1. A Cromolyn sodium (Intal) inhaler is prescribed to a client with asthma. A nurse provides instructions regarding the side effects of this medication. The nurse tells the client that which undesirable effect is associated with this medication?
- Wheezing.
- Insomnia.
- Hypotension.
- Constipation.
2. A client is prescribed with Guaifenesin (Mucinex). The nurse determines that the client understands the proper administration of this medication if the client states that he or she will:
- Drink extra fluids while taking this medication.
- Take the medication with meals only.
- Take an additional dose once fever and cough persist.
- Limit oral fluid intake.
3. A nurse is about to administer Albuterol (Ventolin HFA) 2 puff and Budesonide (Pulmicort Turbohaler) 2 puff by metered dose inhaler. The nurse plans to administer by?
- Alternating with a single puff each, starting with albuterol.
- Alternating with a single puff each, starting with budesonide.
- Budesonide inhaler first then the albuterol.
- Albuterol inhaler first then the budesonide.
4. A nurse is about to administer Naloxone hydrochloride (Narcan) to a client with known opioid overdose. Which of the following equipment should be readily available at the bedside?
- Suction machine.
- Resuscitative equipment.
- Nasogastric tube.
- Dressing tray.
5. A client is receiving theophylline intravenously. After several dosages, the client started to become restless and complains of palpitations. The nurse determines that the client is experiencing theophylline toxicity in which of the following?
- Theophylline level of 10mcg/ml.
- Theophylline level of 15mcg/ml.
- Theophylline level of 20mcg/ml.
- Theophylline level of 25mcg/ml.
6. A client with a chronic obstructive pulmonary disease is prescribed with Ipratropium (Combivent). Upon reviewing the medical history of the patient, the nurse questions the prescription if which of the following is noted?
- History of smoking.
- History of allergy to egg.
- History of allergy to peanut.
- History of a previous infection.
7. Montelukast (Singulair) is prescribed to a client with asthma. During the medication therapy, which of the following laboratories should be monitored?
- Complete blood count (CBC).
- Sodium and Potassium.
- Calcium and Platelet count.
- ALT and AST.
8. The nurse is giving medication teachings to a client receiving theophylline. The nurse instruct the client to limit the intake of which of the following?
- Apple and banana.
- Yogurt and cheese.
- Tuna and oysters.
- Cola and chocolate.
9. A nurse is giving teachings to a client receiving Desloratadine (Clarinex). Which of the following statements made by the client will need further instructions?
- “I can eat gum after I drink the medicine”.
- “I can take the medicine on an empty stomach”.
- “I should avoid using alcohol”.
- “I will avoid driving while using this medication”.
10. A pediatric client with asthma has just received Omalizumab (Xolair). The nurse determines that the client might be suffering a life-threatening effect in which of the following?
- Headache and dizziness.
- Nausea and vomiting.
- Swelling of the tongue.
- Joint pain.
11. A client with influenza is prescribed with an antiviral drug. The nurse determines that the client indicates an understanding of the treatment if he or she state the following?
- “I will take the medication exactly as prescribed”.
- “I will not be able to infect others while I am on this treatment”.
- “I will stop the medication once I feel okay”.
- “I will resume my usual activities because these medications have minimal undesirable effects”.
12. A client is to begin taking Rifampin (Rifadin). The nurse correctly teaches the client this medication:
- Is to be discontinued after three months.
- Is to be taken with food and antacids.
- Take an additional dose once with skip dose.
- Will cause orange discoloration of sweat, urine, and feces.
13. A nurse is caring for a client who is starting a long-term therapy of isoniazid (INH). The nurse plans to instruct the client to which of the following?
- To discontinue vitamin supplements such as Vit B6.
- To report an incidence of yellowish skin.
- To increase intake of tuna for additional nutrition.
- To drink alcohol in moderation.
14. A client has been taking isoniazid (INH). The client went to the health care facility with complaints of numbness and tingling sensation in the extremities. The nurse determines that the client is most likely suffering from?
- Impaired peripheral circulation.
- Hypercalcemia.
- Peripheral neuritis.
- Guillan Barre syndrome.
15. A nurse is monitoring a client receiving an Ethambutol (Myambutol) for adverse effects. The nurse determines that the client is experiencing a side effect of the medication, in which of the following?
- Red-orange colored bodily secretions.
- Damaged hearing.
- Loss of balance.
- Difficulty distinguishing the color red from green.
16. A client with tuberculosis is receiving Ethambutol (Myambutol). All of which are laboratories to be examined, except?
- Complete blood count.
- Liver function test.
- Triglyceride level.
- Uric acid level.
17. A nurse is giving instructions to a client receiving Pyrazinamide. Which of the following is not true regarding this medication?
- Take the medication with food.
- Photosensitivity is one of the side effects.
- It enhances the effect of allopurinol.
- Use with caution in patients with diabetes mellitus.
18. A client is taking streptomycin. The nurse explains the nervous system side effects of this medication. The nurse correctly states that this medication causes damage in which cranial nerve?
- Cranial nerve VII.
- Cranial nerve VIII.
- Cranial nerve IX.
- Cranial nerve X.
19. All of which are examples of antiviral influenza medications except?
- Ethionamide (Trecator).
- Amantadine (Symmetrel).
- Oseltamivir (Tamiflu).
- Zanamivir (Relenza).
20. Rifabutin (Mycobutin) is prescribed to a client with active Mycobacterium avium complex disease and tuberculosis. The nurse determines that the client is experiencing side effects in which of the following, except?
- Tingling and numbness of the fingers.
- Blurred vision.
- Arthralgia.
- Flu-like symptoms.
