ATI Pharmacology 2019 B

A nurse is providing teaching for a client who has multiple sclerosis and a new prescription for methylprednisolone. Which of the following instructions should the nurse include? (SATA) A. Blood glucose levels will be monitored during therapy. B. Avoid contact with people who have known infections. C. Take the medication 1 hr before breakfast. D. Decrease dietary intake of foods containing potassium. E. Grapefruit juice can increase the effects of this medication.

A, B, E "Blood glucose levels will be monitored during therapy" : The nurse should instruct the client that their blood glucose levels will be monitored during therapy because corticosteroids, such as methylprednisolone, can raise blood glucose levels. "Avoid contact with persons who have known infections": The nurse should instruct the client to avoid contact with persons who have known infections because corticosteroids, such as methylprednisolone, suppress the immune response and mask manifestations of infection. "Grapefruit juice can increase the blood levels of the medication": The nurse should instruct the client that grapefruit juice increases the absorption of the medication, which can lead to toxicity and adrenal suppression.

Nurse is completing incident report for med error. Which of following information should nurse include in report?

Administered propranolol 80 mg PO at 1800 to the client who did not have a prescription for the medication. The incident report should clearly and thoroughly report the facts of the error.

The nurse is caring for a pt who has hypocalcemia and is receiving calcium citrate. The nurse should identify that which of following findings indicates therapeutic response to med? A. Client report of decreased paresthesia B. A calcium level of 8.8 mg/dL

Client report of decreased paresthesia Paresthesia is a manifestation of hypocalcemia. A client report of a decrease in paresthesia is an indication of a therapeutic response to calcium citrate. The nurse should also monitor for a decrease in other manifestations of hypocalcemia, including muscle twitching and cardiac dysrhythmias. A calcium level of 8.8 mg/dL is below the reference range of 9.0 to 10.5 mg/dL and does not indicate a therapeutic response to calcium citrate.

Nurse is reviewing lab results for pt who is to receive dose of ceftazidime via intermittent IV bolus. Which of following lab findings is priority for nurse to report to provider before administering the medication? A. Total bilirubn 0.4 mg/dL B. Alanine aminotransferase 26 units/L C. Platelet count 360,000/mm^3 D. Creatinine 2.6 mg/dL

Creatinine 2.6 mg/dL Rationale: Ceftazidime is excreted primarily by the renal system. A serum creatinine level above 1.3 mg/dL can indicate a kidney disorder requiring a reduction in the dose administered. The nurse should notify the provider, who is likely to prescribe a lowered dose of medication. a total bilirubin value of 0.4 mg/dL is within the expected reference range. an alanine aminotransferase value of 26 units/L is within the expected reference range. platelet count of 360,000/mm3 is within the expected reference range.

Nurse is caring for a client who is taking atorvastatin for hyperlipidemia. Which of following client laboratory values should the nurse monitor? A. Creatinine kinase B. Erythrocyte sedimentation rate C. International normalized ratio D. Potassium

Creatinine kinase Rationale: The client who is taking atorvastatin can develop an adverse effect called rhabdomyolysis, which causes muscle weakness or pain and can progress to myositis. Creatinine kinase levels rise in response to enzymes released with muscle injury.

A nurse is teaching a client who is taking allopurinol for the treatment of gout. Which of the following information should the nurse include in the teaching? A. Plan to increase the dosage each week by 200 mg increments. B. Prolonged use of this medication can cause glaucoma. C. Drink 2 L of water daily. D. A fine red rash is transient and can be treated with antihistamines.

Drink 2 L of water daily. The nurse should instruct the client to drink at least 2 L of water each day to prevent renal stone formation and kidney injury, because allopurinol is eliminated through the kidneys.

