ATI Pharmacology Proctored CME - Modified

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A nurse is preparing to administer acetaminophen 650 mg PO every 6 hr PRN for pain. The amount available is acetaminophen liquid 500 mg/5 mL. how many mL should the nurse administer per dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.

6.5

A nurse is preparing to administer furosemide 80 mg PO daily. The amount available is furosemide oral solution 10 mg/1 mL. how many mL should the nurse administer? (Round the answer to the nearest whole number. Do not use a trailing zero.)

8

A nurse is caring for a group of clients who are not protected against Varicella. The nurse should prepare to administer the Varicella vaccine at this time to which of the following clients?

A 32‑year‑old man who has essential hypertension

A nurse is caring for a client who is taking Propylthiouracil. For which of the following adverse effects of this medication should the nurse monitor?

Bradycardia

A nurse is preparing to administer Butorphanol to a client who has a history of substance use disorder. The nurse should identify which of the following information as true regarding Butorphanol?

Butorphanol can cause abstinence syndrome in opioid‑dependent clients

A nurse is administering IV Acyclovir to a client who has Varicella. Which of the following actions should the nurse take?

Monitor for a for hypotension

A nurse is teaching a client who has a new prescription for Escitalopram for treatment of generalized Anxiety disorder. Which of the following statements by the client indicates understanding of the teaching?

"I need to discontinue this medication slowly."

A nurse is teaching a client who has a new prescription for Baclofen to treat muscle spasms. Which of the following statements by the client indicates an understanding of the teaching? (Select all that apply.)

"I know the doctor will gradually increase my dose of this medication for a while." "I should increase fiber to prevent constipation from this medication." "I won't be able to drink alcohol while I'm taking this medication."

A nurse is teaching a client who has Anemia and a new prescription for a liquid Iron supplement. Which of the following information should the nurse include in the teaching? (Select all that apply.)

"Add foods that are high in fiber to your diet." "Rinse your mouth after taking the medication." "Expect stools to be green or black in color." "Add red meat to your diet."

A nurse is teaching a client who has Angina Pectoris and is learning how to treat acute Anginal attacks. The clients asks, "What is my next step if I take one tablet, wait 5 minutes, but still have Anginal pain?" Which of the following responses should the nurse make?

"Call the emergency response team."

A nurse is providing discharge instructions for a client who has a new prescription for an antihypertensive medication. Which of the following statements should the nurse give?

"Change positions slowly when you move from sitting to standing."

A nurse is preparing a teaching plan for a female client who has Bipolar disorder and a new prescription for Carbamazepine. Which of the following instructions should the nurse include in the teaching? (Select all that apply.)

"Eliminate grapefruit juice from your diet." "You will need to have a complete blood count and carbamazepine levels drawn periodically." "Notify your provider if you develop a rash." "Avoid driving for the first few days after starting this medication.

A nurse is teaching the family of a child who has Cystic Fibrosis and a new prescription for Acetylcysteine. Which of the following information should the nurse include in the instructions?

"Expect this medication to smell like rotten eggs."

A nurse is teaching a client who has active tuberculosis about his treatment regimen. The client asks why he must take four different medications. Which of the following responses should the nurse make?

"Four medications reduce the chance that the bacteria will become resistant.

A nurse is teaching a female client who has tobacco use disorder about Nicotine replacement therapy. Which of the following statements by the client indicates understanding of the teaching?

"I should avoid eating right before I chew a piece of nicotine gum."

A nurse is teaching a client about taking Tetracycline to treat a GI infection due to Helicobacter pylori, Which of the following statements should the nurse identify as an indication that the client understands the instructions?

"I will let my doctor know if I start having diarrhea."

A nurse is evaluating teaching for a client who has Rheumatoid Arthritis and a new prescription for Methotrexate. Which of the following statements by the client indicates understanding of the teaching? A. "I will be sure to return to the clinic at least once a year to have my blood drawn while I'm taking methotrexate."

"I'll let the doctor know if I develop sores in my mouth while taking this medication. (Ulcerations in the mouth, tongue, or throat are often the first signs of methotrexate toxicity and should be reported to the provider immediately)

A nurse is providing teaching to a client who has type 2 Diabetes Mellitus and is starting Repaglinide. Which of the following statements by the client indicates understanding of the administration of this medication?

