DIURETICS

21. Which group(s) of diuretics is/are frequently prescribed to treat hypertension and congestive heart
failure? (Select all that apply.)

a. Carbonic anhydrase inhibitors

b. Loop diuretics

c. Osmotic diuretics

d. Potassium-sparing diuretics

e. Thiazide diuretics whi

22. When compared with thiazides, how do loop (high-ceiling) diuretics differ?

a. They are more effective as antihypertensives.

b. They promote potassium absorption.

c. They cause calcium reabsorption.

d. They are more potent as diuretics.

23. The patient has been prescribed hydrochlorothiazide (HCTZ) for her hypertension. When she comes
to the office for a follow-up appointment, the nurse observes her drinking an energy drink. Which herb,
commonly found in some energy drinks, can increase blood pressure when taken with thiazide
diuretics?

a. Ginger

b. Ginkgo

c. Licorice

d. St. John’s wort

24. What is the pharmacologic action of spironolactone (Aldactone)?

a. Increase potassium and sodium excretion

b. Promote potassium retention and sodium excretion

c. Promote potassium, sodium, and calcium retention

d. Promote potassium excretion and sodium retention

25. What is the classication of furosemide (Lasix)?

a. Loop diuretic

b. Osmotic diuretic

c. Potassium-sparing diuretic

d. Thiazide diuretic

26. The 65-year-old patient had an acute myocardial infarction 6 months ago and has been prescribed
spironolactone (Aldactone) 100 mg/d to treat an irregular heart rate. What statement by the patient
indicates that he understands the medication teaching the nurse has provided?

a. “I need sodium so my heart beats regularly.”

b. “This medication is dangerous if you have had a heart attack.”

c. “It helps keep potassium so my heart is not irregular.”

d. “I need to take it with lots of bananas to keep my potassium up.”

27. The nurse has received an order to administer 40 mg furosemide (Lasix) IV to the patient. What does
the nurse know about how this medication should be administered?

a. It must be mixed in 50 mL of normal saline.

b. It can only be given in a central line.

c. The patient must be on a cardiac monitor.

d. It should be given over 1-2 minutes.

28. Which lab value(s) should a nurse monitor for a patient receiving chlorothiazide (Diuril)? (Select all
that apply.)

a. Potassium

b. Sodium

c. Bicarbonate

d. Calcium

e. AST/ALT
29. A patient who has had an acute myocardial infarction has been started on spironolactone
(Aldactone) 50 mg/d. When evaluating routine laboratory work, the nurse discovers the patient has a
potassium level of 5.8 mEq/L. What is the priority intervention to be implemented?

a. The spironolactone dose should be decreased and the patient instructed to decrease intake of foods
rich in potassium.

b. The spironolactone dose should be continued and the patient encouraged to eat fruits and
vegetables.

c. The spironolactone dose should be increased and the patient instructed to decrease foods rich in
potassium.

d. Instruct the patient to continue with the current dose of spironolactone and report any signs or
symptoms of hypokalemia.

30. Which individual is the best candidate to take acetazolamide (Diamox)?

a. A 50-year-old with open-angle glaucoma

b. A 58-year-old with acute heart failure

c. A 60-year-old with narrow-angle glaucoma

d. A 75-year-old with acute glaucoma

31. What type of acid-base imbalance could occur if a patient is taking high doses of acetazolamide
(Diamox) or uses the drug constantly?

a. Metabolic acidosis

b. Metabolic alkalosis

c. Respiratory acidosis

d. Respiratory alkalosis

32. The 70-year-old patient has heart failure and has been prescribed hydrochlorothiazide (Esidrix).
What statement by the patient indicates understanding of the dosing regimen?

a. “I need to take it on an empty stomach for it to work.”

b. “I really only need to take my medicine when I am having a hard time breathing.”

c. “It may take several weeks before it starts to work.”

d. “I should take it in the morning so I don’t have to go to the bathroom at night.”

33. The patient has a complicated medical history including heart failure, cardiac arrhythmias, arthritis,
and depression. He is taking furosemide for his heart failure. Which of his other medications would be of
major concern to the nurse?

a. Amiodarone (Cordarone)

b. Acetaminophen (Tylenol)

c. Amitriptyline (Elavil)

d. Zolpidem (Ambien)

34. The 62-year-old patient has been taking ethacrynic acid (Edecrin) for severe edema. The family calls
to report that the patient is very weak and unable to ambulate and is complaining of severe leg cramps.
Knowing the mechanism of action of ethacrynic acid, the nurse is concerned the patient may be
experiencing which electrolyte imbalance?

a. Hyponatremia

b. Hypermagnesemia

c. Hypokalemia

d. Hyperchloremia

35. What is the optimal time to administer diuretics?

a. At bedtime

b. After arising for the day

c. On an empty stomach

d. With meals

36. The nurse assesses the patient who is taking hydrochlorothiazide (HCTZ) for hypertension. What
might the nurse expect to see if the patient is experiencing undesired side effects? (Select all that apply.)

a. Diarrhea

b. Dizziness

c. Headache

d. Hypocalcemia

e. Vomiting
37. Which drug-lab value interaction is caused by thiazide diuretics?

a. Decreased blood glucose level

b. Elevated lithium level

c. Elevated BUN

d. Decreased calcium level

38. The patient is taking furosemide 80 mg/day. She has a history of hypertension and heart failure.
She presents to the emergency department after sustaining a fall at a local sports bar. She has a
laceration to her posterior scalp. Vital signs are temperature 38.0° C, heart rate 98 beats/min,
respiratory rate 16 breaths/min, and blood pressure 94/62 mm Hg. Her electrolytes are within normal
limits. Her blood alcohol is .06, and her toxicology screen is negative. What does the nurse know
about possible drug interactions?

a. Furosemide can cause severe hypoglycemia and headache.

b. Furosemide can cause hyperkalemia and dizziness.

c. Furosemide can cause orthostatic hypotension when consumed with alcohol.

d. Furosemide can lead to elevated uric acid levels causing the patient to faint.

39. In which patient are loop diuretics contraindicated?

a. The patient with anuria

b. The patient with asthma

c. The patient with allergy to ceftriaxone

d. The patient with gastric ulcers

40. The patient has been prescribed furosemide 80 mg/d as a diuretic. Which food(s) should the nurse
encourage the patient to include in his diet? (Select all that apply.)

a. Raisins

b. Rice

c. Baked potatoes

d. Tomatoes

e. White bread
DRUGS FOR UPPER RESPI

5. Antihistamines are another group of drugs used for the relief of cold symptoms. What properties of
these medications result in decreased secretions?

a. Analgesic

b. Anticholinergic

c. Antitussive

d. Cholinergic

6. Compared to first-generation antihistamines, second-generation antihistamines have a lower

incidence of which side effect?

a. Drowsiness

b. Headache

c. Tinnitus

d. Vomiting

7. The U.S. Food and Drug Administration has ordered removal of all cold remedies containing which
drug?

a. Dextromethorphan

b. Guaifenesin

c. Histamine

d. Phenylpropanolamine

8. The patient has environmental allergies and asks the student health nurse about the appropriate dose
of diphenhydramine. What is the recommended dosage of diphenhydramine (Benadryl)?

a. 25-50 mg q6-8h

b. 25-50 mg daily

c. 50-100 mg q4-6h

d. 100 mg daily

9. What is one of the effects of diphenhydramine (Benadryl)?

a. Anticoagulant

b. Anticonvulsant

c. Antihypertensive

d. Antitussive

10. Diphenhydramine blocks histamine receptors. Which histamine receptors does it block?

a. H1

b. H2

c. B1

d. B2

11. A patient taking diphenhydramine (Benadryl) breastfeeds her infant daughter. What advice will the
nurse give her?

a. Breastfeeding provides allergy relief to the infant.

b. Large amounts of the drug pass into breast milk; breastfeeding is not recommended.

c. Small amounts of the drug pass into breast milk; breastfeeding is not recommended.

d. The drug does not affect breastfeeding.

