Question

A 65-year-old patient with a history of pernicious anemia presents with fatigue, numbness and tingling in the hands and feet, and a recent blood test revealing macrocytic anemia. Which vitamin deficiency should the nurse prioritize in the care plan to address the patient's condition?

Answer 1

Correct Answers:

Vitamin B12 deficiency

Rationale :

🔷 Pernicious anemia results from a lack of intrinsic factor, which is necessary for vitamin B12 absorption in the ileum.

🔷 Vitamin B12 deficiency leads to macrocytic (megaloblastic) anemia, characterized by large, immature red blood cells and neurological manifestations such as numbness, tingling, and fatigue.

🔷 Without replacement therapy (usually parenteral B12), irreversible neuropathy and cognitive impairment may occur.

🔷 Long-term management includes lifelong vitamin B12 injections or high-dose oral supplements if absorption improves.

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Answer 2

Correct Answers:

"l will store the medication at room temperature."

Rationale :

💠 Nystatin suspension is an antifungal used for oral candidiasis (thrush) and must be stored at room temperature to maintain potency.

💠 The medication should be swished and retained in the mouth before swallowing, allowing contact with all oral mucosa for effective treatment.

💠 It should not be spit out, and therapy typically continues for at least 48 hours after symptoms resolve to prevent recurrence.

💠 Clients should avoid eating or drinking for about 30 minutes after administration.

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Answer 3

Correct Answers:

Administer the blood as ordered.

Rationale :

💎 Clients with type AB blood are universal recipients because they have no antibodies against A or B antigens.

💎 Therefore, type B blood is compatible with AB recipients, and transfusion can proceed safely.

💎 The nurse should still verify compatibility and follow proper transfusion protocol before administration.

💎 Observation for transfusion reactions (e.g., fever, chills, back pain) remains essential.

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Answer 4

Correct Answers:

Acyclovir

Rationale :

✨ Acyclovir is an antiviral drug used to treat infections caused by herpes simplex virus (HSV), including genital herpes.

✨ It works by inhibiting viral replication, thereby shortening the duration and severity of the outbreak.

✨ Early initiation of therapy helps reduce viral shedding and transmission to others.

✨ Nursing education includes emphasizing consistent use and safe sexual practices even when asymptomatic.

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Answer 5

Correct Answers:

Systemic candidiasis exhibiting fever and chills

Rationale :

🌟 Amphotericin B is a broad-spectrum antifungal reserved for severe systemic fungal infections, such as systemic candidiasis.

🌟 It binds to ergosterol in fungal cell membranes, causing leakage of cellular components and fungal cell death.

🌟 Due to its high toxicity, it requires close monitoring for side effects like nephrotoxicity, hypokalemia, and chills/fever during infusion.

🌟 Pre-medication with antipyretics and antihistamines is often recommended to reduce infusion reactions.

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Answer 6

Correct Answers:

Continuing the medication helps prevent the virus from spreading and reduces the risk of severe complications.

Rationale :

💎 Oseltamivir (Tamiflu) is a neuraminidase inhibitor that limits viral replication and spread within the body.

💎 Even if symptoms begin to improve, continuing the full course helps prevent complications such as pneumonia or bronchitis and reduces viral shedding, decreasing transmission risk.

💎 The medication works best when started within 48 hours of symptom onset but still provides benefit afterward by shortening illness duration.

💎 Educating clients to complete the prescribed course ensures optimal therapeutic effects and prevents resistance.

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Answer 7

Correct Answers:

Administer vitamin B6 (pyridoxine) daily as prescribed.

Rationale :

🔶 Isoniazid (INH) can cause peripheral neuropathy by depleting vitamin B6 (pyridoxine), which is essential for nerve health.

🔶 Administering vitamin B6 supplementation prevents numbness, tingling, and nerve damage during prolonged INH therapy.