"I'll take this medicine 30 minutes before I eat."

A nurse is providing teaching to a client who has a prescription for Pramlintide for type 1 Diabetes Mellitus. Which of the following should the nurse include in the teaching? (Select all that apply.)

"Inject pramlintide just before a meal." "Discard open vials after 28 days.

A nurse is caring for a client who requests information on the use of Feverfew. Which of the following responses should the nurse make?

"It can decrease the frequency of migraine headaches."

A nurse is teaching a client about the use of Fluticasone to treat Perennial Rhinitis. Which of the following statements by the client indicates an understanding of the teaching?

"It can take as long as 3 weeks before the medication takes a maximum effect."

A nurse is teaching a client who has OCD and has a new prescription for Paroxetine. Which of the following instructions should the nurse include?

"It can take several weeks before you feel like the medication is helping."

A nurse is preparing to administer Leucovorin to a client who has cancer and is receiving chemotherapy with Methotrexate. Which of the following responses should the nurse use when the client asks why Leucovorin is being given?

"Leucovorin protects healthy cells from methotrexate's toxic effect."

A nurse is providing teaching for a male client who has Schizophrenia and is taking Risperidone. Which of the following instructions should the nurse include in the teaching?

"Notify the provider if you develop breast enlargement."

A nurse is providing instructions to a female client who has a new prescription for Zolpidem. Which of the following instructions should the nurse include?

"Notify the provider if you plan to become pregnant."

A nurse in a provider's office is instructing a parent of a toddler how to administer ear drops. Which of the following instructions should the nurse include? (Select all that apply.)

"Place the child on his unaffected side when you are ready to administer the medication." "Warm the medication by gently rolling it between your hands for a few minutes." "Gently shake medication that is in suspension form." "keep the child on his side for 5 minutes after instillation of the ear drops."

A nurse is providing information about Probiotic supplements to a male client. Which of the following information should the nurse include? (Select all that apply.)

"Probiotics are micro‑organisms that are normally found in the GI tract." "Probiotics are used to treat Clostridium difficile." "You can experience bloating while taking probiotic supplements."

A nurse is teaching a client who has Graves' disease about her prescribed medications. Which of the following statements by the client indicates an understanding of the use of Propranolol in the treatment of Graves' disease?

"Propranolol will decrease my tremors and fast heart beat."

A nurse is teaching a client who has angina how to use nitroglycerin transdermal ointment. The nurse should include which of the following instructions?

"Remove the prior dose before applying a new dose."

A nurse is teaching a client who has a new prescription for Beclomethasone. Which of the following instructions should the nurse include?

"Rinse your mouth after each use of this medication."

A nurse is providing a client who has Peptic Ulcer Disease with instructions about managing his condition. Which of the following instructions should the nurse include? (Select all that apply.)

"Seek measures to reduce stress." "Avoid smoking."

A nurse is caring for a client who has end‑stage cancer and is receiving Morphine. The client's daughter asks why the provider prescribed Methylnaltrexone. Which of the following responses should the nurse make?

"The medication will relieve your mother's constipation."

A nurse is teaching a client who has a new prescription for combination oral NRTIs (abacavir, lamivudine, and zidovudine) for treatment of hIV. Which of the following statements should the nurse include?

"These medications work by inhibiting enzymes to prevent hIV replication."

A nurse is teaching a client who has a new prescription for Brimonidine ophthalmic drops and wears soft contact lenses. Which of the following instructions should the nurse include in the teaching?

"This medication can absorb into your contacts."

A nurse is providing teaching to a client who has a new prescription for Buspirone to treat Anxiety. Which of the following information should the nurse include?

"This medication has a low risk for dependency."

A nurse is teaching a client about Terbutaline. Which of the following statements by the client indicates understanding of the teaching?

"This medication will stop my contractions."

A nurse is providing instructions to the parent of an adolescent client who has a new prescription for Albuterol, PO. Which of the following instructions should the nurse include?

"Tremors are an adverse effect of this medication."

A nurse is reviewing a new prescription for oxcarbazepine with a female client who has partial seizures. Which of the following instructions should the nurse include? (Select all that apply.)