12. The health teaching plan for a patient taking diphenhydramine (Benadryl) should include the side
effects of the drug. What might the nurse assess in a patient experiencing a side effect? (Select all that
apply.)

a. Disturbed coordination

b. Drowsiness

c. Hypertension

d. Nausea

e. Urinary retention

13. What is the advantage of systemic decongestants over nasal sprays and drops?

a. Fewer side effects

b. Less costly
c. Preferred by older patients

d. Provide longer relief

14. Which expectorant is frequently an ingredient in cold remedies?

a. Dextromethorphan

b. Ephedrine

c. Guaifenesin

d. Promethazine

15. The patient presents to the clinic with complaints of nasal congestion, sneezing, and fever for 4 days.
She has been diagnosed with a cold. What priority teaching instructions should the nurse include for this
patient? (Select all that apply.)

a. Instruct the patient to cover nose and mouth when sneezing.

b. Advise the patient to discuss use of any herbal remedies with her health care provider.

c. Encourage the patient to drink adequate Àuids.

d. Nasal sprays can be utilized q2h.

e. Promote good hand hygiene.

16. What group(s) of drugs is/are used to treat cold symptoms? (Select all that apply.)

a. Antihistamines

b. Antitussives

c. Decongestants

d. Expectorants

e. Xanthines

17. Decongestants are contraindicated or to be used with extreme caution for patients with which
condition(s)? (Select all that apply.)

a. Cardiac disease

b. Diabetes mellitus

c. Hypertension
d. Hyperthyroidism

e. Obesity

18. Which priority information should be included in teaching a patient who is taking medications for a
common cold and also has a history of atrial ¿brillation and depression? (Select all that apply.)

a. Administer 4 puffs of nasal spray for a full 10 days.

b. Antibiotics are also needed to ¿ght a common cold virus.

c. Do not drive during initial use of a cold remedy containing an antihistamine.

d. Read labels of over-the-counter drugs for any interactions with current medications.

e. Take cold remedies with a decongestant for a better night’s sleep.

DRUGS FOR LOWER RESPI

25. The patient is being treated for chronic obstructive pulmonary disease (COPD). His medication is
delivered via a metered-dose inhaler. Related health teaching would include which priority information?
a. Hold the inhaler upside down.

b. Refrigerate the inhaler.

c. Shake the inhaler well just before use.

d. Test the inhaler each time to see if the spray works.

26. When compared to oral medication for asthma, what information regarding a drug administered by
metered-dose inhaler should the nurse be aware of? (Select all that apply.)

a. The inhaled dose will be lower than an oral medication.

b. There are fewer side effects with an inhaled medication.

c. Inhaled medication is longer-lasting.

d. Inhaled medication has a more rapid onset.

e. Some oral and inhaled medications can be taken together.

27. The patient has been prescribed both ipratropium (Atrovent) and cromolyn (Nasalcrom). How many
minutes should she wait between taking the two medications?
a. 1

b. 5

c. 10

d. Does not matter

28. The patient is taking an inhaled beta agonist and a steroid for his asthma. He states, “I don’t have
time to wait between taking medications. I’m very busy. Why do I have to do this?” What is the nurse’s
best response to the patient?

a. “The inhaled medication will allow the bronchioles to dilate so the steroid works better.” b. “This is
done so you remember which one comes first.”

c. “The inhaled medication will make your heart circulate the steroid faster.”

d. “The steroid may make your nose stuffy, so you take the inhaled medication first.”

29. What is/are the side effect(s) of long-term use of glucocorticoids? (Select all that apply.)

a. Impaired immune response

b. Insomnia

c. Hyperglycemia

d. Vomiting

e. Weight loss

30. What anticholinergic drug has few systemic effects and is administered by aerosol?

a. Albuterol (Proventil)

b. Ipratropium (Atrovent)

c. Isoproterenol (Isuprel)

d. Tiotropium (Spiriva)

31. Drug selection and dosage in older adults with conditions of the lower respiratory tract need to be
considered. The use of large, continuous doses of a beta2 -adrenergic agonist may cause which side
effect(s) in the older adult? (Select all that apply.)

a. Bronchoconstriction

b. Constipation
c. Tachycardia

d. Tremors

e. Urinary retention

32. The 40-year-old patient has been taking theophylline for long-term treatment of his asthma. He has
also been taking ephedra to stay alert while ¿nishing a project at work. The patient presents to the clinic
with complaints of feeling ill. Vital signs are temperature 36.4° C oral, heart rate 124 beats/ min,
respiratory rate 18 breaths/min, blood pressure 170/90 mm Hg, and oxygen saturation 99% on room air.
Fingerstick blood glucose is 210. His theophylline level is 26 mcg/mL. What does the nurse suspect may
be the cause of the patient’s symptoms?

a. Acute allergic reaction

b. Asthma attack

c. Stevens-Johnson syndrome

d. Theophylline toxicity

33. The patient has exercise-induced bronchospasm and is being treated with a short-acting beta2
agonist. Which priority information will the nurse include in a review of inhaler administration for this
patient? (Select all that apply.)

a. “Cleanse all washable parts of inhaler equipment daily.”

b. “Hold your breath for a few seconds, remove mouthpiece, and exhale slowly.”

c. “Keep your lips secure around the mouthpiece and inhale while pushing the top of the canister
once.”

d. “Monitor your heart rate while taking this medication.”

e. “Wait 5 minutes and repeat the procedure if a second inhalation is needed.”

34. The 68-year-old patient has been diagnosed with COPD. When providing health teaching for this
patient, the nurse discusses the side effects that may occur with the use of bronchodilators. What
possible clinical manifestation(s) should the patient be aware of? (Select all that apply.)

a. Bradycardia

b. Dry eyes

c. Insomnia

d. Nervousness
e. Palpitations

35. Which medication(s) when prescribed with theophylline will concern the nurse? (Select all that
apply.) a. Beta blockers b. Digitalis c. Lithium d. Stool softeners e. Phenytoin 36. Which of the following
is/are side effect(s) of theophylline? (Select all that apply.)

a. Cardiac dysrhythmias

b. Diarrhea

c. Gastrointestinal bleeding

d. Headache

e. Seizures

37. The patient has asthma and takes cromolyn (Nasalcrom). What statement by the patient indicates
the need for more education?

a. “I must take this medication every day.”

b. “It will stop an asthma attack that has started.”

c. “I can rinse my mouth out with water to get rid of the taste.”

d. “It is important for me to take this exactly as directed.”

