ATI Pharm A

A nurse is preparing to administer a scheduled antibiotic at 0800 to a client and discovers the antibiotic is not present in the client's medication drawer. The nurse should identify that administration of the medication can occur at which of the following time periods without requiring an incident report? 1000 0900 0830 1200

0830 The nurse should identify that an antibiotic can be administered 30 min before or after the scheduled time to maintain therapeutic blood levels without requiring an incident report.

A nurse is caring for the mother of a newborn. The mother asks the nurse when her newborn should receive his first diphtheria, tetanus, and pertussis vaccine (DTaP). The nurse should instruct the mother that her newborn should receive the immunization at which of the following ages? Bith 2 months 6 months 15 months

2 months The CDC recommends that newborns receive the first dose of the five-dose series of the DTaP immunization at 2 months of age.

A nurse is reviewing the laboratory results for a client who is receiving HEPARIN via continuous IV infusion for DVT. The nurse should discontinue the medication infusion for which of the following client findings? Potassium 5.0 mEq/ L aPTT 2 times the control Hemoglobin 15 g/dL Platelets 96,000/mm3

A platelet count of 96,000/mm3 is below the expected range of 150,000 to 400,000/mm3. A platelet count less than 100,000/mm3 while receiving heparin can indicate heparin-induced thrombocytopenia (HIT), a potentially fatal condition that requires stopping the infusion.

A nurse is caring for a client who is receiving heparin therapy via continuous IV infusion to treat a pulmonary embolism. Which of the following findings should the nurse identify as an adverse effect of the medication and report to the provider? Blood in the urine

Blood in the urine The nurse should report blood in the urine to the provider because this can be a manifestation of heparin toxicity. Other manifestations can include bruising, hematomas, hypotension, and tachycardia.

A nurse is planning care for a client who has hypertension and is to start taking metoprolol. Which of the following interventions should the nurse include in the plan of care? Weigh the client weekly Determine apical pulse prior to administering Administer the medication 30 min prior to breakfast Monitor the client for jaundice

Determine apical pulse prior to administering Life-threatening bradycardia is an adverse effect that might affect this client. Therefore, the nurse should assess the client's apical pulse prior to administering the medication. If the client's pulse rate is less than 60/min, the nurse should withhold the medication and notify the provider.

A nurse is assessing a client's vital signs prior to the administration of PO digoxin. The clients BP is 144/86, heart Rate is 55 and RR is 20/min. The nurse should withhold the medication and contact the provider for which of the following findings Heart rate DBP SBP RR

Heart rate Digoxin slows the conduction rate through the SA and AV nodes, thereby decreasing the heart rate. The nurse should withhold the medication and notify the provider for a heart rate of 55/min because this is an early indication of digoxin toxicity.

A nurse is assessing a client who has myasthenia gravis and is taking NEOSTIGMINE. Which of the following findings should indicate to the nurse that the client is experiencing an adverse effect? Tachycardia Oliguria Xerostomia Miosis

Hint: Muscarinic & Nicotinic effect Miosis Pupillary constriction, a common ADE due to the excessive muscarinic stimulation that causes difficulty with visual accommodation

A nurse is caring for a client who is receiving filgrastim. Which of the following findings should the nurse document to indicate the effectiveness of the therapy? increase neutrophil count Increased neutrophil count Increased RBC count Decreased prothrombin time Decreased triglycerides

Increased neutrophil count Filgrastim stimulates the bone marrow to produce neutrophils. For clients receiving chemotherapy, the risk of infection is minimized

A nurse is planning care for a client who is prescribed metoclopramide following bowel surgery. For which of the following adverse effects should the nurse monitor? Muscle weakness Sedation Tinnitus Peripheral edema

Sedation Metoclopramide has multiple CNS adverse effects, including dizziness, fatigue, and sedation.

A nurse is caring for a client who is taking acetazolamide for chronic open angle glaucoma. For which of the following adverse effects should the nurse instruct the client to monitor and report Tingling of fingers Constipation Weight gain Oliguria

Tingling of fingers The nurse should instruct the client to report the adverse effect of paresthesia, a tingling sensation in the extremities, when taking acetazolamide.

