Questions Part 4

1. You are evaluating an HIV-positive patient who is receiving IV pentamidine (Pentam) as a treatment for Pneumocystis jiroveci (PCP) pneumonia. Which information is most important to communicate to the physician? 

1.     The patient is reporting pain at the site of the infusion.
2.     The patient is not taking in an adequate amount of oral fluids.
3.     Blood pressure is 104/76 mm Hg after pentamidine administration.
4.     Blood glucose level is 55 mg/dL after medication administration.

2. Your patient with rheumatoid arthritis (RA) is taking prednisone (Deltasone) and naproxen (Aleve) to reduce inflammation and joint pain. Which symptom is most important to communicate to the health care provider? 

1.     RA symptoms are worst in the morning
2.     Dry eyes
3.     Round and moveable nodules just under the skin
4.     Dark-colored stools

3. A patient with chronic hepatitis C has been receiving interferon alfa-2a (Roferon-A) injections for the last month. Which information gathered during a home visit is most important to communicate to the physician?

1.     The patient has persistent nausea and vomiting.
2.     The patient injects the medication into the thigh by the intramuscular route.
3.     The patient's temperature is 99.7° F (37.6° C) orally.
4.     The patient reports chronic fatigue, muscle aches, and anorexia.

4. A patient with a history of liver transplantation is receiving cyclosporine (Sandimmune), prednisone (Deltasone), and mycophenolate (CellCept). Which finding is of most concern? 

1.     Gums that appear very pink and swollen
2.     A blood glucose level that is increased to 162 mg/dL
3.     A nontender lump above the clavicle
4.     Grade 1+ pitting edema in the feet and ankles

5. An HIV-positive patient who has been started on HAART is seen in the clinic for follow-up. Which test will be most helpful in determining the response to therapy? 

1.     CD4 level
2.     Complete blood count
3.     Total lymphocyte percent
4.     Viral load

6. You assess a 24-year-old patient with RA who is considering using methotrexate (Rheumatrex) for treatment. Which patient information is most important to communicate to the health care provider?

1.     The patient has many concerns about the safety of the drug.
2.     The patient has been trying to get pregnant.
3.     The patient takes a daily multivitamin tablet.
4.     The patient says that she has taken methotrexate in the past.

7. An 18-year-old college student with an exacerbation of systemic lupus erythematosus (SLE) has been receiving prednisone (Deltasone) 20 mg daily for 4 days. Which medical order should you question? 

1.     Discontinue prednisone after today's dose.
2.     Give a "catch-up" dose of varicella vaccine.
3.     Check the patient's C-reactive protein level.
4.     Administer ibuprofen (Advil) 800 mg PO.

8. A patient with wheezing and coughing caused by an allergic reaction to penicillin is admitted to the emergency department. Which medication do you anticipate administering first? 

1.     Methylprednisolone (Solu-Medrol) 100 mg IV
2.     Cromolyn (Intal) 20 mg via nebulizer
3.     Albuterol (Proventil) 3 mL via nebulizer
4.     Aminophylline (Theophylline) 500 mg IV

9. You are reviewing the client's morning laboratory results. Which of these results is of most concern to you?1.     Serum potassium level of 5.2 mEq/L
2.     Serum sodium level of 134 mEq/L
3.     Serum calcium level of 10.6 mg/dL
4.     Serum magnesium level of 0.8 mEq/L

 10. The health care provider has written all of these orders for a client with a diagnosis of Excess Fluid Volume. The client's morning assessment reveals bounding peripheral pulses, weight gain of 2 lb, pitting ankle edema, and moist crackles bilaterally. Which order takes priority at this time? 

1.     Weigh the client every morning.
2.     Maintain accurate intake and output records.
3.     Restrict fluids to 1500 mL/day.
4.     Administer furosemide (Lasix) 40 mg IV push.