"Use caution if given a prescription for a diuretic medication." "Consider using an alternate form of contraception if you are using oral contraceptives." "Avoid driving until you see how the medication affects you." "Notify your provider if you develop a skin rash

A nurse is providing discharge teaching to a client who has a new prescription for Fluoxetine for PTSD. Which of the following statements should the nurse include in the teaching?

"You may have a decreased desire for intimacy while taking this medication."

A nurse is providing discharge teaching to a client who has a new prescription for Clozapine. Which of the following statements should the nurse include in the teaching?

"You should have your white blood cell count monitored every week.

A nurse is preparing to administer heparin 15,000 units subcutaneously every 12 hr. The amount available is heparin injection 20,000 units/mL. How many mL should the nurse administer per dose? (Round the answer to the nearest tenth. Do not use a trailing zero.

0.8

A nurse is administering gentamicin by IV infusion at 0900. The medication will take 1 hr to infuse. When should the nurse plan to obtain a blood sample for a peak serum level of gentamicin?

1030

A nurse is preparing to administer dextrose 5% in water (D5W) 750 mL IV to infuse over 6 hr. The nurse should set the IV pump to deliver how many mL/hr? (Round the answer to the nearest whole number. Do not use a trailing zero.

125

A nurse is caring for several clients who came to the clinic for a seasonal influenza immunization. The nurse should identify that which of the following clients is a candidate to receive the vaccine via nasal spray rather than an injection?

17‑year‑old who has a hypersensitivity to Penicillin

A nurse is preparing to administer Haloperidol 2 mg PO every 12 hr. The amount available is haloperidol 1 mg/tablet. how many tablets should the nurse administer? (Round the answer to the nearest whole number. Do not use a trailing zero.

2

A nurse is preparing to administer clindamycin 200 mg by intermittent IV bolus. The amount available is clindamycin injection 200 mg in 100 mL 0.9% sodium chloride (0.9% NaCl) to infuse over 30 min. The nurse should set the IV pump to deliver how many mL/hr? (Round the answer to the nearest whole number. Do not use a trailing zero.

200

A nurse is preparing to administer vancomycin 1 g by intermittent IV bolus. Available is vancomycin 1 g in 100 mL of dextrose 5% in water (D5W) to infuse over 45 min. The drop factor of the manual IV tubing is 10 gtt/mL. The nurse should adjust the manual IV infusion to deliver how many gtt/min? (Round the answer to the nearest whole number. Do not use a trailing zero.

22

A nurse is caring for a client who has Reeclampsia and is receiving Magnesium Sulfate IV continuous infusion. Which of the following findings should the nurse report to the provider?

24 mL/hr urinary output

A nurse is evaluating a group of clients at a health fair to identify the need for folic acid therapy. Which of the following clients require folic acid therapy? (Select all that apply.)

24‑year‑old female who has no health problems 55-year‑old female who has alcohol use disorder

A nurse is preparing to administer Amoxicillin 20 mg/kg/day PO to divide equally every 12 hr to a preschooler who weighs 44 lb. The amount available is amoxicillin suspension 250 mg/5 mL. how many mL should the nurse administer per dose? (Round the answer to the nearest whole number. Do not use a trailing zero.)

4

A nurse is caring for four clients who have Peptic Ulcer Disease. The nurse should recognize Misoprostol is contraindicated for which of the following clients?

A client who is pregnant

A nurse in a clinic is caring for a group of clients. The nurse should contact the provider about a potential contraindication to a medication for which of the following clients? (Select all that apply.)

A client who takes Prednisone and has a possible Fungal infection A client who has chronic liver disease and is taking Hydrocodone A client who has a prosthetic heart valve, takes Warfarin, and reports a suspected pregnancy

A nurse orienting a newly licensed nurse is reviewing the procedure for taking a telephone prescription. Which of the following statements should the nurse identify as an indication that the newly licensed nurse understands the process?

A second nurse should listen to a telephone prescription to prevent errors in communication

A nurse is teaching a client who is taking Sucralfate PO for Peptic Ulcer Disease has a new prescription for phenytoin to control seizures. Which of the following instructions should the nurse include?

Allow a 2‑hr interval between these medications

A nurse in an outpatient facility is preparing to administer Nafcillin Im to an adult client who has an infection. Which of the following actions should the nurse plan to take? (Select all that apply.)

