NUR 635 FINAL EXAM 2 LATEST VERSION (VERSION A AND B) 2024 ACTUAL EXAM 350 QUESTIONS AND CORRECT DETAILED ANSWERS|| ALREADY GRADED A+ || BRAND NEW!!

NUR 635 FINAL EXAM 2 LATEST VERSION
(VERSION A AND B) 2024 ACTUAL EXAM 350
QUESTIONS AND CORRECT DETAILED
ANSWERS|| ALREADY GRADED A+ || BRAND
NEW!!
A patient with previous compliant levels of carbamazepine now presents with
subtherapeutic blood levels. The NP suspects?
a. Noncompliance
b. Patient financial strain
c. Malnutrition
d. Expected lab finding - ANSWER-d. Expected lab finding
Carbamazepine auto induces metabolism leading to lower levels of the drug.
The nurse is performing a physical assessment on a patient who is receiving treatment
with abacavir, zidovudine, and lamivudine [Trizivir]. The patient complains of fatigue.
Upon further assessment, the nurse finds a rash and notes that the patient has a
temperature of 101.1 F. What is the nurse's best course of action?
a. Tell the patient that this is an expected response to these medications and to
continue the agents as prescribed
b. Have the patient hold the medications and arrange for an immediate evaluation by
the prescriber
c. Have the patient continue the abacavir but discontinue the other two agents for 3
weeks
d. Instruct the patient to continue all three medications and administer an antihistamine
for the symptoms - ANSWER-b. Have the patient hold the medications and arrange for
an immediate evaluation by the prescriber
a.
ANS: B- The patient is showing early symptoms of a fatal hypersensitivity reaction.
The NP educates the patient regarding the black box warning on carbamazepine by
advising the patient to report signs and symptoms indicative of?
a. Liver toxicity
b. Kidney failure
c. Skin reaction
d. Suicidal tendencies - ANSWER-c. Skin reaction
Carbamazepine can cause SJS and TEN (toxic epidermal necrolysis)
Carbamazepine monitoring should include all of the following except?
a. Routine CBC
b. Osteoporosis screening
c. Carbamazepine drug levels
d. Monthly glucose - ANSWER-d. Monthly glucose
A patient with bipolar disorder takes lamotrigine [Lamictal]. Which statement by the
patient would prompt the nurse to hold the drug and notify the prescriber for further
assessment?
a. "I get a little dizzy sometimes"
b. "I had a headache last week that lasted for about an hour"
c. "I've broken out in a rash on my chest and back"
d. "Last night I woke up twice with a bad dream" - ANSWER-c. "I've broken out in a rash
on my chest and back"
Rash may indicate development of Stevens-Johnson Syndrome.
The patient should be instructed to avoid alcoholic beverages because a disulfiram-like
reaction can occur if metronidazole is taken with alcohol
Which patient should receive fluoroquinolone therapy for a CAP diagnosis?
a. A 22-year-old postal worker
b. A 44-year-old female with diabetes
c. 58-year-old African American
d. A 6-month-old immigrant - ANSWER-b. A 44-year-old female with diabetes
Anyone with a comorbidity should be treated.
Sulfonamides should be avoided in patient's with a G6PD deficiency due to the risk of?
a. Tendon rupture
b. Steven Johnson's syndrome
c. Hemolytic anemia
d. Liver failure - ANSWER-c. Hemolytic anemia
A nurse is caring for an African-American who has been admitted to the unit for longterm antibiotic therapy with sulfonamides. The patient develops fever, pallor, and
jaundice. The nurse would be correct to suspect that the patient has developed?
a. Stevens-Johnson syndrome
b. Kernicterus
c. Hepatotoxicity
d. Hemolytic anemia - ANSWER-d. Hemolytic anemia
Sulfonamides can cause hemolytic anemia in patients of African-American and
Mediterranean origin usually because of genetic deficiency.
A 16-year-old presents to the clinic for treatment of her acne. The NP prescribes which
medication?
a. Minocycline
b. Topical retinoids
c. Tetracycline
d. Combination antibiotic and topical - ANSWER-d. Combination antibiotic and topical
The most effective is combination antibiotic and topical.
A 14-year-old patient has moderate acne that has not responded to topical drugs. The
nurse will suggest that the patient and her parents discuss which treatment with the
provider?
a. Combination oral contraceptive medication
b. Doxycycline (Vibramycin)
c. Isotretinoin (Accutane)
d. Sprironolactone - ANSWER-b. Doxycycline (Vibramycin)
For moderate to severe acne, oral antibiotics are indicated. Doxycycline is the drug of
first choice.
A teenager comes to the clinic with complaint of headache. The NP suspects
minocycline may be causing the symptoms due to its risk of:
a. Increasing blood pressure
b. Increasing intracranial pressure
c. Pseudotumor cerbri
d. Pheochromocytoma - ANSWER-b. Increasing intracranial pressure
c. Pseudotumor cerbri
it can cause both increased intracranial pressure and pseudotumor cerbri.