🔶 This adverse effect is more common in malnourished, diabetic, or alcoholic clients, making prophylaxis critical.

🔶 Routine monitoring for liver toxicity is also important, but preventing neuropathy is the priority linked to pyridoxine use.

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Answer 8

Correct Answers:

"Take the medication with food or a carbonated beverage to improve absorption."

Rationale :

✨ Ketoconazole absorption is enhanced in an acidic environment, so taking it with food or carbonated drinks increases bioavailability.

✨ Concurrent use of antacids, H2 blockers, or proton-pump inhibitors decreases stomach acidity and reduces drug absorption, making therapy ineffective.

✨ Clients should be educated to avoid alcohol due to risk of hepatotoxicity and to report signs of liver injury such as dark urine or jaundice.

✨ The medication should be taken consistently as prescribed for optimal antifungal effect.

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Answer 9

Correct Answers:

TPN contains higher dextrose concentrations (up to 70%) and requires central venous access due to hypertonicity, whereas PPN has lower dextrose concentrations (10% or less) and is administered via peripheral veins.

Rationale :

🔷 Total parenteral nutrition (TPN) provides complete nutritional support through a central line, as its high osmolarity and dextrose content can irritate smaller peripheral veins.

🔷 Peripheral parenteral nutrition (PPN) contains lower concentrations of dextrose and amino acids, making it safe for short-term use via peripheral access.

🔷 TPN is indicated for long-term, high-calorie, or severely malnourished patients, while PPN is for temporary supplementation.

🔷 Accurate differentiation ensures safe administration and prevents phlebitis or vascular injury.

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Answer 10

Correct Answers:

Oseltamivir

Rationale :

🌟 Oseltamivir (Tamiflu) is effective against both influenza A and B viruses, making it the drug of choice for broad influenza coverage.

🌟 It works by inhibiting viral neuraminidase, an enzyme that allows new viral particles to escape infected cells, reducing viral replication.

🌟 When started early, it helps shorten illness duration and prevent complications.

🌟 The nurse should monitor for nausea, vomiting, or confusion, especially in older adults.

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Custom RN PN Pharmacology Midterm Fall 2025

No.

1 :
A 65-year-old patient with a history of pernicious anemia presents with fatigue, numbness and tingling in the hands and feet, and a recent blood test revealing macrocytic anemia. Which vitamin deficiency should the nurse prioritize in the care plan to address the patient's condition?

2 :
A nurse is providing teaching to a client who has oral candidiasis and a new prescription for nystatin suspension. Which of the following statements by the client indicates an understanding of the teaching?

3 :
A nurse is preparing to administer blood to a client. The unit of blood on hand is type B, and the client has type AB blood. Which of the following actions should the nurse take?

4 :
A nurse is caring for a client experiencing their first episode of genital herpes. Which antiviral medication should the nurse anticipate administering to effectively reduce the duration of the outbreak and prevent transmission?

5 :
A nurse is caring for four clients. The nurse should anticipate that a client who has which of the following conditions will be prescribed amphotericin B?

6 :
A nurse is caring for a client diagnosed with influenza who started oseltamivir 36 hours after symptom onset. The client asks why the medication is important even though they feel better. How should the nurse explain the rationale for continuing the antiviral medication?

7 :
A nurse is caring for a client who has started isoniazid (INH) therapy for latent tuberculosis infection. Which nursing intervention is the highest priority to prevent a common serious adverse effect associated with INH?

8 :
A nurse is providing education to a client who has been prescribed oral ketoconazole for the treatment of a systemic fungal infection. Which of the following instructions regarding the administration of the medication should the nurse include?

9 :
A nurse is planning care for a patient prescribed parenteral nutrition but is unsure whether to recommend TPN or PPN based on nutrient concentration needs and vascular access. Which consideration most accurately differentiates TPN from PPN regarding concentration and administration route?