38. A patient presents to the health care provider’s of¿ce for a follow-up visit. The patient is taking
theophylline, and the nurse is reviewing the lab results. What level of theophylline would fall in the
therapeutic range?

a. 2 mcg/mL

b. 8 mcg/mL

c. 14 mcg/mL

d. 23 mcg/mL

ANTIHYPERTENSIVES

16. The patient presents to the health care provider for his annual check-up. His vital signs are blood
pressure 136/82 mm Hg, heart rate 72 beats/min, respiratory rate 16 breaths/min, and temperature
36.2° C. According to the JNC-7, to which hypertension category does this patient belong?

a. Normal
b. Prehypertension

c. Stage 1

d. Stage 2

17. A cardioselective beta-adrenergic blocker is also known by which other term?

a. Alpha-beta blocker

b. Alpha blocker

c. Beta-angiotensin agent

d. Beta blocker

18. Which patient would be most suited for treatment with a nonselective alpha-adrenergic blocker?

a. A 45-year-old with mild to moderate renal failure

b. A 46-year-old with a severe hypertension caused by adrenal medulla tumor

c. A 50-year-old with hyperlipidemia

d. A 55-year-old with type 2 diabetes

19. Where in the body do direct-acting vasodilators act to decrease blood pressure?

a. Cardiac valves

b. Dopaminergic receptors in kidneys

c. Renal tubules

d. Smooth muscles of the blood vessels

20. With use of direct-acting vasodilators, sodium and water are retained, and peripheral edema occurs.
Which category of drugs should be given to avoid Àuid retention?

a. Anticoagulants

b. Antidysrhythmics

c. Cardiac glycosides

d. Diuretics
21. Which is/are action(s) of angiotensin II receptor blockers (ARBs)? (Select all that apply.)

a. Block angiotensin II

b. Cause vasodilation

c. Decrease peripheral resistance

d. Increase sodium retention

e. Slow heart rate

22. An ARB can be combined with the thiazide diuretic hydrochlorothiazide. What is the purpose of
combining these two drugs?

a. To decrease rapid blood pressure drop

b. To enhance the antihypertensive effect by promoting sodium and water loss

c. To increase sodium and water retention for controlling blood pressure

d. To promote potassium retention

23. ARBs may be prescribed for hypertensive patients instead of an ACE inhibitor. What is the most
limiting factor in the use of ACE inhibitors?

a. Coughing

b. Dizziness

c. Shortness of breath

d. Sneezing

24. Which orders should the nurse question if the patient was prescribed an ACE inhibitor? a. A 45-year-
old Hispanic man

b. A 48-year-old Asian woman

c. A 50-year-old white woman

d. A 55-year-old African-American man

25. The patient, a 48-year-old African-American female, presents to her health care provider. Her blood
pressure is 164/88 mm Hg, and a decision is made to start antihypertensive medication. What group of
medications would be more effective than ACE inhibitors for this patient?
a. Angiotensin II blockers

b. Beta blockers

c. Calcium blockers

d. Direct renin inhibitor

26. Herb-drug interactions may occur if the patient is taking certain herbal supplements. An herb history
should be obtained. What may occur in an individual who also uses ma-huang (ephedra) with an
antihypertensive drug?

a. A decrease or counteraction of the effects of the antihypertensive drug

b. An increase in the hypertensive state

c. An increase in the hypotensive effects of the antihypertensive drug

d. No effect on the action of the antihypertensive drug

27. Captopril (Capoten) is from which group of antihypertensives?

a. ACE inhibitor

b. Beta blocker

c. Calcium blocker

d. Direct-acting vasodilator

28. What is the action of captopril (Capoten)?

a. Dilation of the arteries

b. Increase in sodium and water excretion

c. Inhibition of the formation of angiotensin II

d. Inhibition of the alpha receptors

29. What is the protein-binding power of valsartan (Diovan)?

a. Highly protein-bound

b. Moderately to highly protein-bound

c. Moderately protein-bound
d. Low protein-bound

30. The patient has essential hypertension. He is taking captopril (Capoten) 25 mg t.i.d. If the patient
takes captopril with a highly protein-bound drug, what might occur?

a. Captopril and the highly protein-bound drug will compete for protein sites.

b. The concentration of captopril will be increased.

c. There will be moderate drug displacement of captopril, which is moderately to highly protein-bound.

d. There will be no drug displacement, because captopril is not highly protein-bound.

31. If a patient takes captopril (Capoten) with nitrates, diuretics, or adrenergic blockers, what might the
nurse assess in this patient?

a. Hypoglycemic reaction

b. Hypotensive reaction

c. Hyperkalemic reaction

d. Hypertensive reaction

32. Which group(s) of individuals should absolutely not be prescribed valsartan (Diovan)? (Select all that
apply.)

a. African Americans

b. Caucasians

c. Children over age 6

d. Older adults over age 70

e. Pregnant women in third trimester

33. If a patient takes captopril (Capoten) with a potassium-sparing diuretic, what might occur?

a. Hypokalemia

b. Hyperkalemia

c. Hypocalcemia

d. Hypercalcemia
34. A patient states that he wishes to stop taking captopril (Capoten) for his hypertension. What is the
nurse’s best response?

a. “Blood pressure can be controlled by diet and exercise, so you don’t have to take medication.”

b. “It is important to keep taking your medication as directed until you speak with your health care
provider.”

c. “Once your blood pressure is normal for one month, you can stop taking your medication.”

d. “Wean yourself off of the medication over a 10- day period.”

35. A patient’s antihypertensive drug was changed from captopril (Capoten) to nifedipine (Procardia XL)
30 mg q8h. What type of antihypertensive drug is nifedipine?

a. Angiotensin antagonist

b. Beta blocker

c. Calcium channel blocker

d. Centrally acting sympatholytic

36. What is the protein-binding power of amlodipine?

a. Highly protein-bound

b. Moderately to highly protein-bound

c. Moderately protein-bound

d. Low protein-bound

37. The nurse is assessing the patient with essential hypertension following the shift report. What might
the nurse assess if the patient is experiencing side effects from his medications? (Select all that apply.)

a. Dizziness

b. Headache

c. Increased blood pressure

d. Nausea

e. Paranoia

38. Aliskiren is what type of drug?

a. ACE inhibitor

b. Angiotensin II blocker

c. Calcium channel blocker

d. Direct renin inhibitor

39. What action does amlodipine (Norvasc) have in the body?

a. Increased peripheral vascular resistance

b. Peripheral clotting

c. Thrombolysis

d. Vasodilation

40. The patient, 62 years old, is taking amlodipine (Norvasc) and complains of swelling in her ankles.
What is the nurse’s best response to her concern?

a. “Swelling is common when taking Norvasc. You should cut the tablet in half to reduce your dosage.”

b. “Swelling may occur with Norvasc. I will contact your health care provider to determine if the drug
should be changed or if another drug should be added.”

c. “You should not be taking that drug because of your age. I will see what other antihypertensive drug
you can take.”

d. “You should stop taking the drug for several days and check that the swelling has decreased.”

41. What classi¿cation of drug is bisoprolol (Zebeta)?

a. ACE inhibitor

b. Beta blocker

c. Calcium blocker

d. Diuretic

42. What classi¿cation of drug is pindolol (Visken)?

a. ACE inhibitor

b. Beta blocker

c. Calcium blocker
d. Diuretic

43. What is/are the advantage(s) of using cardioselective beta-adrenergic blockers as an

antihypertensive? (Select all that apply.)

a. They can be abruptly discontinued without causing rebound symptoms.

b. They help prevent bronchoconstriction.

c. They increase serum electrolyte levels.

d. They maintain renal blood flow.

e. They minimize hypoglycemic effect.

