Question 1

A nurse is caring for a client who has heart failure and prescribed furosemide. Which statement by the client indicates a need for further education about the medication?

Accepted Answer

Answer reason: " Loop diuretics increase urine output, so dosing should be timed to avoid nocturia and sleep disruption. Taking it right before bedtime would likely cause frequent nighttime urination, increasing fatigue and fall risk in a client with heart failure. Teaching commonly emphasizes morning dosing (and, if ordered twice daily, the second dose mid-afternoon). The other statements reflect appropriate monitoring for hypokalemia and fluid status while on this medication.

Question 2

A nurse is teaching a client who has a new prescription for fluoxetine. Which of the following instructions should the nurse include in the teaching?

Accepted Answer

Answer reason: " SSRIs typically require several weeks of consistent dosing before meaningful antidepressant effects are seen, so setting realistic expectations improves adherence and reduces premature discontinuation. This teaching also helps the client understand that early side effects can occur before mood improves and that they should not stop the medication on their own. Grapefruit avoidance is not a standard key interaction for fluoxetine teaching compared with many other drugs. While GI upset can occur with SSRIs, the most essential instruction for a new start is the delayed onset of therapeutic benefit and the need for continued use as prescribed.

Question 3

A client receiving IV heparin for a pulmonary embolism has an activated partial thromboplastin time (aPTT) of 60 seconds. Which action does the nurse take?

Accepted Answer

Answer reason: 5–2.5 times the client’s baseline, commonly approximating 60–80 seconds depending on the lab and protocol. An aPTT of 60 seconds is within the expected therapeutic range for treatment of pulmonary embolism, so no dose hold or reversal is indicated. Holding the infusion for an hour is reserved for supratherapeutic aPTT values with increased bleeding risk per protocol. Protamine sulfate is used for significant heparin-associated bleeding or markedly excessive anticoagulation, not for a therapeutic aPTT.

Question 4

A nurse is providing teaching to a client with hypoparathyroidism. Which vitamin therapy should she include in her teaching?

Accepted Answer

Answer reason: g., tetany). Vitamin D (often as calcitriol) increases GI calcium absorption and supports maintaining calcium levels when endogenous PTH is deficient. This is a core teaching point because calcium supplementation alone may be insufficient without adequate vitamin D activity. Fat-soluble vitamins like A and E do not correct the underlying calcium regulation problem, and vitamin C is not central to calcium homeostasis in this disorder.

Question 5

The nurse is preparing to administer the client’s medication for treatment of TB. Which medication, if on the client’s MAR, should the nurse plan to administer?

Accepted Answer

Answer reason: This medication is a cornerstone TB drug commonly used in multi-drug regimens and as monotherapy for latent infection. By contrast, fluconazole treats fungal infections, azithromycin is used for various bacterial infections but is not a standard primary TB agent, and acyclovir treats herpesviruses. Therefore, the medication on the MAR that aligns with TB treatment is the antimycobacterial agent listed.

Question 6

The client, who is 8 weeks pregnant, tells the nurse that she wants to try an herbal or natural remedy for treating her nausea. Which herb should the nurse suggest?

Accepted Answer

Answer reason: Ginger has the best evidence among common herbs for reducing pregnancy-related nausea and is generally considered safe when used in typical dietary/supplement amounts. Black cohosh is contraindicated in pregnancy due to uterotonic effects and concern for miscarriage or preterm labor. Milk thistle and echinacea are not standard, evidence-based choices for treating nausea in pregnancy and have less-established safety/efficacy for this indication.

Question 7

The nurse is caring for the older adolescent diagnosed with acromegaly. Which medication should the nurse plan to administer?

Accepted Answer

Answer reason: A somatostatin analog is used to inhibit pituitary GH release and improve symptoms and biochemical control. Somatropin would worsen the condition because it is recombinant growth hormone. Desmopressin treats central diabetes insipidus and clozapine is an antipsychotic, so neither addresses the underlying endocrine excess.

Question 8

The nurse is caring for the pediatric client with nephrotic syndrome. Which medication should the nurse anticipate administering to treat nephritic syndrome?

