Question 1

A patient who takes aspirin for rheumatoid arthritis develops a headache and tinnitus. The patient's lab result includes a plasma salicylate level of 300  μ\muμ g/mL, and a urine pH of 6.0. What action will the provider take?

Accepted Answer

A)   Increase the aspirin dose to better treat the patient's headache.
B)   Order lab work to identify possible renal toxicity.
C)   Prepare to provide respiratory support, related to a possible overdose.
D)   Withhold the aspirin until the patient's symptoms have subsided. E) A) and B)
F) None of the above

Question 2

A provider prescribing vaccines to a child with an immune deficiency disorder will avoid ordering which vaccination?

Accepted Answer

A)   Diphtheria and tetanus toxoids and acellular pertussis (DTaP)  vaccine
B)   Haemophilus influenzae type b (Hib)  vaccine
C)   Polio injection
D)   Varicella virus vaccineE) B) and C)
F) All of the above

Question 3

A patient who takes aspirin daily is scheduled for surgery in 1 week. What action will the provider suggest to minimize the patient's risk for injury?

Accepted Answer

A)   Continue to use aspirin as scheduled.
B)   Reduce the aspirin dosage by half until after surgery.
C)   Stop taking aspirin immediately.
D)   Stop taking aspirin 3 days before surgery.E) B) and D)
F) A) and C)

Question 4

A patient taking a glucocorticoid for arthritis reports feeling bloated and peripheral edema is noted. Which action by the provider is relevant to the care of this patient?

Accepted Answer

A)   Asking the patient about sodium intake
B)   Obtaining a blood glucose level
C)   Suggesting the patient limit potassium intake
D)   Discontinuing the drugE) A) and D)
F) None of the above

Question 5

A 5-year-old child with seasonal allergies has been taking 2.5 mL of cetirizine syrup once daily. The parents tell the provider that the child does not like the syrup, and they do not think that the drug is effective. The provider will discuss which change in medication therapy?

Accepted Answer

A)   Cetirizine 5-mg chewable tablet once daily
B)   Loratadine 10-mg chewable tablet once daily
C)   Fexofenadine syrup 5 mL twice daily
D)   Desloratadine 5-mg rapid-disintegrating tablet once dailyE) All of the above
F) A) and C)

Question 6

A patient will begin taking fexofenadine for hay fever. What information will the provider include in patient teaching?

Accepted Answer

A)   Fexofenadine should be taken with food to prevent gastrointestinal symptoms.
B)   The medication may be taken once or twice daily.
C)   Tolerance to sedation will occur in a few weeks.
D)   With renal impairment, this drug should be taken every other day.E) A) and B)
F) All of the above

Question 7

A pregnant patient in her third trimester asks the nurse whether she can take aspirin for headaches. Which response by the nurse is correct?

Accepted Answer

A)   "Yes, but it is safe during only the second and third trimesters of pregnancy."
B)   "Aspirin may cause premature closure of the ductus arteriosus in your baby so should be avoided."
C)   "Aspirin may induce premature labor and should be avoided in the third trimester."
D)   "No, you should use a first-generation nonsteroidal antiinflammatory medication."E) B) and D)
F) C) and D) B

Question 8

A provider caring for a patient infected with the human immunodeficiency virus (HIV)  will be most concerned about which lab result?

Accepted Answer

A)   High level of eosinophils
B)   Low neutrophil count
C)   Decreased red blood cell (RB
C)   count
D)   Very low helper T lymphocyte countE) A) and C)
F) B) and D)

Question 9

A patient who takes a glucocorticoid reports having tarry stools but denies gastric pain. After ruling out anemia and determining that the patient is not in danger, which action will the provider take?