A nurse on the acute care unit is caring for a client who is receiving GENTAMICIN IV. The nurse should report which of the following findings to the provider as an adverse effect of the medication? Constipation Tinnitus Hypoglycemia Joint pain

Tinnitus Aminoglycosides, such as gentamicin, are ototoxic, which can manifest as tinnitus and deafness. The nurse should monitor the client for high-pitched ringing in the ears and headaches and should notify the provider if these occur.

A nurse at an urgent care clinic is collecting a history from a female client who has a urinary tract infection. The nurse anticipates a prescriptions for ciprofloxacin. The nurse should identify that which of the following client statements indicates a contraindication for administering this medication? "I have tendonitis, so I haven't been able to exercise." "I take a stool softener for chronic constipation." "I take medicine for my thyroid." "I am allergic to sulfa."

"I have tendonitis, so I haven't been able to exercise." The nurse should identify tendonitis as a contraindication for taking ciprofloxacin due to the risk of tendon rupture. Diarrhea is an adverse effect of the medication. Ciprofloxacin is a quinolone antibiotic. Therefore, the client who has a sulfa allergy can take this medication.

A nurse is providing teaching to a client who has a gastric ulcer and a new prescription for famotidine. Which of the following instructions should the nurse include? "Take the medication on an empty stomach for full effectiveness." "You may discontinue this medication when stomach discomfort subsides." "Report yellowing of the skin." "You will be taking this medication for 2 weeks."

"Report yellowing of the skin." Famotidine can be hepatotoxic and cause jaundice. The nurse should instruct the client to monitor for and report yellowing of the skin or eyes to the provider.

A nurse is caring for a client who received 0.9% sodium chloride 1 L over 4 hr instead of over 8 hr as prescribed. Which of the following information should the nurse enter as a complete documentation of the incident? IV fluid infused over 4 hr instead of the prescribed 8 hr. Client tolerated fluids well, provider notified. 0.9% sodium chloride 1 L IV infused over 4 hr. Vital signs stable, provider notified 1 L of 0.9% sodium chloride completed at 0900. Client denies shortness of breath. IV fluid initiated at 0500. Lungs clear to auscultation.

0.9% sodium chloride 1 L IV infused over 4 hr. Vital signs stable, provider notified

A nurse is teaching a client about warfarin. The client asks if she can take aspirin while taking the warfarin. Which of the following responses should the nurse make? It is safe to take an enteric coated aspirin Aspirin will increase the risk of bleeding Acetaminophen may be substituted for aspirin The INR lab work must be monitored more frequently if aspirin is taken

Aspirin will increase the risk of bleeding Aspirin inhibits platelet aggregation and can potentiate the action of the anticoagulant warfarin. Therefore, the client should avoid taking aspirin because it increases the risk for bleeding.

a nurse is reviewing the medication list of a client who wants to begin taking oral contraceptives. The nurse should identify that which of the following client medications will interfere with the effectiveness of oral contraceptives? Carbamazepine Sumatriptan Atenolol Glipizide

Carbamazepine causes an accelerated inactivation of oral contraceptives because of its action on hepatic medication-metabolizing enzymes.

A nurse administers a dose of METFORMIN to a client instead of the prescribed dose of Metoclopramide. Which of the following actions should the nurse take first? Report the incident to the charge nurse Notify the provider Check the client's blood glucose Fill out an incident report

Check the client's blood glucose The first action the nurse should take using the nursing process is to assess the client. The client is at risk for hypoglycemia. The nurse should monitor the client's blood glucose and provide the client with a snack to reduce the risk for hypoglycemia.

A nurse is teaching a client who is to start taking hydrocodone with acetaminophen tablets for pain. Which of the following information should the nurse include in the teaching? The medication should be taken 1 hr prior to eating. It takes 48 hr for therapeutic effects to occur. Decreased respiration might occur. Tablets should not be crushed or chewed.