Accepted Answer

Answer reason: A corticosteroid is expected because it reduces glomerular permeability and typically induces remission of proteinuria in steroid-responsive disease. NSAIDs can worsen renal perfusion and are not a primary treatment for the syndrome. Antibiotics are only indicated when an infection is identified, and diuretics may be adjuncts for edema control but do not treat the underlying glomerular process.

Question 9

The nurse anticipates that a client with intermittent claudication will receive which medication?

Accepted Answer

Answer reason: Pentoxifylline improves red blood cell flexibility and reduces blood viscosity, which can enhance microcirculatory flow and improve walking distance in claudication. Anticoagulants such as warfarin or heparin are not routine treatments for stable claudication unless there is a separate indication like acute thrombosis or embolic disease. Analgesics may reduce pain perception but do not address the underlying perfusion problem.

Question 10

For a client having an episode of acute angle-closure glaucoma, the nurse expects to give which medication?

Accepted Answer

Answer reason: A carbonic anhydrase inhibitor decreases aqueous humor production, producing a fast reduction in intraocular pressure and is a standard acute treatment (often given systemically). An anticholinergic like atropine causes mydriasis, which can worsen angle closure and further raise intraocular pressure. Furosemide is not a primary therapy for lowering intraocular pressure in this setting, and urokinase is a thrombolytic with no role in glaucoma management.

Question 11

The nurse is aware that amiodarone (Cordarone) is used to treat which of the following?

Accepted Answer

Answer reason: Clinically it is used for ventricular arrhythmias such as ventricular tachycardia/ventricular fibrillation and also for supraventricular/atrial rhythms such as atrial fibrillation or atrial flutter. Because its therapeutic scope spans both atrial and ventricular dysrhythmias, the combined option is most accurate. Heart failure is not an indication; instead, this drug’s key nursing concern is monitoring for toxicities (e.g., thyroid, pulmonary, hepatic) while treating arrhythmias.

Question 12

Which treatment would be most appropriate for a child diagnosed with iron deficiency anemia?

Accepted Answer

Answer reason: Oral iron is first-line in most children because it is effective, safe, and appropriate for outpatient management over weeks to months. Dietary iron sources (e.g., fortified cereal) can support prevention and maintenance but typically do not correct established deficiency as reliably or quickly as therapeutic dosing. Parenteral iron is reserved for malabsorption, severe intolerance, or nonadherence, and transfusion is generally limited to hemodynamic instability or severe, symptomatic anemia requiring rapid correction.

Question 13

The goals and effects of conscious sedation include the following?

Accepted Answer

Answer reason: Conscious (moderate) sedation aims to reduce anxiety and discomfort while maintaining protective airway reflexes and the ability to respond purposefully to verbal/tactile stimulation. The desired clinical effect is that the patient remains calm and able to follow instructions during a procedure, which supports safe completion and monitoring. It should not cause major vital-sign instability; significant changes in respirations, blood pressure, or level of consciousness indicate excessive sedation and require intervention. Analgesia is intended to raise pain tolerance (reduce pain perception), not lower the pain threshold, and personality alteration is not a procedural goal.

Question 14

The nurse administered phenylephrine eye drops to the client before performing an ophthalmoscopic eye examination. Which assessment finding should the nurse expect?

Accepted Answer

Answer reason: This expected therapeutic effect is mydriasis rather than miosis, which is more consistent with parasympathomimetic agents. Hypotension is inconsistent with alpha-1 stimulation, which can cause vasoconstriction and may increase blood pressure if systemically absorbed. Tremor is not a typical primary expected finding from topical phenylephrine compared with beta-agonist systemic effects.

Question 15

The unresponsive client with DM is admitted to the ED with a serum glucose level of 35 mg/dL. Which medication should the nurse plan to administer?

Accepted Answer

Answer reason: When the patient cannot safely take oral carbohydrates and IV dextrose may not be immediately available, glucagon is an appropriate emergency medication because it stimulates hepatic glycogenolysis and gluconeogenesis to raise blood glucose. The other agents listed are antihyperglycemic drugs (GLP-1 agonist, amylin analog, alpha-glucosidase inhibitor) and would worsen or fail to correct critical hypoglycemia. After administration, ongoing monitoring and follow-up carbohydrate intake/IV dextrose are needed to prevent recurrent hypoglycemia once hepatic glycogen stores are depleted.

