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Adv Med Surg Ch 33 & 34

Total questions: 33

Worksheet time: 20mins

Name
Class
Date
1.

Match the medication with the classification:

a)

leukotriene receptor antagonist

1.

montelukast

b)

leukotriene receptor inhibitor

2.

zileuton

c)

second-generation H1 inhibitor

3.

levocetirizine

d)

first-generation H1 antihistamines (sedating)

4.

hydroxyzine

e)

second-generation H1 antihistamines (Nonsedating)

5.

cetirizine

2.

The nurse is preparing to administer a medication that has an affinity for H1 receptors. Which medication would the nurse administer?

a)

diphenhydramine

b)

omeprazole

c)

cimetidine

d)

ranitidine

3.

An infant is born to a mother who had no prenatal care during her pregnancy. Which thpe of hypersensitivity reaction does the nurse determine may have occurred?

a)

bacterial endocarditis

b)

Rh-hemolytic disease

c)

lupus erythematosus

d)

rheumatoid arthritis

4.

While monitoring the patient's eosinophil level, the nurse suspects a definite allergic disorder when seeing an eosinophil value of which percentage of the total leukocyte count?

a)

1% to 3%

b)

3% to 4%

c)

5% to 10%

d)

15% to 40%

5.

A patient comes to the clinic with pruritus and nasal congestion after eating shrimp for lunch and is suspected to be experiencing an anaphylactic reaction to the shrimp. These symptoms typically occur within how many hours after exposure?

a)

2 hours

b)

6 hours

c)

12 hours

d)

24 hours

6.

A patient is experiencing an allergic reaction after receiving a dose of penicillin. Which signs and symptoms will the nurse look for in the patient's initial assessment?

a)

dyspnea, bronchospasm, and/or laryngeal edema

b)

hypotension and tachycardia

c)

the presence and location of pruritus

d)

the severity of cutaneous warmth and flushing

7.

The nurse is educating a patient with allergic rhinitis about how the condition is induced. Which factors should the nurse include in the education on this topic?

a)

airborne pollens or molds

b)

ingested foods

c)

parenteral medications

d)

topical creams or ointments

8.

A patient has a sensitivity to ragweed and tells the nurse that it comes at the same time every year. When does the patient typically notice the symptoms?

a)

early spring

b)

early fall

c)

summer

d)

midwinter

9.

A patient asks the nurse if it would be all right to take an over-the-counter antihistamine for the treatment of a rash. Which symptoms will the nurse educate the patient is a major side effect of antihistamines?

a)

diarrhea

b)

anorexia

c)

palpitations

d)

sedation

10.

The nurse is administering a sympathomimetic drug to a patient. Which areas of concern does the nurse have when administering this drug? (select all that apply)

a)

causes bronchodilation

b)

constricts integumentary smooth muscle

c)

dilates the muscular vasculature

d)

causes bronchoconstriction

e)

causes laryngospasm

11.

The nurse is administering injected allergens for "hyposensitization," which may produce harmful systemic reactions. Before administering these allergens, what medication will the nurse have at the bedside?

a)

phenergan hydrochloride

b)

pentazocine

c)

epinephrine

d)

meclizine hydrochloride

12.

A patient was seen in the clinic for hypertension and received a prescription for a new antihypertensive medication. The patient arrived in the emergency department a few hours after taking the medication with severe angioedema. Which medication prescribed is most likely responsible for the reaction?

a)

beta-blocker

b)

angiotensin-converting enzyme (ACE)

c)

angiotensin receptor blocker

d)

vasodilator

13.

A patient has been diagnosed with an allergy to peanuts. Which item is a priority for this patient to carry at all times?

a)

a medical alert bracelet

b)

an H1 blocker

c)

an EpiPen

d)

an oral airway

14.

A patient has had a "stuffy nose" and obtained Afrin nasal spray. Which education should the nurse provide to the patient to prevent "rebound congestion"?

a)

be sure to use the Afrin for at least 10 days to ensure the stuffiness is gone.

b)

use the medication every 4 hours to prevent congestion from recurring

c)

drink plenty of fluids

d)

only use the Afrin for 3 to 4 days once every 12 hours

15.

A patient was seen in the clinic 3 days previously for allergic rhinitis and was given a prescription for a corticosteroid nasal spray. The patient calls the clinic and tells the nurse that the nasal spray is not working. Which is the best response by the nurse?

a)

"You need to come back to the clinic to get a different medication since this one is not working for you."

b)

"You may be immjune to the effects of this medication and will need something else in its place."

c)

"The full benefit of the medication may take up to 2 weeks to be achieved."

d)

"I am sorry that you are feeling poorly, but this is the only medication that will work for your problem."

16.

What education should the nurse provide to the patient taking long-term corticosteroids?

a)

The patient should not stop taking the medication abruptly and should be weaned off the medication.

b)

The patient should take the medication only as needed and not take it unnecessarily.

c)

Corticosteroids are relatively safe drugs with very few side effects.

d)

The patient should discontinue using the drug immediately if weight gain is observed.

17.