Administer the medication deeply into the ventrogluteal muscle. Ask the client about an allergy to penicillin before administering the medication. Monitor the client for 30 min following the injection

A nurse is admitting a client to an acute care facility for a total hip arthroplasty. The client takes hydrocortisone for Addison's disease. Which of the following actions is the nurse's priority?

Administering a supplemental dose of hydrocortisone

A nurse is completing a nursing history for a client who takes Simvastatin. The nurse should identify which of the following disorders as a contraindication to adding Ezetimibe to the client's medications?

Active hepatitis C

A charge nurse is teaching a group of nurses about the importance of prophylactic antimicrobial therapy. Which of the following information should the charge nurse include in the teaching? (Select all that apply.)

Administer prophylactic antimicrobial therapy to clients who report exposure to a sexually transmitted infection. Administer prophylactic antimicrobial therapy to clients who are having orthopedic surgery. Instruct clients who have a prosthetic heart valve about the need for prophylactic antimicrobial therapy before dental work. Consult the provider for prophylactic antimicrobial therapy for clients who have recurrent urinary tract infections

A nurse at a provider's office is preparing to administer RV, DTaP, hib, PCV13, and IPV immunizations to a 4‑month‑old infant. Which of the following actions should the nurse plan to take? (Select all that apply.)

Administer subcutaneous injections in the anterolateral thigh. Giving the infant a pacifier during injections

A nurse is providing instructions to a client who has a new prescription for Albuterol and Beclomethasone inhalers for the control of asthma. Which of the following instructions should the nurse include in the teaching?

Administer the albuterol inhaler prior to using the beclomethasone inhaler.

A nurse is reviewing the health history of a client who has migraine headaches and is to begin prophylaxis therapy with Propranolol. Which of the following findings in the client history should the nurse report to the provider?

An ECG indicates a first‑degree heart block

A nurse is teaching a school‑age child and his parents about a new prescription for Lisdexamfetamine. Which of the following information should the nurse include in the teaching? (Select all that apply.)

An adverse effect is CNS stimulation This medication raises the levels of dopamine in the brain This medication raises the levels of dopamine in the brain

A nurse is caring for a client who is taking oral Oxycodone The client states he is also taking Ibuprofen in three recommended doses daily. The nurse should identify that an interaction between these two medications will cause which of the following findings?

An increase in the expected therapeutic effect of both medications

A nurse is caring for a group of clients who are receiving antimicrobial therapy. Which of the following clients should the nurse plan to monitor for manifestations of antibiotic toxicity?

An older adult client who has prostatitis

A staff educator is reviewing medication dosages and factors that influence medication metabolism with a group of nurses at an in-service presentation. Which of the following factors should the educator include as a reason to administer lower medication dosages? (Select all that apply.)

Answer: Liver Failure Concurrent Use of medication the same pathway metabolizes

A nurse is preparing to administer eye drops to a client. Which of the following actions should the nurse take? (Select all that apply.)

Ask the client to look up at the ceiling Drop the medication into the center of the client's conjunctival sac Instruct the client to close her eye gently after instillation

A nurse is assessing a client who has chronic Neutropenia and who has been receiving Gilgrastim. Which of the following actions should the nurse take to assess for an adverse effect of filgrastim?

Assess for bone pain

A nursing is planning care for a client who is receiving Furosemide IV for peripheral edema. Which of the following interventions should the nurse include in the plan of care? (Select all that apply.)

Assess for tinnitus. Monitor serum potassium levels. Elevate the head of bed slowly before ambulation. Recommend eating a banana daily

A nurse is preparing to administer Pamidronate to a client who has bone pain related to cancer. Which of the following precautions should the nurse take when administering pamidronate?

Assess the IV site for Thrombophlebitis frequently during administration

A nurse is preparing to administer Propranolol to a client who has a dysrhythmia. Which of the following actions should the nurse plan to take?

Assist the client when she sits up or stands after taking this medication.

A nurse is teaching a client who is beginning a course of Metronidazole to treat an infection. For which of the following adverse effects should the nurse instruct the client to stop taking Metronidazole and notify the provider?

Ataxia

A nurse is caring for a client who receives Rituximab to treat Non‑hodgkin's Leukemia and who asks the nurse how Rituximab works. Which of the following should the nurse include?