Question 16

The nurse is reviewing the medication list of the client with Méniére’s disease. Which medication was likely prescribed for treating the client’s vertigo?

Accepted Answer

Answer reason: This medication is an antihistamine with anticholinergic effects that decreases labyrinthine excitability, making it a common PRN agent for acute vertigo episodes. The other choices do not address vestibular symptoms: one is an appetite stimulant/progestin, one is a broad-spectrum antibiotic, and one is a beta-blocker for cardiovascular indications. Therefore it best matches the expected therapeutic action for vertigo management in Méniére’s disease.

Question 17

The nurse is caring for the newborn. Which assessment finding should the nurse expect after administering naloxone?

Accepted Answer

Answer reason: In a newborn exposed to maternal opioids (e.g., intrapartum analgesia), the key expected therapeutic effect is an improvement in respiratory rate, depth, and overall effort. Findings like meconium passage and temperature regulation are not direct outcomes of opioid reversal and would not be the primary expected change after administration. A common clinical concern is that reversal can precipitate acute opioid withdrawal, so irritability may increase rather than decrease.

Question 18

The nurse is preparing to administer newly prescribed medications to the pediatric client with hypertension. Which medication classification, if prescribed, should the nurse question?

Accepted Answer

Answer reason: Nitrates are primarily antianginal/vasodilator medications used for ischemia-related chest pain and acute preload reduction, not standard long-term pediatric hypertension management. If ordered solely for “hypertension” without another indication (e.g., specific cardiac condition requiring venodilation), it suggests a potential mismatch of drug class to diagnosis and warrants clarification. In contrast, the other three classes are commonly used options in pediatric hypertension depending on etiology and comorbidities.

Question 19

Which of the following drug classes should be administered to a client with heart failure to maximize cardiac performance?

Accepted Answer

Answer reason: Positive inotropes increase stroke volume and cardiac output, which most directly maximizes short-term cardiac performance when the priority is improving pump function. Diuretics primarily relieve congestion by reducing preload and symptoms, but do not directly increase contractility or cardiac output. Beta-adrenergic blockers improve long-term outcomes in chronic HFrEF but can acutely reduce contractility and are not used to immediately maximize cardiac performance.

Question 20

The nurse is reviewing first-line therapy medications of a client recently diagnosed with rheumatoid arthritis. Which medication does the nurse anticipate will be included?

Accepted Answer

Answer reason: This option fits the role of first-line symptomatic therapy by inhibiting prostaglandin-mediated inflammation. Cyclophosphamide is a high-toxicity immunosuppressant reserved for severe, refractory autoimmune disease rather than routine early RA. Prednisone can reduce inflammation quickly but is generally used as short-term bridging or for flares due to significant long-term adverse effects, and ferrous sulfate treats iron deficiency, not RA inflammation.

Question 21

A client is admitted to the unit with a thromboembolic stroke. Which medication does the nurse anticipate will be started by day 2?

Accepted Answer

Answer reason: By about 24–48 hours, initiating antiplatelet therapy is standard for most patients who did not receive thrombolysis, and is also used after thrombolysis once the post-tPA delay has passed and repeat imaging rules out bleeding. Thrombolytic therapy must be given within a narrow time window (generally within 3–4.5 hours of onset) and is not something to “start by day 2.” Acetaminophen is supportive for fever/pain and corticosteroids are not routine for ischemic stroke management.

Question 22

To evaluate the effectiveness of levodopa-carbidopa (Sinemet), a nurse should assess the client for?

Accepted Answer

Answer reason: Levodopa is converted to dopamine in the brain, increasing dopaminergic activity to improve the core motor manifestations of Parkinson disease. Carbidopa inhibits peripheral breakdown of levodopa, allowing more drug to reach the CNS and improving clinical response. Effective therapy is therefore reflected by improvement in bradykinesia/rigidity and resting tremor, which are key target symptoms. Dyskinesias are more commonly a dose-related adverse effect of dopaminergic therapy rather than a desired indicator of effectiveness. Visual acuity and short-term memory changes are not primary therapeutic endpoints for this medication.