Nurse is providing teaching to a client who has prescription for trimethoprim/sulfamethoxazole. Which of following instructions should nurse include in teaching? A. Take the medication with food B. Expect a fine, red rash as a transient effect C. Drink 8 to 10 glasses of water daily D. Store the medication in the refrigerator

Drink 8 to 10 glasses of water daily. Rationale: The nurse should instruct the client to increase water intake to 1,920 to 2,400 mL (65 to 81 oz) a day to decrease the chance of kidney damage from crystallization. The nurse should instruct the client to take the medication on an empty stomach either 1 hour before or 2 hours after meals. The nurse should instruct the client to notify the provider if a rash develops, because this can be an indication of Stevens-Johnson syndrome. However, the client should not expect to have a fine, red rash as a transient effect. The nurse should inform the client to store trimethoprim/sulfamethoxazole in a light-resistant container at room temperature.

Nurse is preparing to administer hydrochlorothiazide (HCTZ) to a client. Which of following actions should nurse take prior to administering the medication? A. Ask the client to drink 8oz of water B. Review the client's most recent Hgb level C. Obtain the client's blood pressure D. Determine if the client is allergic to NSAIDs

Obtain the client's blood pressure. Rationale: HCTZ is a thiazide diuretic administered to promote urine output and reduce blood pressure and edema. The nurse should obtain the client's blood pressure prior to administration of the medication.

A nurse is monitoring for adverse effects of hydrochlorothiazide after administering the medication to an older adult client who has heart failure. Which of the following findings should the nurse identify as an adverse effect of the medication? A. Hypoglycemia B. Orthostatic hypotension C. Bradycardia D. Xanthopsia

Orthostatic hypotension The nurse should identify that hydrochlorothiazide is an antihypertensive thiazide diuretic medication, which can cause orthostatic hypotension and light headedness. Therefore, the nurse should instruct the client to rise slowly when moving from a recumbent to a standing position. Hydrochlorothiazide is an antihypertensive thiazide diuretic medication, which can cause hyperglycemia. The nurse should identify palpitations as an adverse effect of hydrochlorothiazide, which is an antihypertensive thiazide diuretic medication. The nurse should identify that hydrochlorothiazide is an antihypertensive thiazide diuretic medication and has an adverse effect of blurred vision. Xanthopsia causes objects to appear yellow and is not an adverse effect of this medication.

Nurse is caring for pt who has DM and is taking glyburide. Pt reports feeling confused and anxious. Which of following actions should nurse take 1st? A. Perform a capillary blood glucose test. B. Provide the client with a protein-rich snack. C. Give the client 120 mL (4 oz) of orange juice. D. Schedule an early meal tray

Perform a capillary blood glucose test. The greatest risk to this client is injury from hypoglycemia. Therefore, the nurse should perform a capillary blood glucose test to determine the client's blood glucose status. Manifestations of hypoglycemia include weakness, anxiety, confusion, sweating, and seizures.

Nurse is providing teaching to a client who is to start therapy with digoxin. For which of following adverse effects should nurse instruct client to monitor and report to provider? A. Dry cough B. Pedal edema C. Bruising D. Yellow-tinged vision

Yellow-tinged vision The nurse should instruct the client to monitor for and report yellow-tinged vision, which is a sign of digoxin toxicity. Other manifestations of digoxin toxicity include nausea, vomiting, loss of appetite, and fatigue. As the digoxin levels increase, the client can experience cardiac dysrhythmias.

Nurse is caring for a client who is receiving end-of-life care and has a prescription for fentanyl patches. Which of the following information regarding the adverse effects of fentanyl should the nurse plan to give to the client and family? A. The provider will prescribe naloxone at home for respiratory depression B. Remove the patch to reverse the adverse effects immediately C. Expect an increase in urinary output D. Take a stool softener on a daily basis

Take a stool softener on a daily basis. Rationale: Constipation is an adverse effect of opioid use. Stool softeners can decrease the severity of this adverse effect.

A nurse is reviewing the medical record of a client who has schizophrenia and a prescription for clozapine. Which of the following laboratory tests should the nurse review before administering the medication? A. Troponin B. Total cholesterol C. Creatinine D. Thyroid stimulating hormone

Total cholesterol The nurse should review the client's total cholesterol before administering clozapine, because this medication can cause hyperlipidemia.