Binds with specific antigens on tumor cells

A nurse is caring for a client who has Depression and a new prescription for Venlafaxine. For which of the following adverse effects should the nurse monitor this client? (Select all that apply)

Cough Dizziness Decreased libido

A nurse is caring for a client who received IV Verapamil to treat supraventricular tachycardia (SVT). The client's pulse rate is now 98/min and his blood pressure is 74/44 mg hg. The nurse should anticipate a prescription for which of the following IV medications?

Calcium gluconate

A nurse is caring for a young adult client whose serum Calcium is 8.8 mg/dL. Which of the following medications should the nurse anticipate administering to this client?

Calcium carbonate

A nurse is caring for a client who has a Cerebrospinal fluid infection with gram‑negative bacteria. Which of the following Cephalosporin antibiotics should the nurse expect to administer IV to treat this infection?

Cefepime

A nurse is reviewing a client's health record and notes that the client experiences permanent extrapyramidal effects caused by a previous medication. The nurse should recognize that the medication affected which of the following systems in the client?

Central nervous

A nurse is providing teaching to a client who has a new prescription for Amitriptyline for treatment of depression. Which of the following should the nurse include in the teaching? (Select all that apply.)

Change positions slowly to minimize dizziness. Chewing sugarless gum to prevent dry mouth

A nurse is teaching a client who has schizophrenia strategies to cope with anticholinergic effects of Fluphenazine. Which of the following should the nurse suggest to the client to minimize anticholinergic effects?

Chew sugarless gum to moisten the mouth.

A nurse is assessing a client who takes Lithium Carbonate for the treatment of Bipolar disorder. The nurse should recognize which of the following findings as a possible indication of toxicity to this medication?

Coarse tremors

A nurse is teaching a client who is taking Digoxin and has a new prescription for Colesevelam. Which of the following instructions should the nurse include in the teaching?

Colesevelam should be taken with food and at least 8 oz of water

A nurse is caring for a client who takes Paroxetine to treat PTSD and reports that he grinds his teeth during the night. The nurse should identify which of the following interventions to manage Bruxism? (Select all that apply.)

Concurrent administration of buspirone Use of a mouth guard Changing to a different class of antidepressant medication

A nurse is caring for a client who has a prescription for Bethanechol to treat urinary retention. The nurse should recognize that which of the following findings is a manifestation of muscarinic stimulation?

Excessive perspiration

A nurse is providing information to a client who has a new prescription for Hydrochlorothiazide. Which of the following information should the nurse include?

Expect increased swelling of the ankles.

A nurse in the operating room is caring for a client who received a dose of Succinylcholine. During the operation, the client suddenly develops rigidity, and his body temperature begins to rise. The nurse should anticipate a prescription for which of the following medications?

Dantrolene

A nurse is caring for a client who has breast cancer and asks why she is receiving a combination therapy of Cyclophosphamide, Methotrexate, and Fluorouracil. The response by the nurse should include that combination chemotherapy is used to do which of the following? (Select all that apply.)

Decrease medication resistance Attack cancer cells at different stages of cell growth Decrease injury to normal body cells

A nurse is providing teaching for a client who is withdrawing from alcohol and has a new prescription for Propranolol. Which of the following information should the nurse to include in the teaching?

Decreases cravings

A nurse in an acute care facility is caring for a client who is receiving IV Nitroprusside for hypertensive crisis. The nurse should monitor the client for which of the following adverse reactions to this medication?

Delirium

A nurse is planning care for a client who has brain cancer and is experiencing headaches. Which of the following adjuvant medications are indicated for this client?

Dexamethasone

A nurse is preparing to administer Cefotaxine IV to a client who has a severe infection and has been receiving Cefotaxime for the past week. Which of the following findings indicates a potentially serious adverse reaction to this medication that the nurse should report to the provider?

Diarrhea

A nurse is reviewing the medication administration record for a client who is receiving transdermal Fentanyl for severe pain. Which of the following medications should the nurse expect to cause an adverse effect when administered concurrently with Fentanyl?

Diazepam

A nurse is taking a medication history from a client who has Angina and is to begin taking Ranolazine. The nurse should report which of the following medications in the client's history that can interact with Ranolazine? (Select all that apply.)