Question 23

A definitive diagnosis of pulmonary embolism has been made for a client. The nurse anticipates which medication will be ordered?

Accepted Answer

Answer reason: Unfractionated heparin (or LMWH) has a fast onset and can be titrated and monitored, making it the expected initial medication after diagnosis. Warfarin has a delayed onset and is used for longer-term outpatient anticoagulation after initial heparinization and stabilization. Thrombolytics like streptokinase are reserved for massive/high-risk PE with hemodynamic instability due to significant bleeding risk, and acyclovir is an antiviral with no role in PE.

Question 24

Short-term steroid therapy is used in clients with leukemia to promote which of the following?

Accepted Answer

Answer reason: g., prednisone, dexamethasone) have predictable short-term metabolic effects, including stimulation of appetite and weight gain. This effect can be therapeutically beneficial in children with cancer who have poor intake related to illness or treatment. Steroids do not increase platelet production as a desired mechanism in leukemia; thrombocytopenia is typically managed with transfusion support and treatment of the malignancy. They also increase, not decrease, infection risk due to immunosuppression, making infection precautions essential.

Question 25

Parents of a premature infant ask the nurse which medication can help to prevent respiratory syncytial virus (RSV). What is the best response by the nurse?

Accepted Answer

Answer reason: Palivizumab is a monoclonal antibody given during RSV season to reduce the risk of severe RSV disease and hospitalization in premature infants and other high-risk groups. Epinephrine, bronchodilators, and corticosteroids may be used in selected situations to manage acute respiratory symptoms but do not provide prophylaxis against RSV infection. The key nursing teaching is that immunoprophylaxis requires scheduled doses and is targeted to eligible high-risk infants.

Question 26

Which medication is used to treat bronchiolitis in an immunosuppressed client with severe infection caused by respiratory syncytial virus (RSV)?

Accepted Answer

Answer reason: g., immunosuppressed) may warrant targeted antiviral therapy rather than only supportive care. This medication is an antiviral agent with activity against RSV and is the classic drug referenced for severe RSV infection in immunocompromised clients. The other options are bronchodilator/anti-inflammatory asthma therapies and do not treat the viral cause of RSV. In an immunosuppressed client, addressing viral replication is key because disease can be progressive and life-threatening despite routine supportive measures.

Question 27

Which medication provides artificially acquired passive immunity?

Accepted Answer

Answer reason: Artificially acquired passive immunity is produced by administering preformed antibodies that provide immediate, short-term protection without requiring the patient to mount an immune response. Antivenin contains ready-made immunoglobulins that bind and neutralize venom, so it functions as passive immunization. In contrast, toxoids and vaccines stimulate the person’s own immune system to form antibodies and memory cells, which is active immunity and takes time to develop. Passive antibody products are used when rapid protection is needed after exposure.

Question 28

A nurse is teaching a client with tuberculosis (TB) about his medication treatment. The client asks the nurse how long medication will be necessary. What is the best response by the nurse?

Accepted Answer

Answer reason: A typical course for active TB is at least 6 months, and many test resources teach a longer overall duration when discussing “medication treatment” broadly and adherence counseling. This option best reflects the extended timeframe clients should anticipate and is safer than suggesting a short course that could promote nonadherence and treatment failure. The shorter timeframe is more consistent with only an initial intensive phase rather than the total expected treatment duration. Extremely long durations are generally reserved for specific resistant or complicated cases rather than routine teaching.

Question 29

A client with tuberculosis (TB) is being treated with isoniazid (INH). The nurse anticipates that the client will also be placed on which treatment?

Accepted Answer

Answer reason: INH is a first-line agent but should not be used alone for active disease; it is typically paired with other anti-tubercular drugs (e.g., rifampin, pyrazinamide, ethambutol) depending on the phase of treatment and susceptibility results. This nursing expectation reflects standard TB management principles rather than treatment of symptoms. Pentamidine is used for Pneumocystis jirovecii pneumonia (often in HIV), and penicillin is not a standard TB therapy.