Accepted Answer

A)   Prescribing an antiulcer medication.
B)   Counseling the patient to use over-the-counter antacids.
C)   Reassuring the patient not to worry unless there is gastric pain.
D)   Discontinuing the glucocorticoid immediately.E) C) and D)
F) A) and B)

Question 10

A 3-year-old child who has asthma is in the clinic for a well-child checkup. The nurse notes that the child is up to date for the DTaP, hepatitis A, hepatitis B, and the MMR vaccines but has only had one each of the Hib, the rotavirus, and the PCV13 vaccines. Which vaccine will the provider prescribe for this child?

Accepted Answer

A)   Hib
B)   PCV13
C)   PCV13 and Hib
D)   RotavirusE) A) and D)
F) B) and C)

Question 11

A 1-year-old child receives the MMR vaccine. The next day, the child's parent calls to report that the child has a temperature of 102.8  °\degree° F. What action will the provider take?

Accepted Answer

A)   File an adverse event report with the Vaccine Adverse Event Reporting System (VAERS) .
B)   Order a lab test to rule out thrombocytopenia.
C)   Reassure the parent that fever can occur with the MMR vaccine.
D)   Advise the parent to take the child to the emergency department. E) A) and D)
F) A) and C)

Question 12

An 11-year-old boy received all childhood immunizations before attending kindergarten. Which vaccines will the provider recommended for this child at his current age? (Select all that apply.)

Accepted Answer

A)   Hepatitis B
B)   PCV-23
C)   Tdap
D)   MCV4
E)   HPVF) C) and E)
G) A) and B)

Question 13

An older male patient takes furosemide and low-dose aspirin. Urine output is low despite the diuretic. Today's blood pressure is 140/80 mm Hg and the serum creatinine and blood urea nitrogen (BUN)  levels are elevated. The patient has also gained 10-pounds over the past 3 months. What action will the provider discuss with the patient?

Accepted Answer

A)   Adding an antihypertensive medication
B)   Recheck the serum creatinine and BUN
C)   Ordering a potassium-sparing diuretic
D)   Withdrawing the aspirinE) B) and C)
F) A) and D)

Question 14

A provider is teaching a patient who has taken glucocorticoids for over a year about glucocorticoid withdrawal. Which statement by the patient indicates a need for further teaching?

Accepted Answer

A)   "I should reduce the dose by half each day until I stop taking the drug."
B)   "I will need to have cortisol levels monitored during the withdrawal process."
C)   "The withdrawal schedule may take several months."
D)   "If I have surgery, I may need to take the drug for a while, even after I have stopped."E) A) and C)
F) A) and D)

Question 15

An adolescent is brought to the emergency department after consuming a bottle of extended-release acetaminophen tablets between 8 and 10 hours ago. Which intervention will the provider order?

Accepted Answer

A)   Acetylcysteine administration
B)   Activated charcoal administration
C)   Hemodialysis
D)   Gastric lavageE) A) and D)
F) A) and C)

Question 16

A 2-month-old infant is scheduled to receive the first dose of DTaP. What information will the provider include in instructions given to the parents?

Accepted Answer

A)   "Usually reactions are mild; a low-grade fever is most common."
B)   "Most children do not experience any reaction."
C)   "Seizures are common and may require anticonvulsant medication."
D)   "The most common reaction is a rash that develops into itchy blisters."E) A) and B)
F) A) and C)

Question 17

A provider is about to prescribe prednisone to a patient for tendonitis. What item in the patient's medical history would cause the provider to reconsider that action?

Accepted Answer

A)   Allergic rhinitis
B)   Gouty arthritis
C)   Seborrheic dermatitis
D)   Systemic fungal infectionE) A) and B)
F) C) and D)

Question 18

A provider orders hydroxyzine for a patient with acute urticaria. What information will the provider include when teaching the patient about this drug?

Accepted Answer

A)   The drug will reduce redness and itching but not edema.
B)   This antihistamine is not likely to cause sedation.
C)   Alcohol should be avoided while taking the drug.
D)   Shortness of breath may occur while taking the drug.E) B) and C)
F) All of the above C

Question 19

A patient taking high doses of a glucocorticoid develops weakness in the muscles of the upper arms and in the legs. What action will the provider take?