44. ARBs have gained popularity for treating hypertension. Which is/are example(s) of ARB agents?
(Select all that apply.)

a. Irbesartan (Avapro)

b. Losartan potassium (Cozaar)

c. Valsartan (Diovan)

d. Lisinopril (Prinivil)

e. Metoprolol (Lopressor)

45. Which statement best describes the direct renin inhibitor aliskiren (Tekturna)?

a. It is effective for treating severe hypertension.

b. It can be combined with another antihypertensive drug such as an ARB.

c. It can cause hypokalemia when taken as a monotherapy drug.

d. It is more effective than calcium channel blockers in treating hypertension in African-American

patients.

ANTICOAGULANTS, ANTIPLATELETS, AND THROMBOLYTICS

32. The patient has had a deep vein thrombosis in her lower leg and has been started on warfarin
(Coumadin). She asks the nurse how warfarin works. What is the nurse’s best response?

a. “Warfarin will help dissolve the blood clots.”

b. “Warfarin is given with thrombolytics to help break up clots.”

c. “Warfarin prevents new clots from forming.”

d. “Warfarin dilates the veins to improve blood Àow.”

33. The nurse has several patients receiving warfarin. Which INR(s) should concern the nurse? (Select all
that apply.) a. 1.2 b. 1.4 c. 1.8 d. 2.0 e. 2.4 34. What is one of the primary reasons LMWHs are given?

a. Enhance the action of warfarin

b. Prevent cerebrovascular accidents

c. Prevention of DVTs after hip or knee surgery

d. Treatment of acute myocardial infarction

35. Which drug is not a LMWH?

a. Enoxaparin sodium (Lovenox)

b. Clopidogrel (Plavix)

c. Dalteparin sodium (Fragmin)

d. Tinzaparin sodium (Innohep)

36. The patient, 58 years old, has unstable angina and is having an emergent percutaneous transluminal
coronary angioplasty (PTCA). The nurse is completing preprocedure teaching and explains that he will be
receiving a medication right before the procedure and then for the next 12 hours by IV drip to prevent
ischemia. What medication is the nurse teaching the patient about?

a. Abciximab (ReoPro)

b. Aminocaproic acid (Amicar)

c. Protamine sulfate

d. Warfarin (Coumadin)

37. The patient weighs 168 pounds and is going to receive abciximab (ReoPro) for unstable angina. What
is the correct dosage for a continuous infusion?

a. 9.5 mcg/min

b. 19 mcg/min
c. 25 mg/min

d. 42 mg/min

38. Which statement best describes clopidogrel (Plavix)?

a. It is the most effective anticoagulant when used with ibuprofen.

b. It is most effective when prescribed as a single drug to prevent stroke.

c. It is an inexpensive alternative to warfarin.

d. It can be used together with aspirin after myocardial infarction (MI) or cerebrovascular accident
(CVA) to prevent platelet aggregation.

39. The 72-year-old patient has a history of atrial ¿brillation and has been discharged from the hospital
on warfarin. He was taking heparin prior to being changed to warfarin for discharge. With regards to lab
monitoring, what is a priority teaching intervention for the nurse?

a. “INR and activated partial thromboplastin time (aPTT) will be monitored closely.”

b. “Periodic evaluation of your electrolytes is very important.”

c. “Your must be monitored for BUN/creatinine values to evaluate for new renal failure.”

d. “You will not need any further lab work while taking this medication.”

40. Enoxaparin sodium (Lovenox) is an anticoagulant used to prevent and treat deep vein thrombosis
and pulmonary embolism. To which category does this drug belong?

a. Oral anticoagulant

b. Low–molecular-weight heparin

c. Standard heparin

d. Thrombolytic

41. The 3-year-old patient has gotten into a box of rat poison under the sink. The family brings the box
to the emergency department, and the main ingredient is warfarin. What priority medication will the
nurse prepare to administer?

a. Anagrelide (Agrylin) b. Protamine sulfate c. Ticlopidine (Ticlid) d. Vitamin K (Mephyton)

42. What is the protein-binding power of warfarin?

a. Highly protein-bound

b. Low protein-bound

c. Not protein-bound at all

d. Moderately protein-bound

43. The patient is given heparin for early treatment of deep vein thrombosis. Later, warfarin is
prescribed. If the patient is also taking Àuoxetine, which is highly protein-bound, what might occur?

a. Drug displacement of the highly protein-bound drug but not displacement of warfarin

b. Drug displacement of warfarin

c. Drug displacement varies from patient to patient

d. No drug displacement of either drug

44. The patient presents to the emergency department with complaints of gastrointestinal bleeding. She
is currently taking fondaparinux (Arixtra) at home after having major orthopedic surgery. She has been
taking 2.5 mg for the past 5 days. What does the nurse anticipate is occurring?

a. Adverse reaction b. Allergic reaction c. Insuf¿cient dose of fondaparinux d. Stevens-Johnson

syndrome

45. What is one of the bene¿ts of rivaroxaban (Xarelto)?

a. Does not require monitoring

b. Inexpensive

c. Long half-life

d. Safe to use in pregnancy

46. The patient is in the emergency department (ED) and has been diagnosed with an acute MI. The
patient will be receiving streptokinase immediately while still in the ED. What might the nurse assess in
a patient who is experiencing an allergic reaction to this drug? (Select all that apply.)

a. Bronchospasm

b. Dyspnea

c. Hives

d. Hypotension
e. Nausea

47. The patient has received alteplase (Activase) for treatment of a CVA. The patient begins to
hemorrhage. What medication does the nurse anticipate will potentially be used as treatment for this
hemorrhage?

a. Reteplase (Retavase)

b. Aminocaproic acid (Amicar)

c. Calcium gluconate

d. Protamine sulfate

48. What action(s) will the nurse perform when caring for a patient who is receiving tenecteplase
(TNKase)? (Select all that apply.)

a. Assess for reperfusion arrhythmias.

b. Monitor liver panel.

c. Observe for signs and symptoms of bleeding.

d. Obtain a type and crossmatch.

e. Record vital signs and report changes.

49. Which patient(s) would be candidate(s) for anticoagulant use? (Select all that apply.)

a. A 28-year-old with deep vein thrombosis

b. A 35-year-old with an arti¿cial heart valve

c. A 45-year-old with migraines

d. A 52-year-old who has had a knee replacement e. A 68-year-old with a CVA

ANTIHYPERLIPIDEMICS AND PERIPHERAL VASODILATORS

7. Which elevated apolipoprotein can be an indication of risk for coronary heart disease (CHD)?

a. Apo A-1

b. Apo A-2

c. Apo B-100
d. Apo C-4

8. The patient is taking atorvastatin (Lipitor) 80 mg/ day. The patient’s partner calls to report that the
patient is feeling weak and complaining of muscle pain. What severe side effect of statins does the nurse
suspect?

a. Stevens-Johnson syndrome

b. Pseudomembranous colitis

c. Gastric ulcers

d. Rhabdomyolysis

9. Homocysteine is a protein in the blood that has been linked to cardiovascular disease and stroke.
What other negative action may it also promote?

a. Flushing of skin

b. Loss of blood vessel elasticity

c. Photosensitivity and sunburn

d. Lowering of low-density lipoprotein levels

10. The patient has intermittent claudication and complains of leg pain. He states, “I don’t believe in
taking all of that medicine stuff. I prefer to use only natural medicines.” What herb does the nurse
recognize as being used by some patients with intermittent claudication?

a. Ginger

b. Ginseng

c. Ginkgo

d. Goldenseal

11. The patient presents to the clinic for a complete physical. The patient states, “I have been doing a lot
of reading, so I know what my cholesterol should be.” What does the nurse know is the desired range
for total cholesterol?

a. 50-100 mg/dL

b. 100-150 mg /dL

c. 150-200 mg/dL
d. 200-250 mg/dL

12. Low-density lipoproteins (LDL) are the so-called “bad” lipoproteins. Why are high levels of LDL
considered unhealthy?

a. There is an increased risk of hyperthyroidism.

b. There is the possibility of digestive problems.

c. There is increased risk of rhabdomyolysis.

d. There is an increased risk of cardiovascular disease.