Question 30

The nurse prepares to administer morphine to a client with an acute myocardial infarction for which reason?

Accepted Answer

Answer reason: By reducing pain-driven catecholamine release, it helps lower myocardial oxygen consumption and can improve the oxygen supply-demand balance. Morphine also produces venodilation, reducing preload and wall stress, further decreasing oxygen demand. Options suggesting increased preload/afterload or increased oxygen demand are opposite of the intended therapeutic effect, and decreasing cardiac output is not the primary goal.

Question 31

The client with MS is prescribed baclofen. Which information is most important for the nurse to evaluate when caring for this client?

Accepted Answer

Answer reason: Tracking changes in muscle rigidity, spasms, and associated pain directly measures therapeutic effectiveness and guides dose titration and safety monitoring. Routine serum drug levels are not typically used to guide baclofen therapy in standard clinical practice. Intake/output and daily weights are not primary outcome measures for baclofen’s intended effect and would only become priority if other clinical problems (e.g., renal dysfunction, fluid imbalance) are present.

Question 32

The client who is 2 days post—cesarean birth has all of following prescribed medications. Which medication should the nurse administer when the client reports painful ulcerations on the perineum?

Accepted Answer

Answer reason: The key medication principle is to select an antiviral with activity against HSV to reduce viral replication, shorten symptom duration, and decrease lesion shedding. Among the choices, only acyclovir is a standard anti-HSV agent used for genital lesions, including in peripartum/postpartum care. The other listed drugs (ritonavir, zidovudine, lamivudine) are antiretrovirals targeting HIV, not HSV, and would not treat painful herpetic ulcerations.

Question 33

The nurse is caring for the client who is receiving magnesium sulfate IV to treat severe preeclampsia. When reviewing the client’s serum magnesium levels, which value should the nurse conclude is therapeutic?

Accepted Answer

Answer reason: This value falls within that expected therapeutic range, indicating adequate serum concentration to reduce neuromuscular excitability and prevent eclamptic seizures. Levels around 2 mg/dL are closer to normal baseline and may be subtherapeutic for seizure prevention in this context. A level around 10 mg/dL approaches toxic range where loss of deep tendon reflexes and respiratory depression become significant risks, especially if renal clearance is impaired.

Question 34

The child with CF is receiving albuterol. Which response should the nurse expect if albuterol is achieving the desired therapeutic effect?

Accepted Answer

Answer reason: When effective, the nurse should observe easier breathing with decreased wheezing and other abnormal breath sounds as airways open. Increased heart rate is a common side effect from beta-agonist activity, not the primary desired therapeutic outcome. Improved weight gain and fewer hospitalizations are longer-term CF goals influenced by many factors and are not direct, immediate indicators of bronchodilation.

Question 35

The child is to start on medication therapy for enuresis that has not resolved with behavioral interventions. Which medication should the nurse anticipate being prescribed for the child?

Accepted Answer

Answer reason: Desmopressin is a vasopressin analog that increases renal water reabsorption, decreasing urine volume and helping the child remain dry overnight. Lorazepam is a benzodiazepine used for anxiety/seizures and does not address bladder function or urine volume. Nitrofurantoin treats urinary tract infection and spironolactone is a diuretic that would increase urine output, worsening symptoms; with desmopressin, the nurse should monitor for water intoxication/hyponatremia and restrict excess evening fluids.

Question 36

A client with a myocardial infarction asks the nurse why he is receiving morphine. What is the best response by the nurse?

Accepted Answer

Answer reason: Morphine provides analgesia and also decreases sympathetic outflow (lowering anxiety, heart rate, and blood pressure), which collectively reduces cardiac workload and oxygen demand. It can also promote venodilation, decreasing preload and further reducing myocardial work. Options focused only on pain, anxiety, or sedation are partial effects but do not capture the key therapeutic goal in MI management.

Question 37

Which medication would the nurse expect to find on the electronic medication administration record (E-MAR) for treating the pain associated with irritable bowel disease?