Digoxin Simvastatin Verapamil

A nurse is caring for a client who received Prochlorperazine 4 hr ago. The client reports spasms of his face. The nurse should anticipate a prescription for which of the following medications?

Diphenhydramine

A nurse is preparing to administer Filgrastim for the first time to a client who has just undergone a bone marrow transplant. Which of the following interventions is appropriate?

Discard vial after removing one dose of the medication

A nurse is providing teaching to a client who has a new prescription for Clonidine to assist with maintenance of abstinence from opioids. The nurse should instruct the client to monitor for which of the following adverse effects?

Dry mouth

A nurse is teaching a client who has a new prescription for Diphenhydramine for allergic Rhinitis. The nurse should instruct the client to monitor for which of the following adverse reactions of this medication? (Select all that apply.)

Dry mouth Drowsiness Urinary hesitation

A nurse is caring for a client who has a new diagnosis of Fibromyalgia. Which of the following medications should the nurse anticipate being prescribed for this client?

Duloxetine

A nurse is caring for a client who has increased intracranial pressure and is receiving Mannitol. Which of the following findings should the nurse report to the provider?

Dyspnea

A nurse is assessing a client's IV infusion site. Which of the following findings should the nurse identify as an indication of phlebitis? (Select all that apply.)

Erythema Pain

A nurse is preparing to administer a medication to a client who has absence seizures. The nurse should anticipate administering which of the following medications to the client? (Select all that apply.)

Ethosuximide's Valproic acid Lamotrigine

A nurse is caring for a client who has Subacute Bacterial Endocarditis and is receiving several antibiotics, including Streptomycin Im. For which of the following manifestations should the nurse monitor as an adverse effect of this medication?

Extremity paresthesias

A nurse is providing teaching to a client who has a new prescription for Digoxin. The nurse should instruct the client to monitor and report which of the following adverse effects that is a manifestation Digoxin toxicity? (Select all that apply.)

Fatigue anorexia diplopia

A nurse is caring for a client who takes several antiretroviral medications, including the NRTI Zidovudine, to treat hIV infection. The nurse should monitor for which of the following adverse effects of Zidovudine? (Select all that apply.)

Fatigue hyperventilation Vomiting

A nurse is caring for a client who has been taking Sertraline for the past 2 days. Which of the following assessment findings should alert the nurse to the possibility that the client is developing Serotonin syndrome?

Fever

A nurse is caring for a client who is receiving moderate sedation with Diazepam IV. The client is oversedated. Which of the following medications should the nurse anticipate administering to this client?

Flumazenil

A nurse is caring for a hospitalized client who has an activated partial thromboplastin time (aPTT) greater than 1.5 times the expected reference range. Which of the following blood products should the nurse prepare to transfuse?

Fresh frozen plasma

A nurse is assessing a client during transfusion of a unit of whole blood. The client develops a cough, shortness of breath, elevated blood pressure, and distended neck veins. The nurse should anticipate a prescription for which of the following medications?

Furosemide

A nurse is assessing a client who takes Desmopressin for Diabetes Insipidus. For which of the following adverse effects should the nurse monitor?

Headache

A nurse is planning to administer IV Alteplase to a client who is demonstrating manifestations of a massive Pulmonary Embolism. Which of the following interventions should the nurse plan to take?

Hold direct pressure on puncture sites for up to 30 min.

A nurse is providing teaching to a client who is taking Raloxifene to prevent Postmenopausal Osteoporosis. The nurse should advise the client that which of the following are adverse effects of this medication? (Select all that apply.)

Hot flashes Swelling or redness in calf Shortness of breath

A nurse is caring for a client who is taking Ritonavir, a protease inhibitor, to treat HIV infection. The nurse should monitor for which of the following adverse effects of this medication?

Hyperlipidemia

A nurse is planning caring for a client who is has a new prescription for Torsemide. The nurse should plan to monitor for which of the following adverse reactions of this medications? (Select all that apply.)

Hypokalemia Hypotension Ototoxicity Ventricular dysrhythmias

A nurse is completing discharge teaching for a client who has a new prescription for transdermal patches. Which of the following statements should the nurse identify as an indication that the client understands the instructions?