13. What is the standard preferred level of LDL?

a. Less than 250 mg/dL

b. Less than 200 mg/dL

c. Less than 150 mg/dL

d. Less than 100 mg/dL

14. The patient has a lipid pro¿le drawn as part of an annual physical exam. What does the nurse know
about a high-density lipoprotein (HDL) level of 22 mg/dL?

a. This value puts the patient in a high-risk category.

b. An HDL of 22 mg/dL places the patient in a moderate-risk category.

c. The HDL level must be compared with all other levels before a decision can be made.

d. This value is within the standard preferred range.

15. The patient had a total cholesterol of 228 mg/dL. After 2 months of a low-fat, low-cholesterol diet,
the total cholesterol is 212 mg/dL. Why is this level not lower?

a. The patient most likely did not adhere to the diet.

b. Diet modi¿cation usually decreases cholesterol levels by only 10% to 30%.

c. The patient lost less than 10 pounds on the diet.

d. The patient’s exercise program was not rigorous enough.

16. The patient is prescribed simvastatin (Zocor). She asks if she can eat whatever she wants now that
she is taking Zocor. What is the nurse’s best response?

a. “Yes, you may eat whatever you want as long as you are taking Zocor.”

b. “Diet is not an important factor if you are compliant with your medications.”

c. “You should maintain a low-fat, low-cholesterol diet and exercise as well.”

d. “With Zocor, you must lose weight as well as exercise.”

17. What is a usual dose of cilostazol (Pletal)?

a. 100 mg q12h

b. 200 mg q12h

c. 250 mg q12h

d. 300 mg q12h

18. What priority information should the nurse include in the health teaching plan for a patient taking
cilostazol (Pletal)? (Select all that apply.)

a. Take medications with meals.

b. Avoid drinking grapefruit juice.

c. Do not take acetaminophen.

d. Monitor for side effects such as headache and abdominal pain.

e. Monitor blood pressure weekly.

19. Which medication(s), other than the statins, is/are prescribed for reducing cholesterol and LDL
levels? (Select all that apply.)

a. Bile-acid sequestrants

b. Alpha-adrenergic agents

c. Direct thrombin inhibitors

d. Nicotinic acid

e. Antiplatelets

f. Cholesterol absorption inhibitors

20. What type of medication is rosuvastatin (Crestor)?

a. HMG-CoA reductase inhibitor

b. Cholesterol absorption inhibitor

c. Bile-acid sequestrant

d. Combination of two antilipidemics

DRUGS FOR GASTROINTESTINAL TRACT

8. Which area(s) in the brain cause(s) vomiting when stimulated? (Select all that apply.)

a. Chemoreceptor trigger zone

b. Nausea center

c. Medulla

d. Vertigo center

e. Vomiting center

9. Of the following groups of medications, which can be used as antiemetics? (Select all that apply.)

a. Anticholinergics

b. Antihistamines

c. Cannabinoids

d. Opioids

e. Phenothiazines

10. The patient has severe nausea and vomiting and has been prescribed promethazine 25 mg PO q4-6h.
The patient asks how the medication works. What is the nurse’s best response?

a. “It stimulates the dopamine receptors in the brain associated with vomiting.”

b. “It blocks the histamine receptor sites and inhibits the CTZ.”

c. “It blocks the acetylcholine receptors associated with vomiting.”

d. “It prohibits the muscle contraction in the abdominal wall, preventing vomiting.”
11. The 16-year-old patient has been vomiting since last night. His mother calls the health care provider
for an appointment but will be unable to come in for several hours. What nonpharmacologic method(s)
can the nurse suggest to decrease nausea and vomiting? (Select all that apply.)

a. “Drink weak tea.”

b. “Takes sips of Àat soda.”

c. “Eat small amounts of gelatin if tolerated.”

d. “Crackers may be helpful.”

e. “Breathe deeply in and out through your nose.”

12. The patient has a history of seasickness but is going boating this weekend. How far in advance
should the nurse advise her to apply a scopolamine patch? a. Immediately b. 1 hour c. 4 hours d. 24
hours

13. The nurse is taking care of a newly pregnant patient who is complaining of morning sickness. She
asks the nurse what she can do to help stop the nausea. How will the nurse respond? (Select all that
apply.) a. “Ask your health care provider for a prescription for hydroxyzine.”

b. “Take over-the-counter antiemetics like bismuth subsalicylate.”

c. “Try drinking Àat soda or weak tea.” d. “Consider some dry toast or crackers.” e. “This will just go
away in a few months. There is nothing to do.”

14. Which drugs are most commonly used to treat motion sickness? a. Anticholinergics b. Antihistamines
c. Cannibinoids d. Osmotics

15. The major ingredient in cannabinoids is tetrahydrocannabinol. This substance is also the main
psychoactive ingredient in what other drug? a. Amphetamine b. Cocaine c. Heroin d. Marijuana 16. The
patient has nausea, vomiting, and vertigo. She has been prescribed diphenidol (Vontrol). Which
condition is this medication most likely to be prescribed for? a. Bell’s palsy b. Ménière’s disease c.
Opiate withdrawal d. Stevens-Johnson syndrome

17. What is the goal behind giving activated charcoal? a. Absorb poison b. Cause diarrhea c. Promote
vomiting d. Stop nausea

18. What drug(s) is/are classi¿ed as antidiarrheal? (Select all that apply.) a. Adsorbents b.
Anticholinergics c. Opioids d. Proton pump inhibitors e. Selective serotonin reuptake inhibitors 19. The
patient is receiving diphenoxylate with atropine (Lomotil) for treatment of diarrhea. What side effect(s)
might the nurse expect to see during treatment? (Select all that apply.) a. Dilated pupils b. Drowsiness c.
Hypertension d. Hypoglycemia e. Urinary retention 20. What should potentially concern the nurse caring
for a patient who has been taking opiates and opiate-related drugs for an extensive period of time to
treat chronic diarrhea? (Select all that apply.) a. Abuse b. Major side effects c. Misuse d. Potentiation e.
Tolerance 21. The patient has recently had surgery and has been taking opioids for pain control. He has
become constipated and has been prescribed a laxative. When providing health care teaching for this
patient, what type of stool should the nurse tell the patient to expect? a. Hard and dry b. Liquid c. Soft d.
Soft with hard pieces 22. Which is/are a type of laxative/cathartic? (Select all that apply.) a. Adsorbents
b. Bulk-forming c. Emetics d. Emollients e. Stimulants