Decreased respiration might occur. The nurse should instruct the client that hydrocodone with acetaminophen might cause respiratory depression, which is an adverse effect of the medication. The client should avoid taking over-the-counter medications or newly prescribed medications without consulting their provider to avoid increased respiratory depression.

A nurse is reviewing the medication administration record of a client who has hypocalcemia and a new prescription for IV Calcium Gluconate. The nurse should identify that which of the following medications can interact with Calcium Gluconate? Felodipine Guaifenesin Digoxin Regular insulin

Digoxin The nurse should identify that calcium gluconate can cause hypercalcemia, which increases the risk of digoxin toxicity.

A nurse in an emergency department is caring for a client whose family reports the client has taken large amounts of diazepam. Which of the following medications should the nurse anticipate administering? Ondansetron Magnesium sulfate Flumazenil Protamine sulfate

Flumazenil The nurse should anticipate administering flumazenil, an antidote used to reverse benzodiazepines such as diazepam.

A nurse is providing teaching to a client who has PUD and is to start a new prescription for SUCRALFATE. Which of the following actions of sucralfate should the nurse include in the teaching? Decreases stomach acid secretion Neutralizes acids in the stomach Forms a protective barrier over ulcers Treats ulcers by eradicating H Pylori

Forms a protective barrier over ulcers Secretions by the parietal and chief cells, hydrochloric acid and pepsin, can further irritate the ulcerated areas. Sucralfate, a mucosal protectant, forms a gel-like substance that coats the ulcer, creating a barrier to hydrochloric acid and pepsin.

A nurse is collecting a medication history from a client who has a new prescription for lithium. The nurse should identify that the client should discontinue which of the following over Aspirin Ibuprofen Famotidine Bisacodyl

Ibuprofen Most NSAIDs can significantly increase lithium levels. Therefore, the client should not take ibuprofen and lithium concurrently.

A nurse is assessing a client who is taking propylthiouracil for the treatment of Graves' disease. Which of the following findings should the nurse identify as an indication that the medication has been effective? Increase in ability to focus

Increase in ability to focus A client who has Graves' disease can experience psychological manifestations such as difficulty focusing, restlessness, and manic-type behaviors. Propylthiouracil is a thyroid hormone antagonist that decreases the circulating T4 hormone, reducing the manifestations of hyperthyroidism. An increased ability to focus indicates that the medication has been effective.

A nurse is providing teaching to a client who is taking bupropion as an aid to quit smoking. which of the following finding should the nurse identify as an adverse effect of the medication? Cough Joint pain Alopecia Insomnia

Insomnia Bupropion, an atypical antidepressant, has stimulant properties, which can result in agitation, tremors, mania, and insomnia.

A nurse is planning to teach about the use of a spacer to a child who has a new prescription for a fluticasone inhaler to treat chronic asthma. the nurse should include that the spacer deceases the risk for which of the following adverse effect of the medication? Oral Candidiasis Headache Joint pain Adrenal suppression

Oral candidiasis Dysphonia and oral candidiasis are adverse effects of inhaled corticosteroids. Using a spacer and rinsing the mouth after inhalation will minimize the amount of medication remaining in the oropharynx, preventing the development of these adverse effects.

A nurse is caring for a 20 year old female client who has been prescribed isotretinoin for severe nodulocystic acne vulgaris. Before the client can obtain a refill, the nurse should advise the client which of the following tests will be required Serum calcium Pregnancy test 24 hour urine collection for protein Aspartate aminotransferase level

Pregnancy test The nurse should instruct the client that isotretinoin has teratogenic effects; therefore, pregnancy must be ruled out before the client can obtain a refill. The client must provide two negative pregnancy tests for the initial prescription and one negative test before monthly refills.

