older than 60 years, the nurse needs to closely monitor for peptic ulcer disease or gastritis that can lead to gastrointestinal bleeding or even bowel perforation. These events can occur at any time, with or without warning. Ibuprofen may also cause excessive or abnormal bleeding, especially in patients with anemia, but it is not known to cause anemia. Interstitial nephritis is one of the less common renal toxicities associated with ibuprofen as is constipation. NURS 6521 Walden University Quiz |
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A 40-year-old woman with a diagnosis of fibromyalgia has been prescribed cyclobenzaprine (Flexeril) as an adjunct to her existing drug regimen. What nursing diagnosis should the nurse prioritize when updating the nursing care plan for this patient? |
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| Response Feedback: |
The CNS depression that is associated with the use of cyclobenzaprine constitutes a risk for injury. The anticholinergic effects of the drug constitute a risk for constipation, not diarrhea. Nutrition and swallowing are not typically affected by the use of cyclobenzaprine. |
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A patient receives 25 units of NPH insulin at 7.AM. At what time of day should the nurse advise the patient to be most alert for a potential hypoglycemic reaction? |
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| Response Feedback: |
After an early morning dose of NPH insulin, the patient should be alert for a possible hypoglycemic reaction during mid- to late-afternoon. The lengthy peak action time produces additional risks for hypoglycemic reactions. |
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A 33-year-old man has developed acute gouty arthritis. He has been prescribed colchicine. When developing a care plan for this patient, which factor will be most important for the nurse to consider? |
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| Response Feedback: |
The nurse must consider the patient’s dietary habits because foods high in purines increase uric acid concentrations in the blood, making a gouty attack more likely. Assessing the patient’s work environment, fluid intake, and ethnicity are not as important as assessing his dietary habits. |
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1 out of 1 points
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A nurse is caring for a patient who has been diagnosed with hypothyroidism. Levothyroxine (Synthroid) has been prescribed. Before the drug therapy is started, the nurse will assess for which of the following? |
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NURS 6521 Walden University Quiz
| Response Feedback: |
If the patient is taking anticoagulant drugs, there is a risk of a drug–drug interaction with levothyroxine that can result in an increased risk of bleeding. Therefore, the nurse should assess the patient’s medical record and drug history. Bleeding times such as INR, PR, and PTT should be closely monitored if it is necessary for the two drugs to be given together. There is no evidence that an allergy to seafood, the patient’s age, or hirsutism, which is excessive hair growth, would need to be assessed in this case. |
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The nurse is conducting a medication reconciliation of a new resident of a long-term care facility. The nurse notes that the resident takes allopurinol on a daily basis for the treatment of gout. What is the primary purpose of this drug? |
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| Response Feedback: |
Uricosuric drugs such as allopurinol help to balance urate levels and thus prevent gout attacks. They do not influence the remodeling of synovial membrane, provide analgesia, or affect the metabolism of purines. NURS 6521 Walden University Quiz |
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A patient in need of myocardial infarction prophylaxis has been prescribed sulfinpyrazone for gout. Which of the following will the nurse monitor the patient most closely for? |
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| Response Feedback: |
Since sulfinpyrazone inhibits antiplatelet action, it is important for the nurse to monitor the patient for signs of bleeding. It is also important to avoid administration of sulfinpyrazone with other drugs such as salicylates and anticoagulants (warfarin) that affect platelet aggregation. The drug does not pose a risk of hypothermia, hypotension, or renal dysfunction. |
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A 49-year-old woman has been diagnosed with myalgia. The physician has recommended aspirin. The patient is concerned that the aspirin will upset her stomach. The nurse will encourage the patient to |
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| Response Feedback: |
Taking aspirin with milk or food minimizes the stomach upset because it buffers the stomach wall from direct contact with the medication, decreasing gastric distress. Chewable tablets can be chewed before swallowing or crushed and then advised to be taken with food or mixed in a drink. Swallowed whole, extended-release tablets are enteric coated to delay release of the aspirin, which again buffers the stomach wall from the medication, decreasing gastric distress. Nonchewable tablets should be swallowed whole and should never be advised to be crushed or chewed. |
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NURS 6521 Walden University Quiz |
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A nurse is instructing a patient who was recently diagnosed with multiple sclerosis about dantrolene (Dantrium). The patient is a 38-year-old-male and the foreman for a construction company. In order to minimize one important adverse effect of the drug, the nurse will give the patient which of the following instructions? |
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| Response Feedback: |
The nurse will need to caution the patient about the adverse effect of photosensitivity, especially considering his work. He should be advised to wear protective clothing and sunglasses and to use sunscreen whenever he is outside on the job site. A complete blood cell count should be done before therapy begins but would not be needed again unless indicated. A nurse must check with the prescriber before advising a patient to decrease a drug dosage. A diet high in protein is not necessary with this drug. |
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A nurse is assessing a patient who has come to the emergency department complaining of back spasms. The patient states that he has a history of opioid addiction and does not want to take any drug that “puts me at risk of becoming physically dependent.” Which of the following medications would the nurse question, if ordered? |
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NURS 6521 Walden University Quiz
| Response Feedback: |
The nurse would be concerned if the physician ordered cyclobenzaprine because long-term use of this drug may result in physical dependence. The other drugs listed are not associated with physical dependence. |
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A female patient with a diagnosis of type 1 diabetes mellitus has been experiencing increasing neuropathic pain in recent months, a symptom that has not responded appreciably to conventional analgesics. The patient’s care provider has begun treatment with gabapentin (Neurontin). How is the addition of this drug likely to influence the management of the patient’s existing drug regimen? |
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| Response Feedback: |
Gabapentin is unusual in that it does not interact with other drugs and does not alter the serum concentrations of other anticonvulsants. Consequently, it is unnecessary to modify the patient’s existing drug regimen. Regular assessment of renal function is necessary in patients with diabetes, but this is not a consequence of the use of gabapentin. |