23. The patient is scheduled for a barium enema and has a prescription for bisacodyl (Dulcolax) the day
before the procedure. She asks the nurse to explain how this medication works to prepare her for her
test. What is the nurse’s best response? a. “Bisacodyl increases peristalsis by irritating the sensory nerve
endings in the mucosa.” b. “By stimulating more smooth muscle contraction, bisacodyl will cause your
bowel to empty.” c. “Bisacodyl increases water in the gut.” d. “Bisacodyl is an emetic, so you will vomit
and your stomach will be empty for the test.” 24. The 65-year-old patient has recently had a myocardial
infarction. His health care provider has ordered docusate sodium (Colace) 200 mg daily. What is the
purpose of this medication for this patient? a. Treat diarrhea b. Prevent straining with a bowel
movement c. Stop vomiting d. Prevent nausea associated with arrhythmias 25. The use of saline
cathartics should be questioned by the nurse for which patient? a. 38-year-old with diabetes b. 48-year-
old with peripheral vascular disease c. 50-year-old with chronic obstructive pulmonary disease (COPD) d.
62-year-old with heart failure 26. Which is a bulk-forming laxative? a. Bisacodyl (Dulcolax) b. Magnesium
citrate (Citroma) c. Psyllium (Metamucil) d. Sodium biphosphate (Fleet Phospho-Soda) 27. The patient is
taking mineral oil as a laxative. If she continues to take mineral oil for an extended period of time, what
should concern the nurse? a. Abdominal bloating and Àatulence b. Decreased absorption of fat-soluble
vitamins A, D, E, and K c. Dependence on the drug d. Excessive Àuid loss due to diarrhea 28. What
priority instructions should be given to a patient experiencing constipation? (Select all that apply.) a.
Avoid use of stimulant laxatives, which may cause electrolyte imbalance. b. Increase water and ¿ber
intake in your diet. c. Increase the amount of exercise you do regularly. d. Know that some laxatives may
cause urine discoloration. e. Take a laxative every day until regularity returns. 29. With regards to the
gastrointestinal system, what do opiates do? a. Absorb toxic materials b. Decrease intestinal motility c.
Gently stimulate peristalsis d. Stimulate the CTZ 30. Which patient should not use a laxative/cathartic? a.
48-year-old patient with cirrhosis b. 55-year-old patient with Parkinsonism c. 60-year-old patient with
stable angina d. 65-year-old patient with bowel obstruction 31. The patient has been prescribed
promethazine (Phenergan) 25 mg PO for nausea that accompanies her migraines. What side effect(s)
should be included in the patient teaching? (Select all that apply.) a. Blurred vision b. Diarrhea c.
Drowsiness d. Dry mouth e. Hypotension 32. The patient has recently started taking prochlorperazine
(Compazine) for nausea and vomiting. What priority information should be included in the health
teaching plan for this patient? (Select all that apply.) a. “You may also wish to try nonpharmacologic
methods to help with the nausea.” b. “You should try to stay busy to keep your mind off the nausea.” c.
“You should avoid driving or operating heavy machinery while taking Compazine.” d. “You should avoid
alcohol while taking this medication.” e. “You should be aware that your urine may turn dark.” 33. The
patient has cancer and is being treated with dronabinol (Marinol) for nausea and vomiting caused by
chemotherapy. When should this drug be administered? a. 1-3 hours before and for 24 hours after
chemotherapy b. 12 hours before and for 24 hours after chemotherapy c. 6 hours before and during
chemotherapy d. Every 4-6 hours as needed 34. How is the dose of dronabinol (Marinol) determined? a.
Patient age b. Patient size c. Severity of nausea d. Type of cancer
35. The nurse will question an order for antidiarrheal medication for which patient? a. 46-year-old with
diabetes b. 36-year-old with COPD c. 60-year-old with heart failure d. 65-year-old with hepatitis C 36.
The patient has severe diarrhea. What should the nurse monitor? (Select all that apply.) a. Bowel sounds
b. Cardiac rhythm c. Electrolytes d. Vital signs e. White blood cell count 37. The patient is experiencing
diarrhea. Which food(s) will the nurse advise the patient to avoid? (Select all that apply.) a. Bottled
water b. Clear liquids c. Fried foods d. Milk products e. Raw vegetables 38. Which food(s) should the
nurse encourage a patient with constipation to eat? (Select all that apply.) a. Fresh fruit b. Oat bran c.
Processed cheese d. Water e. Whole grains

Chapter 49 Drugs for Eye and Ears Disorders

1. Topical anesthetics are used during an eye exam and before removal of a(n) foreign body from the
eye.

2. Lubricants are used to moisten contact lenses and/or to replace ___tears__.

3. Miotics are used to lower _intraocular_ pressure.

4. Carbonic anhydrase inhibitors were developed as _diuretics . They are effective in treating open-
angle glaucoma.

5. Osmotic drugs are used to (decrease/increase) the vitreous humor volume. (Circle correct answer.)

6. Mannitol is contraindicated for clients with the condition of anuria or ___dehydration.

7. The drug group used to paralyze the muscles of accommodation is _cycloplegics__.

8. Acute otitis media occurs most frequently in children_.

9. Instruct patients with glaucoma to avoid atropine-like drugs because they (decrease/increase)
intraocular pressure. (Circle correct answer.)

10. Antiinfectives are used to treat infections of the eye, including inÀammation of the membrane
covering the eyeball and lining the eyelid known as _conjunctivitis.

11. Drugs that interfere with production of carbonic acid, leading to decreased aqueous humor
formation and decreased intraocular pressure, belong to the group carbonic anhydrase inhibitor.

12. The group of drugs used in the emergency treatment of acute closed-angle glaucoma because of the
ability to rapidly decrease intraocular pressure is the osmotic.

Column I

__e__ 13. Conjunctivitis

__d__ 14. Optic

__f__ 15. Cerumen

__a__ 16. Lacrimal duct

__b__ 17. Miosis

__c__ 18. Otic

Column II

a. Passage that carries tears into the nose

b. Contraction of the pupil
c. Ear
d. Eye
e. Inflammation of the membrane covering the eyeball
f. Earwax

NCLEX Review Questions Select the best response.

19. The patient presents to her ophthalmologist for a routine eye examination. Prior to the exam,
eyedrops are used to dilate her eyes. Such medication belongs to which group of drugs?

a. Carbonic anhydrase inhibitors

b. Cerumenolytics
c. Mydriatics
d. Osmotics

20. A patient is taking acetazolamide (Diamox) for acute closed-angle glaucoma. The nurse will assess for
which side effect associated with drugs in the group?
a. Agitation
b. Constipation
c. Electrolyte imbalances
d. Urinary retention

21. The African-American patient has open-angle glaucoma. The nurse knows that which glaucoma
medication is more effective in African-American patients?
a. Bimatoprost (Lumigan)
b. Latanoprost (Xalatan)
c. Travoprost (Travatan Z)
d. TaÀuprost (Zioptan)

22. The patient has open-angle glaucoma and is being treated with latanoprost (Xalatan). What is/are
priority teaching point(s) for this patient? (Select all that apply.)
a. Permanent brown pigmentation of the iris may occur.
b. Eyelids may darken.
c. Blurred vision may occur.
d. Eyes may feel itchy.
e. Pupils may get very small.