Accepted Answer

Answer reason: This option provides analgesia without the constipation, ileus risk, and dependence potential that can complicate bowel disorders when stronger narcotics are used. Steroids are used to reduce inflammation during flares rather than as primary analgesics. Stool softeners address constipation and do not treat visceral inflammatory pain.

Question 38

A nurse is reviewing the physician’s orders for a client with systemic lupus erythematosus (SLE). The nurse determines that the medication most appropriate for the treatment plan is?

Accepted Answer

Answer reason: SLE is an autoimmune inflammatory disorder where disease control relies on immunomodulation to reduce flares and organ damage. Hydroxychloroquine is a core long-term therapy for many patients because it improves constitutional and joint/skin symptoms and decreases flare frequency. The other options are symptomatic or unrelated: morphine treats pain but does not modify autoimmune activity, ketoconazole is an antifungal, and dimenhydrinate is an antiemetic/antihistamine. Therefore, the medication that best fits an SLE treatment plan is the antimalarial immunomodulator.

Question 39

The nurse is teaching the parents of an infant diagnosed with diabetes insipidus. What is the most important treatment for the nurse to include in teaching?

Accepted Answer

Answer reason: The key treatment parents must understand is replacing or augmenting ADH activity (e.g., desmopressin for central DI) and monitoring response by urine output, weight, and hydration status. Fluid restriction is unsafe in DI because it can rapidly worsen dehydration and sodium elevation, especially in infants. Antihypertensives and blood products do not address the underlying pathophysiology and are not routine therapy for DI.

Question 40

Which medication would the nurse expect the physician to order most commonly for a client with leukemia as prophylaxis against Pneumocystis carinii pneumonia?

Accepted Answer

Answer reason: Trimethoprim-sulfamethoxazole provides effective prevention against this opportunistic organism and is the most commonly used agent for prophylaxis. Oral nystatin is used for candidiasis (thrush) prevention/treatment and does not prevent Pneumocystis infection. Prednisone and vincristine are used as components of chemotherapy regimens but are not primary prophylactic agents against this pneumonia and can further suppress immune function.

Question 41

The physician writes an order that states: methimazole (Tapazole) 15 mg daily PO. Which disease process is most likely being treated with this medication?

Accepted Answer

Answer reason: Methimazole is a thionamide antithyroid medication that inhibits thyroid hormone synthesis by blocking thyroid peroxidase (iodination and coupling), lowering T3/T4 levels over time. An order for daily oral methimazole most directly aligns with treatment of hyperthyroid states such as Graves disease or toxic nodular goiter. It would not treat adrenal insufficiency (which requires glucocorticoid/mineralocorticoid replacement) and has no disease-modifying role in rheumatoid arthritis or dopamine replacement role in Parkinson’s disease. The dose given is consistent with chronic management aimed at reducing excessive thyroid hormone production rather than symptomatic-only therapy.

Question 42

Which evaluation statement by the nurse is most accurate for a client who has been taking colchicine (Colgout)?

Accepted Answer

Answer reason: Colchicine is used primarily to treat acute gout flares by suppressing neutrophil-mediated inflammation, so the most appropriate outcome focuses on symptom relief and reduced inflammatory pain. A nursing evaluation statement should reflect the therapeutic goal of improved joint pain/tenderness and function. Hematologic effects of colchicine are more often adverse (e.g., bone marrow suppression) rather than a desired increase in platelets. It does not directly improve cardiac output, and “free from infection” is not an expected therapeutic outcome and may be less likely if leukopenia occurs.

Question 43

A nurse caring for a client with Alzheimer’s disease administers tacrine hydrochloride (Cognex) to the client four times a day. The nurse knows this medication works by binding to?

Accepted Answer

Answer reason: Tacrine is an acetylcholinesterase inhibitor, meaning it exerts its therapeutic effect by inhibiting the enzyme that breaks down acetylcholine in the synaptic cleft. By binding to and inhibiting cholinesterase, it increases the availability of acetylcholine in the CNS, which can modestly improve or stabilize cognition in Alzheimer’s disease. A direct binding to acetylcholine itself is not the mechanism; the key pharmacologic target is the degradative enzyme. Norepinephrine and epinephrine are catecholamines and are not the primary neurotransmitter deficit targeted by this class of Alzheimer medications.