A nurse is developing a teaching plan for a client who has a new prescription for simvastatin. Which of the following instructions should the nurse include in the teaching plan? (Select all that apply.) Report muscle pain to the provider Avoid taking the medication with grapefruit juice Take the medication in the early morning Expect a flushing of the skin as a reaction to the medication Expect therapy with this medication to be lifelong

Report muscle pain to the provider Avoid taking the medication with grapefruit juice Expect therapy with this medication to be lifelong

A nurse is providing teaching to a client who is to start treatment for asthma with beclomethasone and albuterol inhalers. Which of the following instructions should the nurse include in the teaching? "Take beclomethasone to avoid an acute attack." "Use beclomethasone 5 minutes before using albuterol." "Limit your calcium and vitamin D intake when taking beclomethasone." "Rinse your mouth after inhaling beclomethasone"

Rinse your mouth after inhaling beclomethasone The client should rinse their mouth after using beclomethasone, a glucocorticoid inhaler, to prevent oropharyngeal candidiasis and hoarseness.

A nurse is providing discharge teaching about handling medication to a client who is to continue taking oral transmucosal fentanyl raspberry-flavored lozenges on a stick. Which of the following information should the nurse include in the teaching? Store unused medication sticks in a storage container.

Store unused medication sticks in a storage container. The nurse should instruct the client to store unused, used, or partially used medication sticks in the safe storage container that comes in the kit when the medication is initially prescribed.

A nurse is assessing a client who is postoperative following an outpatient endoscopy procedure using midazolam. The nurse should monitor for which of the following findings as an indication that the client is ready for discharge? The client's capnography has returned to baseline.

The client's capnography has returned to baseline. The nurse should identify that the client is ready for discharge when the capnography level indicates that gas exchange is adequate.

A nurse is caring for a client who has acute acetaminophen toxicity. The nurse should anticipate administering which of the following medication? Vitamin K Acetylcysteine Benztropine Physostigmine

Acetylcysteine Acetylcysteine is a specific antidote for acetaminophen toxicity. It can prevent severe injury when given orally or by IV infusion within 8 to 10 hr. Vitamin K --> used to treat increased WARFARIN (indicated by elevated PT/INR) Benztropine (anticholinergic med) used to treat ADE of Parkinson's disease by reducing rigidity and tremors Physostigmine (effective antidote for antimuscarinic poisoning from medications such as atropine, scopolamine, some antihistamines, phenothiazines, and tricyclic antidepressants. It has no effect on acetaminophen toxicity.)

A nurse is planning care for a client who is receiving mannitol via continuous IV infusion. The nurse should monitor the client for which of the following adverse effects? Weight loss Increased intraocular pressure Auditory hallucinations Bibasilar crackles

Bibasilar crackles Mannitol, an osmotic diuretic, can precipitate heart failure and pulmonary edema. Therefore, the nurse should recognize lung crackles as an indicator of a potential complication and stop the infusion.

A nurse is providing teaching to a client who has a prescription for ergotamine sublingual to treat migraine headaches. Which of the following information should the nurse include in the instructions? "Take one tablet three times a day before meals." "Take one tablet at onset of migraine." "Take up to eight tablets as needed within a 24-hour period." "Take one tablet every 15 minutes until migraine subsides."

Take one tablet at onset of migraine The client should take one tablet immediately after the onset of aura or headache

A nurse is assessing a client who has schizophrenia and is taking haloperidol. The nurse should report which of the following to the provider as a manifestation of neuroleptic malignant syndrome (NMS)? Temperature of 39.7° C (103.5° F) Urinary retention Heart rate 56/min Muscle flaccidity

Temperature of 39.7° C (103.5° F) The nurse should report fever to the provider as an indication of NMS, an acute life-threatening emergency. Other manifestations can include respiratory distress, diaphoresis, and either hyper- or hypotension.

A nurse is caring for a client who is in labor. The client is receiving oxytocin by continuous IV infusion with a maintenance IV solution. The external FHR monitor indicates late decelerations. Which of the following actions should the nurse take first? Turn the client to a side-lying position Disconnect the client's oxytocin from the maintenance IV Apply O2 to the client by face mask Increase the client's maintenance IV infusion rate

Turn the client to a side-lying position The greatest risk to the fetus experiencing late decelerations is injury from uteroplacental insufficiency. Therefore, the priority action the nurse should take is to place the client in a lateral position.