10 :
A nurse is caring for a patient diagnosed with influenza type A and B who has started antiviral therapy. Which medication should the nurse anticipate administering to effectively treat both types of influenza?

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Custom RN PN Pharmacology Midterm Fall 2025

No.

1 : A 65-year-old patient with a history of pernicious anemia presents with fatigue, numbness and tingling in the hands and feet, and a recent blood test revealing macrocytic anemia. Which vitamin deficiency should the nurse prioritize in the care plan to address the patient's condition?

2 : A nurse is providing teaching to a client who has oral candidiasis and a new prescription for nystatin suspension. Which of the following statements by the client indicates an understanding of the teaching?

3 : A nurse is preparing to administer blood to a client. The unit of blood on hand is type B, and the client has type AB blood. Which of the following actions should the nurse take?

4 : A nurse is caring for a client experiencing their first episode of genital herpes. Which antiviral medication should the nurse anticipate administering to effectively reduce the duration of the outbreak and prevent transmission?

5 : A nurse is caring for four clients. The nurse should anticipate that a client who has which of the following conditions will be prescribed amphotericin B?

6 : A nurse is caring for a client diagnosed with influenza who started oseltamivir 36 hours after symptom onset. The client asks why the medication is important even though they feel better. How should the nurse explain the rationale for continuing the antiviral medication?

7 : A nurse is caring for a client who has started isoniazid (INH) therapy for latent tuberculosis infection. Which nursing intervention is the highest priority to prevent a common serious adverse effect associated with INH?

8 : A nurse is providing education to a client who has been prescribed oral ketoconazole for the treatment of a systemic fungal infection. Which of the following instructions regarding the administration of the medication should the nurse include?

9 : A nurse is planning care for a patient prescribed parenteral nutrition but is unsure whether to recommend TPN or PPN based on nutrient concentration needs and vascular access. Which consideration most accurately differentiates TPN from PPN regarding concentration and administration route?

10 : A nurse is caring for a patient diagnosed with influenza type A and B who has started antiviral therapy. Which medication should the nurse anticipate administering to effectively treat both types of influenza?

1 :
A 65-year-old patient with a history of pernicious anemia presents with fatigue, numbness and tingling in the hands and feet, and a recent blood test revealing macrocytic anemia. Which vitamin deficiency should the nurse prioritize in the care plan to address the patient's condition?

2 :
A nurse is providing teaching to a client who has oral candidiasis and a new prescription for nystatin suspension. Which of the following statements by the client indicates an understanding of the teaching?

3 :
A nurse is preparing to administer blood to a client. The unit of blood on hand is type B, and the client has type AB blood. Which of the following actions should the nurse take?

4 :
A nurse is caring for a client experiencing their first episode of genital herpes. Which antiviral medication should the nurse anticipate administering to effectively reduce the duration of the outbreak and prevent transmission?

5 :
A nurse is caring for four clients. The nurse should anticipate that a client who has which of the following conditions will be prescribed amphotericin B?

6 :
A nurse is caring for a client diagnosed with influenza who started oseltamivir 36 hours after symptom onset. The client asks why the medication is important even though they feel better. How should the nurse explain the rationale for continuing the antiviral medication?

7 :
A nurse is caring for a client who has started isoniazid (INH) therapy for latent tuberculosis infection. Which nursing intervention is the highest priority to prevent a common serious adverse effect associated with INH?

8 :
A nurse is providing education to a client who has been prescribed oral ketoconazole for the treatment of a systemic fungal infection. Which of the following instructions regarding the administration of the medication should the nurse include?

9 :
A nurse is planning care for a patient prescribed parenteral nutrition but is unsure whether to recommend TPN or PPN based on nutrient concentration needs and vascular access. Which consideration most accurately differentiates TPN from PPN regarding concentration and administration route?

10 :
A nurse is caring for a patient diagnosed with influenza type A and B who has started antiviral therapy. Which medication should the nurse anticipate administering to effectively treat both types of influenza?