I will apply the patch to an area of skin with no hair

A nurse is reviewing a new prescription for Terbutaline with a client who has a history of preterm labor. Which of the following client statements indicates understanding of the teaching?

I will report increasing intensity of contractions to my doctor

A nurse is providing teaching to a client who is experiencing migraine headaches. Which of the following instructions should the nurse provide? (Select all that apply.)

Identify and avoid trigger factors. Lie down in a dark quiet room at the onset of a migraine. Avoid foods that contain Tyramine.

A nurse working in an emergency department is caring for a client who has Benzodiazepine toxicity due to an overdose. Which of the following actions is the nurse's priority?

Identify the client's level of orientation.

A nurse in a provider's office is reviewing the medical record of a client who is pregnant and is at her first prenatal visit. Which of the following immunizations may the nurse administer safely to this client?

Inactivated influenza vaccine

A nurse is teaching a client who has a new prescription for Verapamil to control Hypertension. Which of the following instructions should the nurse include?

Increase the amount of dietary fiber in the diet

A nurse is preparing to administer medications to a 4‑month‑old infant. Which of the following pharmacokinetic principles should the nurse consider when administering medications to this client? (Select all that apply.)

Infants have immature liver function. Infants' blood‑brain barrier is poorly developed. Infants have an increased ability to absorb topical medications.

A nurse is preparing to administer Potassium Chloride IV to a client who has Hypokalemia. Which of the following actions should the nurse take? (Select all that apply.)

Infuse medication through a large‑bore needle. Implement cardiac monitoring Administer the infusion using an IV pump

A nurse is planning to administer Ciprofloxacin IV to a client who has cystitis. Which of the following actions should the nurse take?

Infuse the medication over 60 min.

A nurse is planning to administer subcutaneous enoxaparin 40 mg using a prefilled syringe of Enoxaparin 40 mg/0.4 mL to an adult client following hip arthroplasty. Which of the following actions should the nurse plan to take?

Insert the needle completely into the client's tissue

A nurse is teaching a female client who has a severe UTI about ciprofloxacin. Which of the following information about adverse reactions should the nurse include? (Select all that apply.)

Observe for pain and swelling of the Achilles tendon. Watch for a vaginal yeast infection. Inspect the mouth for cottage cheese‑like lesions

A nurse is caring for a client who has angina and asks about obtaining a prescription for sildenafil to treat erectile dysfunction. Which of the following medications is contraindicated with Sildenafil?

Isosorbide

A nurse is collecting data from a client who is taking Gemfibrozil. Which of the following assessment findings should the nurse identify as an adverse reaction to the medication?

Jaundice

A nurse is planning care for a client who is to receive Tetracaine prior to a Bronchoscopy. Which of the following actions should the nurse include in the plan of care?

Keep the client NPO until pharyngeal response returns

A nurse is teaching the parents of a school‑age child about transdermal Methylphenidate. Which of the following instructions should the nurse include?

Leave the patch on for 9 hr.

A nurse is caring for a client who has a new prescription for Lithium Carbonate. When teaching the client about ways to prevent Lithium toxicity, the nurse should advise the client to do which of the following?

Limit aerobic activity in hot weather

A nurse is caring for a school‑age child who has a new prescription for Atomoxetine. The nurse should monitor the client for which of the following adverse effects of this medication?

Liver damage

A nurse is caring for a client in an outpatient facility who has been taking Acarbose for type 2 Diabetes Mellitus. Which of the following laboratory tests should the nurse plan to monitor?

Liver function tests

A charge nurse is planning a staff education session to discuss medications used during the care of a client experiencing alcohol withdrawal. Which of the following medications should the charge nurse include in the discussion? (Select all that apply.)

Lorazepam Diazepam

A nurse is preparing a client's medications. Which of the following actions should the nurse take in following legal practice guidelines? (Select all that apply.)

Maintain skill competency. Monitor for adverse effects. Safeguard medications.

A nurse is caring for a client who has Diabetes and is experiencing Nausea due to Gastroparesis. The nurse should anticipate a prescription for which of the following medications?

Metoclopramide

A nurse is planning care for a client who has cancer and is taking a Glucocorticoid as an adjuvant medication for pain control. Which of the following interventions should the nurse include in the plan of care? (Select all that apply.)