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A nurse will instruct a patient taking allopurinol to take each dose |
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NURS 6521 Walden University Quiz
| Response Feedback: |
The nurse should teach the patient to take each dose after a meal to decrease the potential for nausea and vomiting. Taking this medicine at night, in the morning, or before a meal would not help decrease the GI symptoms associated with this drug. |
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A 65-year-old woman has an advanced form of rheumatoid arthritis. Her treatment includes a regular dosage of methotrexate. The nurse will advise her to take which of the following vitamin supplements while taking the drug? |
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| Response Feedback: |
Taking vitamin B every day will help decrease the potential for adverse effects of methotrexate. This drug is given cautiously to very young and elderly patients, because these patients’ livers and kidneys cannot adequately clear the drug. Vitamin C is contraindicated with most antiarthritic and antigout drugs because it decreases the renal excretion of drugs. Supplements of vitamin A or D would not be necessary. |
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A 32-year-old female patient is taking tizanidine (Zanaflex) for spasticity related to her multiple sclerosis. The nurse will inform the patient and her husband that the adverse effect that poses the greatest safety risk to the patient is |
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| Response Feedback: |
Tizanidine (Zanaflex) has been associated with hypotension, which could be a safety risk, especially if the patient is also taking an antihypertensive drug. Constipation, dry mouth, and fatigue are common adverse effects that do not pose a safety risk. |
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A nurse has been invited to speak to a support group for persons with movement disorders and their families. Which of the following statements by the nurse addresses the chronic nature of these diseases and the relevant drug therapies? |
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NURS 6521 Walden University Quiz
| Response Feedback: |
It is most important that patients and their families know that movement disorders are chronic, that there is no cure, and that drug therapy only serves to help decrease the severity of the symptoms. Symptoms are not normally eliminated completely. Culture must be considered because of catecholamine-O-methyltransferase (COMT), which affects the absorption of levodopa in the body. Some of the drugs used to treat movement disorders can pose a risk of causing renal or hepatic dysfunction, but not all. |
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A 34-year-old male patient is prescribed methimazole (MMI). The nurse will advise him to report which of the following immediately? |
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| Response Feedback: |
The nurse should ask the patient to report immediately if he notices decreased cardiac rate, intolerance to cold, or weight gain. These are indications of hypothyroidism resulting from antithyroid therapy, and if the medication is continued unchanged, insidious goitrogenic hypothyroidism may occur. Vertigo, drowsiness, loss of appetite, and epigastric distress are possible adverse effects of the therapy but would not present an immediate risk to the patient’s health. |
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A clinic nurse is following a 9-year-old boy who is taking somatropin. Which of the following will the nurse monitor periodically? |
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| Response Feedback: |
Somatropin is used for the long-term treatment of pediatric patients who have growth failure due to an inadequate secretion of endogenous growth hormone; therefore, the nurse should check the patient’s height. If the patient’s growth rate does not exceed the pretreatment rate by at least 2 cm per year, nonadherence to therapy, antibody formation, malnutrition, or hypothyroidism may be considered as possible causes. Somatropin would not significantly affect antidiuretic hormone (ADH) levels, or cause dehydration or water retention. NURS 6521 Walden University Quiz. |
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Which of the following would be the most important safety-related instruction for a nurse to give to a patient taking baclofen (Lioresal)? |
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| Response Feedback: |
In a patient experiencing spasticity, the nurse should advise the patient to stop drinking alcohol. Alcohol consumption may increase the adverse effect of sedation, causing sleepiness, dizziness, and blurred vision. The patient should not drive or walk after taking the drug; he should learn to self-administer the drug; and constipation is a concern. However, the most important safety concern is to avoid alcohol. |
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A nurse will monitor which of the following when assigned to a patient taking allopurinol for chronic gout who visits the clinic every 2 months? |
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| Response Feedback: |
The most common adverse effects of allopurinol include pruritus, maculopapular rash, nausea and vomiting, elevated liver function tests, and acute gout symptoms. Blood sugar levels, blood pressure, and body temperature are not associated with adverse effects of allopurinol. |
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A patient with type 1 diabetes has been admitted to the hospital for orthopedic surgery and the care team anticipates some disruptions to the patient’s blood glucose levels in the days following surgery. Which of the following insulin regimens is most likely to achieve adequate glycemic control? |
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| Response Feedback: |
Subcutaneous insulin therapy for type 1 diabetes frequently consists of daily injections of mixtures of short-acting regular insulin with intermediate-acting insulins; multiple doses of regular insulin before each meal in association with one or two daily doses of long-acting insulin may also be used. Frequent, fixed doses of rapid-acting or intermediate-acting insulin may result in unsafe blood sugar levels. NURS 6521 Walden University Quiz. |
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To minimize the risk of adverse effects of glucagon when given to an unconscious diabetic patient, as the patient regains consciousness, the nurse should |
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| Response Feedback: |
While it is important to monitor a patient for nausea and vomiting and help him or her into a more comfortable position, it is most important to administer supplemental carbohydrates as soon as the patient becomes conscious. Administering supplemental carbohydrates serves to restore liver glycogen and prevent secondary hypoglycemia. Calcium supplements are not necessary in this situation. |
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Following an assessment by her primary care provider, a 70-year-old resident of an assisted living facility has begun taking daily oral doses of levothyroxine. Which of the following assessment findings should prompt the nurse to withhold a scheduled dose of levothyroxine? |
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| Response Feedback: |
If the pulse rate is greater than 100 bpm, it is necessary to withhold a levothyroxine dose in an older adult. Anorexia, recent vaccination, and recent falls do not necessary indicate a need to withhold this medication. |
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