Which treatment is appropriate for a patient with new onset cluster headaches?
a. IV cocktail of Benadryl and Zofran
b. Imitrex
c. Titration of a beta blocker
d. 100% oxygen for 15 minutes - ANSWER-d. 100% oxygen for 15 minutes
the other treatment options are indicated for migraines.
Supplemental oxygen has been shown to help reduce symptoms for which type of
headache?
a. Cluster
b. Menstrual migraine
c. Migraine
d. Tension-type - ANSWER-a. Cluster
Cluster headaches can be treated with 100% oxygen inhalation.
When should the NP expect to see clinical improvement after starting antibiotic therapy
for a pneumonia patient?
a. 2-3 hours
b. 2-3 days
c. 7 days
d. 10 days - ANSWER-b. 2-3 days
A 4-year-old comes in with ear pain and on exam the TM is erythematous, bulging, and
non-mobile. Vital signs are BP 112/62, pulse 122, RR 16, T is 102.5. The NP decides to
proceed with:
a. Watchful waiting, determine if symptoms resolve in 2-3 days spontaneously
b. Watchful waiting with a post-date prescription for antibiotics
c. Start the patient on amoxicillin or Augmentin
d. Refer to the ER for further evaluation - ANSWER-c. Start the patient on amoxicillin or
Augmentin
An 18-month-old child is seen in the clinic with a temperature of 40 C. The child's
parents tell the nurse that the child developed the fever the previous evening and was
inconsolable during the night. The provider examines the child and notes a bulging,
erythematous tympanic membrane. The nurse will expect to:
a. Ask the patient to return to the clinic in 2 days to see whether antibiotics need to be
started
b. Discuss a referral to an ear, nose, and throat specialist for follow-up treatment
c. Teach the parent to give analgesics for 3 days while observing for worsening
symptoms
d. Tell the parent to administer amoxicillin at 45 mg/kg/dose twice daily - ANSWER-d.
Tell the parent to administer amoxicillin at 45 mg/kg/dose twice daily
Patients with severe symptoms of AOM should begin treatment with antibiotics upon
diagnosis.
A 2 year old child is seen in the clinic in July with otalgia, erythematous, bulging
tympanic membranes (TMs), and rupture of the right TM. The child also has a
temperature of 39.4 C. The child's parents tells the nurse, "This is the fifth ear infection
this year. What can we do?". The nurse will expect the provider to:
a. Administer ceftriaxone (Rocephin) IM and give the influenza vaccine
b. Begin prophylactic antibiotic therapy with trimethoprim/sulfamethoxazole (Septra)
c. Prescribe amoxicillin-clavulanate (Augmentin) and refer the child to an otolaryngolist
d. Prescribe high-dose amoxicillin (Amoxil) and administer the influenza vaccine -
ANSWER-c. Prescribe amoxicillin-clavulanate (Augmentin) and refer the child to an
otolaryngolist
Recurrent AOM is defined as AOM that occurs three or more times within 6 months o
four or more times in a year. Giving an antibiotic, such as Augment, is appropriate for
each episode.
This patient has scurvy with acute, severe symptoms, and needs intravenous vitamin C.
First line drug of choice for community acquired pneumonia in a previously healthy is?
a. Penicillin
b. Amoxicillin
c. Azithromycin
d. Levaquin - ANSWER-c. Azithromycin
One month after starting phenytoin for seizures, a 28-year-old male presents with
complaints of fever, rash, and swollen lymph nodes. The NP suspects which syndrome?
a. Phenytoin toxicity
b. Phenytoin hypersensitivity reaction
c. Normal side effects of phenytoin
d. Mononucleosis - ANSWER-b. Phenytoin hypersensitivity reaction
A 6 year old is seen with symptoms of acute otitis media without a fever. The NP
recommends which treatment for this patient?
a. Watchful waiting, determine if symptoms resolve in 2-3 days spontaneously
b. Watchful waiting with a post-dated prescription for antibiotics
c. Start the patient on lidocaine drops to help with ear pain
d. Refer the patient to the ER for further evaluation - ANSWER-c. Start the patient on
lidocaine drops to help with ear pain
A provider has told a parent that a 3-year-old child has a minor ear infection and that an
antibiotic would be prescribed in a couple of days if the child's symptoms worsened. The
parent asks the nurse why the child cannot get an antibiotic today. Which response by
the nurse is correct?
a. "If the eardrum ruptures, we can culture the fluid to determine which antibiotic is best"
b. "Most ear infection are caused by viruses, so antibiotics are not effective"
c. "Most ear infections will resolve on their own without antibiotics"
d. "Your child will develop tolerance to antibiotics if they are prescribed too often" -
ANSWER-c. "Most ear infections will resolve on their own without antibiotics"
The vast majority of acute otitis media episodes resolve without treatment