23. A patient who has frequent cerumen impaction has had his ears irrigated at the clinic. To determine
the results of the irrigation, what structure must be visualized?
 a. Auricle
b. External auditory canal
c. Semicircular canals
d. Tympanic membrane

24. The patient has frequent cerumen buildup. Which medication does the nurse anticipate the health
care provider will suggest for this patient?
a. Bimatoprost (Lumigan)
b. Carbamide peroxide (Debrox)
c. Echothiphate (Phospholine Iodide)
d. Proparacaine (Alcaine)

25. The patient is receiving pilocarpine (Isopto Carpine) eyedrops for treatment of glaucoma. Which side
effect(s) is/are most likely to occur? (Select all that apply.)
a. Blurred vision
b. Brow ache
c. Dry mouth
d. Headache
e. Nausea
f. Vomiting

26. The patient has a severe increase in intraocular pressure and requires mannitol (Osmitrol). What is/
are side effect(s) that the nurse must be aware of? (Select all that apply.)
a. Constipation
b. Dizziness
c. Electrolyte imbalance
d. Headache
e. Nausea

27. A baby is born vaginally to a mother with gonorrhea and has ophthalmia neonatorum. What is the
medication of choice for treatment?
a. Gentamicin sulfate
b. Silver nitrate 1%
c. Sulfacetamide
d. Tetracycline HCl

28. Which solution(s) is/are commonly used to irrigate the ear? (Select all that apply.)

a. Acetic acid
b. Boric acid
c. Cyclopentolate HCl
d. Hydrogen peroxide 3%
e. Hypotonic HCl solution 10%

29. The patient has been diagnosed with dry age related macular degeneration (ARMD). What
medication(s) is/are available for treatment? (Select all that apply.)
a. AÀibercept (Eylea)
b. Bevacizumab (Avastin)
c. Pegaptanib (Macugen)
d. Ranibizumab (Lucentis)
e. There is no treatment for dry ARMD.

30. A patient presents to his ophthalmologist with complaints of dry, itching eyes. He works as a
landscaper. What option(s) does he have for treatment? (Select all that apply.

a. Naphazoline (Clear Eyes)

b. Olopatadine (Patanol)
c. Oxymetazoline (Ocuclear)
d. Tetrahydrozoline (Opti-Clear)
e. Tetracaine HCl (Pontocaine)

Case Study
Read the scenario and answer the following questions on a separate sheet of paper.
Y.G., 80 years old, has chronic open-angle glaucoma and ocular hypertension. She presents to her
health care provider for a follow-up appointment. Her medical history is also positive for hypertension,
depression, arthritis, and atrial ¿brillation. She states that she has been “doing pretty good, I guess.” She
denies any specific complaints except some blurred vision. She self-administers timolol (Timoptic) 2 gtt
q8h.
1. What is open-angle glaucoma?

Open-angle glaucoma occurs when there is too much aqueous humor that causes pressure and damages
the optic nerve, which leads to decreased vision. As aqueous humor is formed, excess fluid drains
though the trabecular meshwork structure of the eye. In open-angle glaucoma, the trabecular network
is clogged and the excess fluid cannot drain. Primary open-angle glaucoma occurs gradually and the
cause is unknown

2. What kind of a medication is timolol, and how does it work?

There are several different classes of medications that are used to treat glaucoma. Timolol is a beta
blocker. Beta blockers are usually the first-line drug in glaucoma treatment. Beta blockers work by
decreasing the production of aqueous humor.

3. How are these eyedrops administered?

The patient should wash her hands prior to administration of the drug and be very careful not to touch
the tip of the bottle to the eye. The head should be tipped back and one drop instilled in the conjunctival
sac of the lower lid. The patient should not rub her eyes after the medication is instilled. A tissue can be
used to dab at the extra. Eyedrops should be instilled before any eye ointment.

4. Is this the appropriate dose for this patient? Why or why not?

This dose is too high. The standard dose is 1 gtt of 0.25%-0.5% solution b.i.d. initially, then decrease to 1
gtt/day as the condition stabilizes. The patient must be carefully observed for bradycardia,
bronchospasm, and indications of developing or worsening heart failure, since this medication may
cause systemic effects.
Medication Administration
Study Questions Complete the following.
1. ______________________ and ______________________ capsules must be swallowed whole to be
effective.
2. Handheld nebulizers deliver a very ______________________ spray of medication.
3. When giving a patient a medication via handheld nebulizer, the patient should be placed in
______________________ position.
4. A nasogastric tube should be Àushed with ______ mL of water (or the prescribed amount) following
medication administration.
5. Following insertion of a rectal suppository, the patient should remain in a side-lying position for
______ minutes.

Match the route in Column I with the correct length of needle in Column II

Column I
__C__ 6. Subcutaneous (SQ)
__a__ 7. Intradermal
__b__ 8. Intramuscular (IM)

Column II

a. 3 »8 to 5 »8 inch in length

b. 1 to 11 »2 inches in length

c. 1 »2 to 5 »8 inch in length

Complete the following.

9. The injection site that is well-defined by bony anatomic landmarks is ____Intamuscular____.

10. The preferred site for intramuscular injections for infants and children is ____Vastus Lateralis_____.

11. The site that is easily accessible but is suitable for only small-volume doses is ___Subcutaneous___.

12. The preferred site for the Z-track technique is ___Deltoid___.

13. The site (not visible to the patient) that has the danger of injury if incorrect technique is used is
___Ventrogluteal____.

NCLEX Review Questions

Select the best response.

14. The patient is vomiting and has been prescribed an antiemetic. Which route does the nurse know is
contraindicated for this patient?
a. Intradermal
b. Intravenous
c. Oral
d. Rectal suppository

15. The 2-year-old patient has been prescribed antibiotic ear drops. The nurse is providing education to
the parents. Which is the correct direction in which to pull the auricle?
a. Down and back
b. Forward and back
c. Forward and up
d. Up and back
16. The patient has been prescribed an intramuscular injection. The medication is thick and must be
administered deep IM. Which does the nurse choose for the injection site?

a. Deltoid
b. Dorsolateral
c. Vastus lateralis
d. Ventrogluteal

17. What is the preferred site for an IM injection for an 8-week-old infant?

a. Deltoid
b. Dorsogluteal
c. Vastus lateralis
d. Ventrogluteal

18. The patient is being discharged on new medications. Which statement made by the patient would
indicate that more teaching is required?

a. “I can take any over-the-counter medication or herbal preparation that I think would be helpful.”
b. “I need to make sure I keep appointments with my health care provider.”
c. “I need to report any side effects to my health care provider.”
d. “I will contact my pharmacy if I am going out of town to ensure that I have enough medication.”

19. The patient has been started on a new oral prescription. What information will the nurse include in
the patient teaching? (Select all that apply.)

a. Desired effect of the medication

b. Dietary considerations
c. Storage of all medication in the refrigerator
d. Research testing and development
e. Written instructions on how to administer the medication

20. The patient has been prescribed a steroid metered-dose inhaler (MDI) for asthma. What statement
by the patient indicates understanding of how to use this medication?

a. “I can use it as often as I need it.”

b. “I need to rinse out my mouth after I use it.”
c. “I should put my mouth tightly over the end.”
d. “I can administer multiple puffs at one time.”