Match the clinical interpretation/laboratory significance listed with its associated test:

a)

a decrease can be seen in chronic inflammation

1.

hematocrit

b)

a positive test is associated with systemic lupus erythematosus (SLE), RA, and Raynaud's disease

2.

antinuclear antibody (ANA)

c)

an increase in this substance is seen with gout

3.

uric acid

d)

this protein substance is decreased in RA and SLE

4.

complement

18.

Match the clinical interpretation/laboratory significance listed with its associated test:

a)

this is present in 80% of those who have RA

1.

rheumatoid factor

b)

this is presnet in 85% of those with ankylosing spondylitis

2.

HLA-B27 antigen

c)

frequently positive for RA and SLE

3.

C-reactive protein (CRP)

d)

an increase may indicate renal damage, as in scleroderma

4.

creatinine

19.

A patient is seen in the office for reports of joint pain, swelling, and a long-grade fever. Which laboratory studies reviewed by the nurse indicate a positive diagnosis of RA? (select all that apply)

a)

positive C-reactive protein (CRP)

b)

positive antinuclear antibody (ANA)

c)

red blood cell (RBC) count of <4.0 million/mcL

d)

serum complement level (C3) of >130 mg/dL

e)

aspartate aminotransferase (AST) and alanine transaminase (ALT) levels of 7 units/L

20.

A patient has a serum study that is positive for the rheumatoid factor. Which does the nurse identify is the significance of this test result?

a)

the test results are diagnostic for Sjogren's syndrome

b)

the test results are diagnostic for systemic lupus erythematosus

c)

the test results are specific for rheumatoid arthritis

d)

the test results are suggestive of rheumatoid arthritis

21.

The nurse is caring for a patient who presents with the symptom of blanching of fingers when exposed to cold. Which rheumatic disorder does the nurse prepare to assess the patient for?

a)

Ankylosing spondylitis

b)

Raynaud's phenomenon

c)

Reiter syndrome

d)

Sjogren's syndrome

22.

A patient is suspected of having myositis. The nurse prepares the patient for which procedure that will confirm the diagnosis?

a)

bone scan

b)

computed tomography (CT)

c)

magnetic resonance imaging (MRI)

d)

muscle biopsy

23.

The nurse is educating a patient about the risks of stroke related to the new prescription for a COX-2 inhibitor and which symptoms should be reported. Which COX-2 inhibitor is the nurse educating the patient about?

a)

ibuprofen

b)

celecoxib

c)

piroxicam

d)

tolmetin sodium

24.

A patient is prescribed a DMARD that is successful in the treatment of rheumatoid arthritis (RA) but has side effects, including retinal eye changes. Which medication does the nurse educate the patient about?

a)

azathioprine

b)

diclofenac

c)

hydroxychloroquine

d)

aurothioglucose

25.

A patient with an acute exacerbation of arthritis is temporarily confined to bed. Which position will the nurse recommend to prevent flexion deformities?

a)

Prone

b)

Semi-Fowler

c)

Side-lying with pillows supporting the shoulders and legs

d)

Supine with pillows under the knees

26.

A patient comes to the clinic with an inflamed wrist. How will the nurse splint the joint to immobilize it?

a)

slight dorsiflexion

b)

extension

c)

hyperextension

d)

internal rotation

27.

A patient arrives at the clinic with reports of pain in the left great toe. The nurse assesses a swollen, warm, erythematous left great toe. Which laboratory test will the nurse prepare the patient for to identify the cause?

a)

uric acid level

b)

hemoglobin

c)

potassium level

d)

erythrocyte sedimentation rate

28.

The nurse is educating the patient with gout about ways to prevent recurrence of an attack. Which foods will the nurse encourage the patient to avoid?

a)

baked chicken

b)

steak

c)

asparagus

d)

pineapple

29.

The nurse is assessing a patient with a diagnosis of scleroderma. Which clinical manifestations of scleroderma does the nurse assess? (select all that apply)

a)

decreased ventilation owing to lung scarring

b)

dysphagia owing to hardening of the esophagus

c)

dyspnea owing to fibrotic cardiac tissue

d)

productive cough

e)

butterfly-shaped rash on the face

30.

A patient is hospitalized with a severe case of gout. The patient has gross swelling of the large toe and rates pain a 10 out of 10. With a diagnosis of gout, which will the laboratory results reveal?

a)

glycosuria

b)

hyperuricemia

c)

hyperproteinuria

d)

ketonuria

31.

A patient is being placed on a purine-restricted diet. Which food should be suggested by the nurse?

a)

dairy products

b)

organ meats

c)

raw vegetables

d)

shellfish

32.

A patient is taking nonsteroidal anti-inflammatory drugs (NSAIDS) for the treatment of osteoarthritis. Which education should the nurse give the patient about the medication?

a)

take the medication on an empty stomach in order to increase effectiveness

b)

since the medication is able to be obtained over the counter, it has few side effects

c)

take the medication with food to avoid stomach upset

d)

inform the primary provider if there is ringing in the ears

33.

The nurse is educating a patient that is prescribed adalimumab for the treatment of psoriatic arthritis. Which statement made by the patient indicates that further education is required?

a)

"I will receive a tuberculin skin test prior to beginning this medication."

b)

"I will administer this medication in the muscle of my leg every 2 weeks."

c)

"If I have a fever, I won't administer the medication and will notify

d)

"I should avoid large crowds and protect myself from infections."