Accepted Answer

A)   Reducing the dose of the glucocorticoid medication
B)   Encourage the patient to restrict sodium intake.
C)   Reassure the patient that this is an expected side effect.
D)   Discontinue the medication immediately.E) C) and D)
F) A) and B)

Question 20

Parents report that their 5-year-old child has frequent motion sickness. Which antihistamine will the provider recommend?

Accepted Answer

A)   Desloratadine
B)   Dimenhydrinate
C)   Hydroxyzine
D)   PromethazineE) A) and B)
F) A) and C) B

Exam 13: Anti-Inflammatory, Antiallergic, and Immunologic Drugs

A patient who takes aspirin for rheumatoid arthritis develops a headache and tinnitus. The patient's lab result includes a plasma salicylate level of 300 $\mu$ g/mL, and a urine pH of 6.0. What action will the provider take?

Correct Answer
verified

A provider prescribing vaccines to a child with an immune deficiency disorder will avoid ordering which vaccination?

Correct Answer
verified

A patient who takes aspirin daily is scheduled for surgery in 1 week. What action will the provider suggest to minimize the patient's risk for injury?

Correct Answer
verified

A patient taking a glucocorticoid for arthritis reports feeling bloated and peripheral edema is noted. Which action by the provider is relevant to the care of this patient?

Correct Answer
verified

A 5-year-old child with seasonal allergies has been taking 2.5 mL of cetirizine syrup once daily. The parents tell the provider that the child does not like the syrup, and they do not think that the drug is effective. The provider will discuss which change in medication therapy?

Correct Answer
verified

A patient will begin taking fexofenadine for hay fever. What information will the provider include in patient teaching?

Correct Answer
verified

A pregnant patient in her third trimester asks the nurse whether she can take aspirin for headaches. Which response by the nurse is correct?

Correct Answer
verified
B

A provider caring for a patient infected with the human immunodeficiency virus (HIV) will be most concerned about which lab result?

Correct Answer
verified

A patient who takes a glucocorticoid reports having tarry stools but denies gastric pain. After ruling out anemia and determining that the patient is not in danger, which action will the provider take?

Correct Answer
verified

Correct Answer
verified

A 1-year-old child receives the MMR vaccine. The next day, the child's parent calls to report that the child has a temperature of 102.8 $\degree$ F. What action will the provider take?

Correct Answer
verified

An 11-year-old boy received all childhood immunizations before attending kindergarten. Which vaccines will the provider recommended for this child at his current age? (Select all that apply.)

Correct Answer
verified

Correct Answer
verified

A provider is teaching a patient who has taken glucocorticoids for over a year about glucocorticoid withdrawal. Which statement by the patient indicates a need for further teaching?

Correct Answer
verified

An adolescent is brought to the emergency department after consuming a bottle of extended-release acetaminophen tablets between 8 and 10 hours ago. Which intervention will the provider order?

Correct Answer
verified

A 2-month-old infant is scheduled to receive the first dose of DTaP. What information will the provider include in instructions given to the parents?

Correct Answer
verified

A provider is about to prescribe prednisone to a patient for tendonitis. What item in the patient's medical history would cause the provider to reconsider that action?

Correct Answer
verified

A provider orders hydroxyzine for a patient with acute urticaria. What information will the provider include when teaching the patient about this drug?

Correct Answer
verified
C

A patient taking high doses of a glucocorticoid develops weakness in the muscles of the upper arms and in the legs. What action will the provider take?

Correct Answer
verified

Parents report that their 5-year-old child has frequent motion sickness. Which antihistamine will the provider recommend?

Correct Answer
verified
B

Exam 13: Anti-Inflammatory, Antiallergic, and Immunologic Drugs

A patient who takes aspirin for rheumatoid arthritis develops a headache and tinnitus. The patient's lab result includes a plasma salicylate level of 300 μ\muμ g/mL, and a urine pH of 6.0. What action will the provider take?