21. The nurse is administering a medication via the Z-track method. Which site(s) is/are acceptable for
administration by this method? (Select all that apply.)
a. Deltoid
b. Dorsogluteal
c. Vastus lateralis
d. Ventrogluteal
e. Forearm

Medication Calculations

32. 1 g = _________ mg, or _________ gr 1000 mg; 15 gr

33. _________ g = 500 mg, or _________ gr 0.5 g; 71 or 2 gr
34. 0.1 g = _________ mg, or _________ gr 100 mg; 11 or 2 gr
35. 1 gr = _________ mg 60 or 64 mg
36. 0.4 mg = _________ gr 1 /150 gr
37. _________ L = 1000 mL, or _________ qt 1 L; 1 qt
38. 240 mL = _________ fl oz, or _________ glass 8 fl oz; 1 medium-sized glass
39. 30 mL = _________ fl oz, or _________ T, or _________ t 1 fl oz; 2 T; 6 t
40. 5 mL = _________ t 1t
41. 3 T = _________ À oz, or _________ t 11 fl oz; 9 t
42. 5 À oz = _________ mL, or _____T 150 mL; 10 T

1. What is/are the method(s) for administering medications by parenteral routes? (Select all that apply.)

a. Via a nasogastric tube

b. Subcutaneous
c. Intramuscular
d. Intradermal
e. Intravenous
f. Any liquid medication via all routes

2. What is/are the route(s) of administration for insulin and heparin? (Select all that apply.)

a. Oral
b. Intramuscular
c. Subcutaneous
d. Intravenous
e. Intradermal

3. Vials are glass containers with (self-sealing rubber tops/tapered glass necks). Vials are usually
(discarded/reusable if properly stored). (Circle correct answer.)

4. Before drug reconstitution, the nurse should check the drug circular and/or drug label for instructions.
After a drug has been reconstituted and additional dose(s) are available, what should the nurse write on
the drug label? (Select all that apply.)
a. Date to discard
b. Initials
c. The health care provider’s order
d. What it is reconstituted with

5. A tuberculin syringe (is/is not) used for insulin administration. (Circle correct answer.)
6. Insulin syringes are calibrated in (units/mL). (Circle correct answer.)
7. After use of a pre¿lled cartridge and Tubex injector, which piece(s) of equipment should be discarded?

a. Cartridge

b. Cartridge and Tubex injector

c. Neither cartridge nor Tubex injector
d. Tubex injector

8. The nurse is preparing an IM injection for an adult. What should be used for the needle gauge and
length?

a. 20, 21 gauge; ½, 5 »8 inch in length

b. 23, 25 gauge; ½, 5 »8 inch in length
c. 19, 20, 21 gauge; 1, 1½, 2 inches in length
d. 25, 26 gauge; 1, 1½ inches in length

9. Which two parts of a syringe must remain sterile?

a. Outside of syringe and plunger
b. Tip of the syringe and plunger
c. Both the tip and outside of the syringe
d. Tip and outside of syringe and plunger

10. Subcutaneous injections can be administered at which degree angle(s)?

a. 10-degree and 15-degree angles

b. 45-degree, 60-degree, and 90-degree angles

c. 45-degree angle only

d. 90-degree angle only

11. The nurse calculates the drug dosage to be 0.25 mL. What type of syringe should be selected?

a. 3-mL syringe
b. Insulin syringe
c. Tuberculin syringe
d. 10-mL syringe

12. To mix 4 mL of sterile saline solution in a vial containing a powdered drug, which size syringe should
be selected?
a. Tuberculin syringe
b. Insulin syringe
c. 3-mL syringe
d. 5-mL syringe

Section 14E—

Calculations of Intravenous Fluids

Select the best response.

1. The health care provider orders the type and amount of intravenous (IV) solutions per 24 hours. What
should the nurse use to calculate the IV Àow rate? (Select all that apply.)

a. Drop factor
b. Amount of Àuid to be infused
c. Time of administration
d. Weight of the patient

2. When should drugs such as potassium chloride (KCl) and multiple-vitamin solutions be injected into
the IV bag or bottle?
a. As soon as the order is written.
b. When one-half of the bag has been administered.
c. Before the infusion is started.
d. Just after the infusion has been started.

Complete the following.

3. Macrodrip infusion sets deliver _10-20 gtt/mL; microdrip infusion sets deliver 60 gtt/mL.

4. If the infusion rate is less than 100 mL/hr, the preferred IV set is (macrodrip/microdrip). (Circle correct
answer.)
5. KVO means __keep vein open__. The preferred size of IV bag for KVO is (1000 mL/500 mL/250 mL).
(Circle correct answer.) Give the abbreviations for the following solutions.

6. 5% dextrose in water: __D5W___

7. Normal saline solution or 0.9% sodium chloride (NaCl): NSS or 0.9% NaCl_______________

8. 5% dextrose in ½ normal saline solution (0.45% NaCl): _ D5 1 NSS, 5%D/1 NSS, or 5%D/0.45%
NaCl______________

9. 5% dextrose in lactated Ringer’s: D5 LR or 5%D/LR

Complete the following.

10. Intermittent IV administration is prescribed when a drug is administered in a (small/large) volume of

IV Àuid over a (long/short) period of time. (Circle correct answers.)

11. The Buretrol is a (calibrated cylinder with tubing/small IV bag of solution with short tubing). It is used
in (continuous IV drug administration/intermittent IV drug administration). (Circle correct answers.)
12. The pump infusion regulator that delivers mL/hr is a (volumetric/nonvolumetric) IV regulator. (Circle
correct answer.)

13. Patient-controlled analgesia (PCA) is a method used to administer drugs intravenously. The
purpose/objective is to provide

_____ uniform concentration of the drug, patient control and ownership of the pain__

Continuous Intravenous Administration

14. Order: 1 liter or 1000 mL of D5 W to infuse over 6 hours.

Available: Macrodrip set: 10 gtt/mL.

The IV flow rate should be regulated as ___ 27-28 gtt/min___ gtt/min.

15. Order: 1000 mL of D5 ½ NS with multiple vitamins and KCl 10 mEq to infuse over 8 hours.

Available: Macrodrip set: 15 gtt/mL KCl (potassium chloride) 20 mEq/10 mL ampule Multiple vitamin
(MVI) vial Calculate the IV Àow rate in gtt/min. 31-32 gtt/min

16. Order: 1 L of 0.9% NaCl (normal saline solution) to infuse over 12 hours. A. b; B. 83 gtt/min

Available: Macrodrip set: 10 gtt/mL Microdrip set: 60 gtt/mL

A. Which IV set should be used?

a. Macrodrip set
b. Microdrip set

B. Calculate the IV Àow rate in gtt/min according to the IV set selected. _______________

17. Order: 2.5 L of IV Àuids to infuse over 24 hours. This includes 1 L of D5 W, 1 L of D5 ½ NS, and 500 mL
of 5% D/ LR.

Available: The three above solutions.

A. One liter is equal to _1000_ mL.
B. Total number of mL of IV solutions to infuse in 24 hours in __2500 ml.
C. Approximate amount of IV solution to administer per hour is ___100 mL/hr (104 mL/ hr)___ mL.
D. Which type of IV set would you select? _. macrodrip set
E. Calculate the IV Àow rate according to the IV set you selected. 16-17 gtt/min gtt/min

18. A liter of IV Àuid was started at 7:00 AM and was to run for 8 hours. The IV set delivers 10 gtt/mL. At
12:00 PM, only 500 mL were infused.

A. How much IV Àuid is left?

a. 100 mL
b. 200 mL
c. 300 mL
d. 400 mL
e. 500 mL

B. Recalculate the flow rate for the remaining IV Àuids. Keep in mind that if the patient has a
cardiovascular problem, rapid IV flow rate may not be desired. B. 27-28 gtt/min