Medication and Blood Products

The patient whose mother chose not to vaccinate him presents to the clinic the day after his 18th birthday to receive all eligible vaccinations. The nurse uses which statement to counsel the patient about the hepatitis B vaccine series?

The 18-year-old patient calls the clinic two weeks after receiving the 2nd vaccination in the three-dose series for human papillomavirus (HPV). She states, “I didn’t realize it when I got the vaccine, but I was 6 weeks pregnant. Will my baby be okay?” Which response by the nurse is most appropriate?

The nurse is providing discharge education to the patient regarding immunizations following a hematopoietic stem cell transplant. When does the nurse instruct the patient to visit the clinic for the Haemophilus influenzae type b (Hib) vaccine?

The public health nurse encourages which individuals to receive the hepatitis A vaccine? Select all that apply.

The 18-year-old healthy female presents to the clinic requesting to receive the vaccinations her mother refused for her when she was a child. Reviewing the chart, the nurse notes the patient never received the measles, mumps, rubella (MMR) vaccine. Prior to administering the vaccination, which test is most important?

The nurse has provided discharge instructions to the patient with type II diabetes. How does the nurse assess the patient’s understanding of the teaching?

The nurse is providing discharge education to the 48-year-old patient with a third grade reading level about his new prescription for valsartan. Which is the best way for the nurse to assess the patient’s understanding of the teaching?

The 7-year-old child with pica is brought to the emergency room (ER) with decreased level of consciousness after ingesting lead paint. His blood lead level (BLL) is determined to be 72 mcg/dL. The nurse prepares to administer which medication?

The nurse holds the dose of propranolol and contacts the provider for which vital sign?

The nurse is teaching the patient who has been prescribed propranolol. Which statement by the patient indicates an understanding of the teaching?

The nurse is providing medication instructions for iron supplements to a patient with anemia. Which information is included?

The home care nurse visits the home of an elderly married couple who lives with their adult children. Medication bottles and loose pills are found throughout the house. The nurse provides which information about safe storage of medications? Select all that apply.

Which medication is used to treat epilepsy?

Which instruction does the nurse give the patient with epilepsy who is 6 weeks pregnant?

Which medication is a beta blocker?

Which medication is an anxiolytic?

A nurse reviews a patient’s medication list and recognizes an antibiotic. Which medication does the nurse recognize as an antibiotic?

Which medication is a hypoglycemic agent?

Which medication is a member of the biologic pharmacologic class?

The 35-year-old woman is interested in starting hormonal birth control. Which characteristic, if found in the patient's medical record, indicates the patient requires an alternative form of contraceptive?

The patient has come to the emergency department by ambulance for presumed heroin overdose. The nurse expects the patient to have received which medication in the field?

An acutely intoxicated child is brought to the ED because his parents suspect he has consumed antifreeze. The nurse anticipates administering which medication?

The nurse notices that the patient’s peripheral IV insertion site is red and indurated. What action does the nurse perform first?

The patient wants to quit smoking before starting hormonal birth control. Using motivational interviewing, which statement by the nurse would best elicit change talk from the patient?

The patient presents to the emergency department with abdominal pain, dehydration, a blood glucose level of 425 mg/dL. Blood testing reveals metabolic acidosis, hypokalemia, and ketones. The patient is alert and conversant, but in moderate distress. The nurse anticipates administering which medication?

The nurse receives shift report on four patients. Which patient does the nurse see first?

The patient with a severe peanut allergy was inadvertently exposed to peanuts at work. Dyspnea persists despite the patient using the epinephrine autoinjector and emergency medical services was contacted. Which concentration of epinephrine does the first responder prepare for intramuscular injection?

Which symptoms, if present in the patient receiving a blood transfusion, indicate the patient is experiencing an acute hemolytic transfusion reaction? Select all that apply.

The registered nurse is caring for a 48-year-old patient with a surgical wound infected with methicillin-resistant Staphylococcus aureus (MRSA) requiring q6h intravenous antibiotic infusions and dressing changes twice per shift. The patient with which diagnosis is most appropriate to be added to this nurse’s assignment?

The nurse is caring for the patient who was admitted to the hospital in septic shock due to Escherichia coli bacteremia. Which patient assessment is most appropriate to report to the inpatient pharmacist on the patient’s medical team?

