ATI Pharmacology Practice Assessment (Analgesic and F&E Meds)

A nurse is caring for a client who is refusing their scheduled morning furosemide. Which of the following statements should the nurse make? A. "By not taking your furosemide, you might retain fluid and develop swelling" B. " You can double your dose this evening if that would be better for you" C. "If you do not take your furosemide, we might get in trouble" D. "I'll go ahead and mix the furosemide into your breakfast cereal"

A. "By not taking your furosemide, you might retain fluid and develop swelling" The nurse should respect the client's right to refuse the medication and inform the client of the risks of not taking the medication, notify the provider, and document the refusal. Furosemide is a loop diuretic given to reduce edema.

A nurse in a provider's office is assessing a client who has been taking aspirin daily for the past year. for which of the following findings should the nurse report to the provider immediately? A. Hyperventilation B. Heartburn C. Anorexia D. Swollen ankles

A. Hyperventilation When using the urgent vs. nonurgent approach to client care, the nurse should determine that the priority finding is hyperventilation. This finding indicates the client might have acute salicylate poisoning, which causes respiratory alkalosis in the early stages.

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

B. 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.

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

B. Presence of U-waves The nurse should identify the presence of U-waves as a manifestation of hypokalemia, an adverse effect of furosemide.

A nurse is preparing to administer hydrochlorothiazide (HCTZ) to a client. Which of the following actions should the nurse take prior to administering this medication? A. Ask the client to drink 8 oz 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.

C. Obtain the client's blood pressure. 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 planning to discharge teaching for a client who has a prescription for furosemide. The nurse should plan to include which of the following statements in teaching? A. "This medication increases your risk for hypertension." B. "Avoid potassium-rich foods in your diet." C. "Take each dose of medication in the evening before bed." D. "Drink a glass of milk with each dose of medication."

D. "Drink a glass of milk with each dose of medication." The client should take furosemide with food or milk to reduce gastric irritation.

A nurse is preparing to administer PO sodium polystyrene sulfonate to a client that has hyperkalemia. Which of the following actions should the nurse plan to take? A. Hold the client's other oral medications for 8 hr post-administration. B. Inform the client that this medication can turn the stool a light tan color. C. Keep the client's solution in the refrigerator for up to 72 hr. D. Monitor the client for constipation.

D. Monitor the client for constipation. The nurse should monitor the client for the adverse effect of constipation and report it to the provider because this can lead to fecal impaction.

A nurse is providing discharge teaching to a client who has a new prescription for furosemide twice daily. The nurse should include which of the following instructions in the teaching? (Select all apply) A. "Take the second dose at bedtime." B. "Increase intake of potassium-rich foods." C. "Obtain your weight weekly." D. "Monitor for muscle weakness." E. "Dangle your legs from the side of the bed before standing."

B. "Increase intake of potassium-rich foods" Loop diuretics, such as furosemide, act at the loop of Henle by blocking the resorption of sodium, water, and potassium. An adverse effect of the medication is the development of electrolyte imbalances such as hyponatremia, hypochloremia, and hypokalemia. To prevent hypokalemia, the client should increase intake of potassium-rich foods, such as potatoes, spinach, dried fruit, and nuts. D. "Monitor for muscle weakness" Furosemide, a loop diuretic, causes a loss of potassium, which can result in manifestations of hypokalemia such as difficulty concentrating, shallow respirations, hyporeflexia, and muscle weakness. The nurse should instruct the client to monitor for these manifestations and report them to the provider. E. "Dangle your legs from the side of the bed before standing" Loop diuretics, such as furosemide, reduce vascular tone and increase fluid excretion. These effects decrease blood return to the heart and can manifest as dizziness and lightheadedness when going from a lying to a standing position. The client should change positions slowly to minimize orthostatic hypotension.

A nurse in an emergency department is caring for a client who has heroin toxicity. The client is unresponsive with pinpoint pupils and a respiratory rate of 6/min. Which medication should the nurse plan to administer? A. Methadone B. Naloxone C. Diazepam D. Bupropion

B. Naloxone The nurse should administer naloxone, an opioid antagonist, to a client who has heroin toxicity to reverse the respiratory depressive effects of the heroin. However, the nurse should not administer naloxone too quickly because naloxone can cause hypertension, tachycardia, nausea, vomiting, and might cause the client to enter a state of opioid withdrawal.

A nurse is monitoring for the adverse effects of hydrochlorothiazide after administering the medication to an older adult 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. Conjunctivitis

B. 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.

A nurse is assessing a client 1 hr after administering morphine for pain. The nurse should identify which of the following findings as as the best indication that the morphine has been effective? A. The client's vital signs are within normal limits. B. The client has not requested additional medication. C. The client is resting comfortably with eyes closed. D. The client rates pain as 3 on a scale from 0 to 10.

D. The client rates pain as 3 on a scale from 0 to 10. The client's description of the pain is the most accurate assessment of pain.