Pharmacological and Parenteral Therapies

The patient with major depressive disorder has been prescribed sertraline. Which medication, if discontinued the day prior in the patient’s chart, prompts the nurse to hold the medication and contact the provider?

Benzodiazepines act on which neuroreceptor to decrease anxiety and panic symptoms?

The patient who has been abusing benzodiazepines for 4 years tells the nurse, “I can’t let this drug control my life any longer. Take my pills; I’m quitting today.” Which response by the nurse is most appropriate?

The patient has been diagnosed with post-traumatic stress disorder (PTSD) following sexual assault. The nurse anticipates providing education about which medication?

The patient is receiving hydrochlorothiazide. Which arterial blood gas values indicate the patient is experiencing an adverse effect from this medication?

Which characteristic, if found in the patient’s chart, would prompt the nurse to hold the ordered bumetanide and contact the provider?

The nurse anticipates administering vasopressin to the patient with which condition?

The patient who is 21 weeks pregnant complains of musculoskeletal pain and headaches and asks the nurse, “Can I take ibuprofen to treat my pain?” Which response by the nurse is most appropriate?

Which patients may benefit from exogenous surfactant administration? Select all that apply.

The 48-pound patient is in the intensive care unit with hypovolemic shock. Intravenous norepinephrine has been ordered to run continuously at 0.05 mcg/kg/min. The pharmacy dispenses the medication in a 1 mg/mL concentration. What is the rate in milliliters per hour that the patient will receive? Enter your answer to the hundredth decimal.

The infant who weighs 3.8 kg has a total fluid order of 120 ml/kg/day. Continuous infusions include dexmedetomidine running at 0.38 mL/h, morphine running at 0.2 mL/h, dopamine at 0.4 mL/h, and midazolam at 1.2 mL/h. At what rate will the nurse program the patient’s total parenteral nutrition to meet the total fluid goal? Enter your rate in mL/h to the tenth decimal place.

Which blood pressure is an indication the 34-year-old patient requires an increase in norepinephrine infusion dosage?

The nurse understands which is an indicator that norepinephrine is having its desired effect?

Which adverse effect of gabapentin is of greatest concern for the 85-year-old patient?

A 6-day-old neonate in the newborn intensive care unit has been prescribed oxacillin for a suspected central line-associated bloodstream infection. The nurse receives the following order: oxacillin IV 50 mg/kg/day, divided q12h. The neonate weighs 2 lb. 11 oz and the pharmacy dispenses the medication in a concentration of 20 mg/mL. How many milliliters will the nurse administer for each dose? Round your answer to the nearest tenth decimal place.

The nurse receives an order to administer digoxin 0.125 mg intramuscularly each morning to a patient in heart failure. Which part of the order does the nurse question?

The nurse anticipates seeing the effect of which medication most quickly? 

The nurse prepares the patient who has been newly prescribed atorvastatin (Lipitor) for which periodic laboratory evaluation prior to the first dose?

The patient’s stool sample is positive for Entamoeba histolytica. The nurse plans education about which class of medication for this patient?

Which statement by a patient with type 1 diabetes mellitus indicates understanding of teaching about the recommended diet?

The patient with bloody diarrhea and liver abscess is diagnosed with an Entamoeba histolytica infection. The nurse anticipates administering which medication?

The patient receiving thyroid supplementation for hypothyroidism reports insomnia, fatigue, tachycardia, and headache. Which statement by the nurse is appropriate?

The neonate is diagnosed with purpura fulminans. Which order does the nurse anticipate first?

The nurse notes the patient is oozing blood from the IV site and has black, tarry stools. Which order will be most helpful for this patient?

The patient with anemia has been prescribed a transfusion of packed red blood cells. The patient’s blood type is AB+ and the blood received from the blood bank is B-. Which action by the nurse is most appropriate?

The patient with increased intracranial pressure has been administered mannitol. Which patient symptom indicates the drug is having its intended effect?

The patient with malignant hypertension has suffered from a transient ischemic attack. He asks the nurse if he can continue taking his St. John’s wort for depression. Which answer by the nurse is most appropriate?

To which patient does the nurse most likely anticipate administering total parenteral nutrition (TPN)?