The nurse anticipates administering which medications to the patient with meningitis? Select all that apply.

The 22-year-old woman has selected the Depo-Provera injection as her preferred method of contraception. Which information, if present in the patient’s chart, prompts the nurse to hold the medication and alert the physician?

The nurse receives an alert that a packed red blood cell transfusion has been ordered for the patient who was admitted after a laparoscopic cholecystectomy. Which is the nurse’s initial action?

The nurse is asked to help properly dispose of the patient’s soiled linens. Which question is most important for the nurse to ask?

The nurse is planning care for the patient receiving adalimumab. Which nursing intervention does the nurse utilize to prevent complications of the medication?

The nurse is providing discharge teaching to a patient who will receive chemotherapy at home for cervical cancer. Which statement by the patient indicates a need for further teaching?

The patient in the intensive care unit is being weaned off of a continuous morphine infusion after being extubated 6 hours ago. Which assessments indicate the patient is failing to tolerate the treatment plan? Select all that apply.

The nonverbal patient is improving in the intensive care unit following a motor vehicle accident; as such, the continuous hydromorphone infusion is being weaned according to a schedule. The nurse provides education to the patient’s guardian about which signs and symptoms that the pain medicine is being weaned too quickly? Select all that apply.

The 14-year-old patient was admitted following surgical reduction of an open femur fracture. The patient, who has reported good pain control with the patient-controlled analgesia (PCA) pump, is sleeping peacefully. During hourly rounding, the nurse observes the parent press the button to administer the bolus of pain medication. Which action by the nurse is appropriate?

The patient is receiving alefacept. Which finding indicates the patient is having the desired response to therapy?

The nurse advocates for the use of secukinumab in which patient?

The patient receiving patient-controlled analgesia (PCA) with morphine is found to be sleeping deeply and minimally responsive. Which action does the nurse take first?

The LPN/LVN informs the supervising RN, “I didn’t realize until after administering the medication, but I was supposed to give the patient a half tablet of levothyroxine; I gave him a whole tablet.” Which action does the nurse take first?

The nurse is planning care for the patient who will undergo hip replacement surgery in a month. When is the best time to provide teaching about the use of a patient-controlled analgesia (PCA) pump?

The 56-year-old intubated and sedated patient’s arterial blood gas results are as follows: pH = 7.25, PCO2 = 36, PaO2 = 50, HCO3- = 15, SaO2 = 86%. Other lab values are notable for a hemoglobin of 7.9 mg/dL, albumin of 2.5 g/dL, sodium of 152 mEq/L, potassium of 2.1 mEq/L, chloride of 118 mEq/L. Vital signs are notable for a heart rate of 118 bpm, blood pressure of 86/38 mmHg, temperature of 102°F, and pulse oximetry of 85% on room air. The nurse advocates for which order?

The 3.2 kg patient with persistent pulmonary hypertension of the newborn (PPHN) has the following order: Infuse norepinephrine 0.05 mcg/kg/min IV and titrate q15 minutes by 0.05 mcg/kg/min to maintain mean arterial pressure between 45 and 55 mm Hg. Overnight, the norepinephrine had been titrated to 0.25 mcg/kg/min for persistent hypotension. At 0900, the MAP rose to 62 mm Hg and the nurse decreased the infusion from 0.25 mcg/kg/min to 0.20 mcg/kg/min. At 0905, the patient’s blood pressure fell to 42 mm Hg. Which action does the nurse take first?

The patient has experienced an extravasation of norepinephrine in the right forearm. It is cool to the touch, firm, and pale. Distal to peripheral pulses are not well felt and the fingertips are dusky. Which order does the nurse clarify with the provider?

The nurse assesses the peripheral IV site of the patient who is receiving norepinephrine, which was started for profound, life-threatening hypotension and finds the hand to be firm to the touch, cool, and pale. Which action does the nurse take?

The asymptomatic patient tested positive for Neisseria gonorrhoeae during routine screening for sexually transmitted infections (STI). The nurse anticipates administering which medications? Select all that apply.

The 32-weeks-pregnant woman who presents with genital lesions is diagnosed with herpes simplex virus-2. The nurse prepares a patient information handout for which medication for this patient?