Correct AnswerverifiedShow Answer

A provider prescribing vaccines to a child with an immune deficiency disorder will avoid ordering which vaccination?

Correct AnswerverifiedShow Answer

A patient who takes aspirin daily is scheduled for surgery in 1 week. What action will the provider suggest to minimize the patient's risk for injury?

Correct AnswerverifiedShow Answer

A patient taking a glucocorticoid for arthritis reports feeling bloated and peripheral edema is noted. Which action by the provider is relevant to the care of this patient?

Correct AnswerverifiedShow Answer

A 5-year-old child with seasonal allergies has been taking 2.5 mL of cetirizine syrup once daily. The parents tell the provider that the child does not like the syrup, and they do not think that the drug is effective. The provider will discuss which change in medication therapy?

Correct AnswerverifiedShow Answer

A patient will begin taking fexofenadine for hay fever. What information will the provider include in patient teaching?

Correct AnswerverifiedShow Answer

A pregnant patient in her third trimester asks the nurse whether she can take aspirin for headaches. Which response by the nurse is correct?

Correct AnswerverifiedB

A provider caring for a patient infected with the human immunodeficiency virus (HIV) will be most concerned about which lab result?

Correct AnswerverifiedShow Answer

A patient who takes a glucocorticoid reports having tarry stools but denies gastric pain. After ruling out anemia and determining that the patient is not in danger, which action will the provider take?

Correct AnswerverifiedShow Answer

Correct AnswerverifiedShow Answer

A 1-year-old child receives the MMR vaccine. The next day, the child's parent calls to report that the child has a temperature of 102.8 °\degree° F. What action will the provider take?

Correct AnswerverifiedShow Answer

An 11-year-old boy received all childhood immunizations before attending kindergarten. Which vaccines will the provider recommended for this child at his current age? (Select all that apply.)

Correct AnswerverifiedShow Answer

Correct AnswerverifiedShow Answer

A provider is teaching a patient who has taken glucocorticoids for over a year about glucocorticoid withdrawal. Which statement by the patient indicates a need for further teaching?

Correct AnswerverifiedShow Answer

An adolescent is brought to the emergency department after consuming a bottle of extended-release acetaminophen tablets between 8 and 10 hours ago. Which intervention will the provider order?

Correct AnswerverifiedShow Answer

A 2-month-old infant is scheduled to receive the first dose of DTaP. What information will the provider include in instructions given to the parents?

Correct AnswerverifiedShow Answer

A provider is about to prescribe prednisone to a patient for tendonitis. What item in the patient's medical history would cause the provider to reconsider that action?

Correct AnswerverifiedShow Answer

A provider orders hydroxyzine for a patient with acute urticaria. What information will the provider include when teaching the patient about this drug?

Correct AnswerverifiedC

A patient taking high doses of a glucocorticoid develops weakness in the muscles of the upper arms and in the legs. What action will the provider take?

Correct AnswerverifiedShow Answer

Parents report that their 5-year-old child has frequent motion sickness. Which antihistamine will the provider recommend?

Correct AnswerverifiedB

A patient who takes aspirin for rheumatoid arthritis develops a headache and tinnitus. The patient's lab result includes a plasma salicylate level of 300 $\mu$ g/mL, and a urine pH of 6.0. What action will the provider take?

Correct Answer
verified

Correct Answer
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Correct Answer
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Correct Answer
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Correct Answer
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Correct Answer
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Correct Answer
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B

Correct Answer
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Correct Answer
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Correct Answer
verified

A 1-year-old child receives the MMR vaccine. The next day, the child's parent calls to report that the child has a temperature of 102.8 $\degree$ F. What action will the provider take?

Correct Answer
verified

Correct Answer
verified

Correct Answer
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Correct Answer
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Correct Answer
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Correct Answer
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Correct Answer
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Correct Answer
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C

Correct Answer
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Correct Answer
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B