The nurse is caring for a patient receiving total parenteral nutrition (TPN). The nurse most closely assesses for which complication in this patient? 

The nurse is most vigilant for signs of which complication in a patient receiving total parenteral nutrition (TPN)?

The patient with chronic malnourishment is started on total parenteral nutrition (TPN). The nurse is vigilant for signs of which complication?

The patient with acquired immunodeficiency syndrome (AIDS) is receiving zidovudine (AZT). The nurse requests an order for which lab test to monitor adverse effects of the drug?

The patient with chronic pain and generalized anxiety disorder has been prescribed alprazolam. Which medication, if also prescribed to the patient, prompts the nurse to clarify the order with the provider?

The nurse is assigned to care for a 45-year-old patient who presents with a three-day history of fever, sore throat, chills, and myalgia. On physical assessment, the nurse notes the patient has multiple erythematous macular areas surrounding bullous lesions, some of which have ruptured and desquamated. Past medical history is significant for a recently diagnosed seizure disorder, managed with lamotrigine. Which intervention will be performed first?

The patient who has taken phenytoin for the past 12 years for seizure disorder reports feeling something strange in the mouth. The nurse anticipates observing which condition? 

The nurse is assigned to a 55-year-old patient with Streptococcus viridans endocarditis who is receiving penicillin and amikacin. The nurse is vigilant for which adverse effect?

The nurse is assigned to a 45-year-old HIV-positive male patient who is admitted with a MRSA skin infection on his right arm secondary to intravenous drug use. The patient is prescribed intravenous vancomycin. Twenty minutes after starting the vancomycin infusion, the patient develops a mild erythematous macular rash on the face, trunk and extremities. Which action is performed first?

The nurse is caring for a 45-year-old patient undergoing treatment with doxorubicin for small cell lung cancer. The nurse focuses education on which adverse effects? Select all that apply.

The patient is being treated with intravenous quinidine for malaria that was contracted while in Africa. Several hours after administration of the medication, the patient develops palpitations and dizziness. Electrocardiogram shows tachycardia and twisting of the QRS complexes around an isoelectric line. Which best describes the most likely etiology of this patient’s arrhythmia?

The nurse is assigned to care for a patient who presents with fever, chills, lethargy, and sore throat. Past medical history is significant for schizophrenia diagnosed three months ago for which clozapine was prescribed. Which additional laboratory finding does the nurse expect to see in this patient?

The nurse is taking care of a patient who is prescribed chloramphenicol. After three days, the patient develops fatigue and dyspnea on exertion. Physical assessment reveals tachycardia, pallor and multiple petechiae on the trunk and extremities. The nurse anticipates which laboratory result(s)?

A new mother is discussing alcohol consumption while breastfeeding her baby. Which statement indicates a need for further teaching? 

The patient is prescribed phenytoin for treatment of a seizure disorder. The nurse instructs the patient about which adverse effect of treatment? 

The nurse is assigned to a 38-year-old patient who presents with polydipsia and polyuria. Past medical history is significant for bipolar disorder diagnosed two months ago, for which the patient was prescribed lithium. The nurse anticipates further testing will reveal which condition? 

The nurse is assigned to care for a 31-year-old male with a past medical history significant for long-standing diabetes mellitus and hypertension. Current medications are metformin, furosemide, and captopril. Laboratory tests reveal serum potassium of 3.2 mEq/L, so the patient is started on spironolactone. The nurse provides education about which side effect of therapy?

The 4-hour-old neonate in the nursery begins making rhythmic movements with the hands and smacking of the lips. An electroencephalogram is performed, and seizures are observed. The nurse prepares to administer which medication?

Which statement is most important for the nurse to include in the teaching of a male patient undergoing treatment for invasive amebiasis?

The patient with a heart rate of 233 bpm has been diagnosed with supraventricular tachycardia on electrocardiogram (ECG). The nurse prepares to administer which medication?

The 4-year-old child is admitted with measles. Which medication does the nurse prepare to administer initially?

The 39-week-gestation neonate is born to a mother with chorioamnionitis. The provider has ordered ampicillin 75 mg/kg/day in divided doses every 8 hours and administered intravenously. The neonate weighs 4.2 kg. How many milligrams does the nurse administer with each dose? Enter your answer using a whole number.