A nurse is teaching a client about the use of risedronate for the treatment of osteoporosis. The nurse should identify which of the following statements as an indication that the client understands the teaching? "I will drink a glass of milk when I take the risedronate." "I will take the risedronate 15 minutes after my evening meal." "I should take an antacid with the risedronate to avoid nausea." "I should sit up for 30 minutes after taking the risedronate."

"I should sit up for 30 minutes after taking the risedronate." Sitting upright for at least 30 min after taking risedronate will reduce the adverse gastrointestinal effects of esophagitis and dyspepsia. Risedronate is contraindicated for a client who cannot sit or stand upright for this length of time.

A nurse is providing discharge instructions to a client who has heart failure and a new prescription for captopril. Which of the following client statements indicates an understanding of the teaching? "I should take the medication with food." "I should take naproxen if I develop joint pain." "I should tell my provider if I develop a sore throat." "I should expect the medication to cause my urine to look orange."

"I should tell my provider if I develop a sore throat." The client should report a sore throat to the provider because this can indicate neutropenia, a serious adverse effect of captopril. Neutropenia can be reversed if it is identified early and the medication is promptly discontinued.

A nurse is instructing a client on the application of nitroglycerin transdermal patches. Which of the following statements by the client indicates an understating of the teaching? "I should apply a patch every 5 minutes if I develop chest pain." "I will take the patch off right after my evening meal" "I will leave the patch off at least 1 day each week." "I should discard the used patch by flushing it down the toilet."

"I will take the patch off right after my evening meal" Clients should remove the patch each evening for a medication free time of 12 to 14 hr before applying a new patch to avoid developing a tolerance to the medication's effects.

A nurse in an emergency department is caring for a client who has myasthenia gravis and is in a cholinergic crisis. Which of the following medications should the nurse plan to administer? Potassium Iodide Glucagon Atropine Protamine

Atropine A cholinergic crisis is caused by an excess amount of cholinesterase inhibitor, such as neostigmine. The nurse should plan to administer atropine, an anticholinergic agent, to reverse cholinergic toxicity

A nurse is providing teaching to a client who has multiple sclerosis and a new prescription for methlypredinisolone. which of the following instructions should the nurse include? Blood glucose levels will be monitored during therapy Avoid contact with people who have known infections Take the medication 1 hour before breakfast Decrease dietary intake of foods containing potassium Grapefruit juice can increase the effects of the medication

Blood glucose levels will be monitored during therapy The nurse should monitor the client for hyperglycemia while providing methylprednisolone to the client. Glucocorticoids, such as methylprednisolone, increase serum glucose levels and can require management with insulin or antihyperglycemics. Avoid contact with people who have known infections The nurse should instruct the client to avoid exposure to infectious agents, such as contact with those who have active infections or illnesses. Glucocorticoids, such as methylprednisolone, depress the immune system, placing the client at an increased risk for developing an infection. Grapefruit juice can increase the effects of the medication The nurse should instruct the client that grapefruit and grapefruit juice can increase the level of methylprednisolone in the body.

A nurse receives a verbal order from the provider to administer morphine five milligrams every 4 hours subcutaneously for severe pain as needed. The nurse should identify which of the following entries as the correct format for the medication administration record (MAR)? MSO4 5 mg subcut every 4 hr PRN severe pain Morphine 5 mg subcut every 4 hr PRN severe pain MSO4 5 mg SQ every 4 hr PRN severe pain Morphine 5.0 mg subcutaneously every 4 hr PRN severe pain

Morphine 5 mg subcut every 4 hr PRN severe pain The nurse should identify this entry as the correct format for the MAR. The medication name is spelled out and there are not any abbreviations from The Joint Commission's "Do Not Use" list included in the transcription.

A nurse is reviewing the ECG of a client who is receiving IV furosemide for HF. The nurse should identify which of the following as an indication of hypokalemia? Tall, tented T waves Presence of U waves Widened QRS complex ST elevation

Presence of U waves Manifestation of HYPERkalemia - Tall, tented T waves - Widened QRS complex Manifestation of HYPOkalemia - PRESENCE OF U WAVES - Flattened or inverted T-waves - ST depression Manifestation of ischemia - ST elevation