Question 44

A 17-year-old client tells the nurse that she has vulvar itching and a thick, cream cheese-like vaginal discharge. The nurse anticipates treating the client with which medication?

Accepted Answer

Answer reason: An intravaginal/topical azole such as miconazole targets Candida species by disrupting fungal cell membrane synthesis, leading to symptom resolution. Metronidazole is used for bacterial vaginosis and trichomoniasis (typically thin gray discharge or frothy discharge with odor), not yeast. Broad-spectrum antibiotics like amoxicillin or erythromycin would not treat Candida and can worsen yeast overgrowth by altering normal vaginal flora.

Question 45

The nurse evaluates that pancrelipase is having the optimal intended benefit for the client with CF. Which assessment finding prompted the nurse’s conclusion?

Accepted Answer

Answer reason: Pancrelipase replaces pancreatic enzymes to improve digestion and absorption of fat, protein, and carbohydrates in clients with cystic fibrosis who have pancreatic insufficiency. When it is effective, stool fat decreases and weight gain or better overall nutritional markers are expected. Weight loss and increased steatorrhea indicate ongoing malabsorption and inadequate therapeutic response. Heartburn relief is not a primary therapeutic outcome for pancreatic enzyme replacement, so it does not best demonstrate intended benefit.

Question 46

The nurse is caring for the postpartum client. Which assessment finding should prompt the nurse to conclude that the administration of carboprost tromethamine has been effective?

Accepted Answer

Answer reason: When uterine atony improves, uterine vessels are compressed and postpartum bleeding decreases, which is reflected by reduced lochia/less heavy lochia rubra. Fever is more consistent with an adverse effect of prostaglandins rather than a therapeutic outcome. Stable blood pressure can be a downstream sign of improved hemodynamics, but it is less direct and can lag behind the primary goal of reducing uterine bleeding.

Question 47

The nurse is preparing a child for abdominal irradiation. Which medications should the nurse plan to administer to prevent nausea and vomiting?

Accepted Answer

Answer reason: A corticosteroid adds antiemetic synergy and improves control of both acute nausea and vomiting when combined with a 5-HT3 blocker. The other options each pair an antiemetic with a chemotherapeutic agent (or an inappropriate/nonstandard agent) rather than providing an evidence-based antiemetic regimen. Preventive administration before the irradiation session is key, because treating after symptoms start is typically less effective.

Question 48

The 14-year-old who has GERD is receiving lansoprazole. Which response should the nurse expect if lansoprazole is achieving the desired therapeutic effect?

Accepted Answer

Answer reason: When GERD acid exposure is reduced, the expected outcome is improvement in heartburn/epigastric burning and related pain symptoms. Increased GI motility is not a therapeutic action of PPIs (that would align more with prokinetic agents). Appetite changes and rectal gas are not reliable indicators of acid suppression or GERD control.

Question 49

Which intervention should be included in the collaborative management of a client with Crohn’s disease?

Accepted Answer

Answer reason: Corticosteroids are a key anti-inflammatory medication used during flares and, in some regimens, may be continued when clinically indicated under close monitoring for adverse effects. Increasing fiber can worsen symptoms or risk obstruction/stricture-related complications, and laxatives are generally avoided because diarrhea and inflammation predominate and they may increase fluid/electrolyte losses. Increasing physical activity is beneficial for general health but is not a primary collaborative intervention for controlling active intestinal inflammation.

Question 50

The nurse has instructed the client on self-administration of heparin injections. The nurse determines teaching is effective when the client makes which statement?

Accepted Answer

Answer reason: Heparin is an anticoagulant that works by enhancing antithrombin activity, which decreases thrombin and factor Xa activity and thereby prolongs clot formation time. This is the most accurate patient-friendly description of its expected therapeutic action. Saying it “stops” clotting implies complete prevention of coagulation, which is unsafe and incorrect because some clotting still occurs. It also does not “dissolve” existing clots; that action is associated with thrombolytics, not heparin.

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