Answers and Rationale
1. Answer: A. Wheezing. Cromolyn Sodium (Intal) is used to prevent asthma attacks in people with bronchial asthma. Undesirable side effects associated with the use of inhaler is wheezing, cough, nasal congestion, bronchospasm and throat irritation.
- Options B, C, and D, are not related to the medication.
2. Answer: A. Drink extra fluids while taking this medication. Guaifenesin is an expectorant. Drink extra fluids to help loosen the congestion and lubricate the throat while taking this medication.
- Option B: The medication does not have to be taken with meals.
- Option C: Additional doses should not be taken without the prescription of the doctor.
- Option D: Fluids are needed to loosen the secretions.
3. Answer: D. Albuterol inhaler first then the budesonide. If two different inhaled medications are prescribed and one of the medications contains a corticosteroid, administer the bronchodilator (Albuterol) first and the corticosteroid (Budesonide) second. This will allow for the widening of the air passages by the bronchodilator, making the corticosteroids more effective.
4. Answer: B. Resuscitative equipment. While administering Narcan, resuscitation equipment, oxygen, mechanical ventilator should be readily available.
- Options A, C, and D are not used during the medication therapy.
5. Answer: D. Theophylline level of 25mcg/ml. Theophylline toxicity is likely to occur when the serum level is higher than 20 mcg/ml. Early signs of toxicity include restlessness, nervousness, tachycardia, tremors and palpitations.
6. Answer: C. History of allergy to peanut. The client with a peanut allergy should not take ipratropium because the product contains soy lecithin, which is in the same plant family as peanuts.
7. Answer: D. ALT and AST. Montelukast (Singulair) is a leukotriene receptor and is used with caution in clients with impaired renal function. Alanine aminotransferase (ALT) and Aspartate aminotransferase (AST) should be monitor while taking this medication.
- Options A, B, and C are not related to the use of this medication.
8. Answer: D. Cola and chocolate. Theophylline is a methylxanthine bronchodilator. The nurse instructs the client to limit the intake of xanthine-containing foods such as chocolate, cola, and coffee.
9. Answer: B. “I can take the medicine on an empty stomach”. This medicine should be taken with food or milk to minimize gastrointestinal upset.
- Option A: Use gum or hard candy to minimize dry mouth.
- Options C and D: The medication causes drowsiness so avoid taking alcohol or engaging in activities which require mental alertness such as driving a car.
10. Answer: C. Swelling of the lips. Omalizumab (Xolair) Xolair is an anti-inflammatory that is used to treat moderate to severe asthma that is caused by allergies. An anaphylactic reaction may happen such as flushing, rash, wheezing or swelling of the face, lips or tongue.
- Options A, B, and D are some of the side effects but will not alert the nurse for an anaphylactic reaction.
11. Answer: A. “I will take the medication exactly as prescribed”. Antiviral drugs are taken exactly as prescribed
- Option B: Antiviral drugs do not prevent the spread of influenza and patients are still contagious for up to two days after the start of the therapy.
- Option C: The durations for the medications are followed until the last day of the treatment.
- Option D: Side effects such as dizziness and drowsiness will alert the client to be careful resuming their daily activities.
12. Answer: D. Will cause orange discoloration of sweat, urine, and feces. Rifampin causes red-orange discolorations of bodily secretions such as sweat, urine, tears, and feces.
- Option A: The client should not stop the therapy unless with a doctor’s advice.
- Option B: The medication is taken on an empty stomach.
- Option C: Doses are not to be doubled or skipped.
13. Answer: B. To report an incidence of yellowish skin. Isoniazid (INH) is hepatotoxic hence the client is instructed to report signs of jaundice (Yellowish of skin or the sclera).
- Option A: Vitamin B6 can help in preventing peripheral neuritis.
- Option C: Tuna which contains tyramine causes a reaction characterized by redness, flushing, sweating, itching of the skin while taking INH.
- Option D: Avoid alcohol because the medication is hepatotoxic.
14. Answer: C. Peripheral neuritis. Isoniazid (INH) causes peripheral neuritis characterized by numbness, tingling, and paresthesias in the extremities.
- Options A and B are not related to the use of the medication.
- Option D: Guillain-Barre syndrome is a rare condition in which your immune system attacks your nerves, leading to muscle weakness and even paralysis.
15. Answer: D. Difficulty distinguishing the color yellow from orange. Ethambutol (Myambutol) causes optic neuritis characterized by decreased visual acuity and the ability to distinguish between the color red from green.
- Option A: Side effect of Rifampin.
- Option B: Side effect of Streptomycin.
- Option C: not a related symptom to the anti-TB medications.
16. Answer: C. Triglyceride level. Triglyceride level is not monitored during the treatment.
- Option A: Monitor for thrombocytopenia.
- Option B: Monitor for hepatotoxicity.
- Option D: Monitor for hyperuricemia.
17. Answer: C. It enhances the effect of allopurinol. Patients taking pyrazinamide decreases the effects of allopurinol, colchicine, probenecid, and sulfinpyrazone.
- Option A: Taken with food to reduce gastric upset.
- Option B: To instruct the client to avoid sunlight.
- Option D: This medication causes hyperglycemia.
18. Answer: B. Cranial nerve VIII. Nervous system side effects of streptomycin include eighth cranial nerve toxicity, which typically affects the vestibular system (Clumsiness, dizziness, unsteadiness), but may also affect the auditory component (Ringing in the ear, loss of hearing).
- Option A is the facial nerve
- Option C is the glossopharyngeal nerve.
- Option D is the vagus nerve.
19. Answer: A. Ethionamide (Trecator). Ethionamide (Trecator) is an antibiotic used in the treatment of tuberculosis.
20. Answer: A. Tingling and numbness of the fingers. Tingling and numbness of the fingers is more associated with the use of isoniazid (INH).
- Options B, C, and D are the side effects of Rifabutin.