Monitor serum glucose. Monitor serum potassium level. Monitor for gastric bleeding

A nurse is preparing to administer Belimumab for a client who has Systemic Lupus Erythematosus. Which of the following actions should the nurse plan to take?

Monitor the client for hypersensitivity reactions

A nurse is preparing to administer Penicillin V to a client who has a streptococcal infection. The client tells the nurse that she has difficulty swallowing tablets and doesn't "do well" with liquid or chewable medications because the taste gags her, even when the a nurse mixes the medication with food. The nurse should request a prescription for which of the following medications?

Nafcillin

A nurse is providing teaching for a client who has gout and a new prescription for Allopurinol. For which of the following adverse effects should the client be taught to monitor? (Select all that apply.)

Nausea Rash increase in gout pain

A nurse is assessing a male client who recently began taking Haloperidol. Which of the following findings is the highest priority to report to the provider?

Neck spasms

A nurse is caring for a client who has cancer and is taking Morphine and Carbamazepine or pain. Which of the following effects should the nurse monitor for when giving the medications together? (Select all that apply.)

Need for reduced dosage of the opioid Reduced adverse effects of the opioid Increased analgesic effects

A nurse in the post‑anesthesia recovery unit is caring for a client who received a nondepolarizing neuromuscular blocking agent and has muscle weakness. The nurse should anticipate a prescription for which of the following medications?

Neostigmine

A nurse is caring for a client who has a new prescription for Captopril for hypertension. The nurse should monitor the client for which of the following adverse effects of this medication?

Neutropenia

A nurse is teaching a client who has a new prescription for Nitrofurantoin. Which of the following information should the nurse include? (Select all that apply.)

Observe for bruising on the skin. Take the medication with milk or meals. Expect brown discoloration of urine

A nurse reviewing a client's medical record notes a new prescription for verifying the trough level of the client's medication. Which of the following actions should the nurse take?

Obtain a blood specimen immediately prior to administering the next dose of medication.

A nurse is implementing a plan of care for a client who has a wound infection. Which of the following actions should the nurse perform first?

Obtain a wound specimen for culture

A nurse in an acute mental health facility is caring for a client who is experiencing withdrawal from Opioid use and has a new prescription for Clonidine. Which of the following actions should the nurse identify as the priority?

Obtain baseline vital signs

A nurse is preparing to transfuse a unit of packed red blood cells (PRBCs) for a client who has severe anemia. Which of the following interventions will prevent an acute hemolytic reaction?

Obtain help from another nurse to confirm the correct client and blood product.

A nurse is caring for a client who is in labor and receiving IV Opioid analgesics. Which of the following actions should the nurse take?

Offer oral hygiene every 2 hr

A nurse is caring for a client who has Atrial Fiibrillation and a new prescription for Dabigatran to prevent development of Thrombosis. Which of the following medications is prescribed concurrently to treat an adverse effect of Dabigatran?

Omeprazole

A provider prescribes phenobarbital for a client who has a seizure disorder. The medication has a long half-life of 4 days. How many times per day should the nurse expect to administer this medication?

One

A nurse is caring for a client who has a new prescription for Phenelzine for the treatment of depression. Which of the following indicates that the client has developed an adverse effect of this medication?

Orthostatic hypotension

A nurse is reviewing laboratory findings and notes that a client's plasma Lithium level is 2.1 mEq/L. Which of the following is an appropriate action by the nurse?

Perform immediate gastric lavage.

A nurse in the post‑anesthesia care unit is caring for a client who is experiencing malignant hyperthermia. Which of the following actions should the nurse take? (Select all that apply.)

Place a cooling blanket on the client. Administer oxygen at 100%. Administer iced 0.9% sodium chloride. Monitor core body temperature

A nurse is providing teaching to a client who has migraine headaches and a new prescription for Ergotamine. For which of the following adverse effects should the nurse instruct the client to stop taking the medication and notify the provider? (Select all that apply.)

Positive home pregnancy test Numbness and tingling in fingers Muscle pain

A nurse in a provider's office is monitoring serum electrolytes for four older adult clients who take digoxin. Which of the following electrolyte values increases a client's risk for Digoxin toxicity?

Potassium 3.4 mEq/L

A nurse is assessing a client who is taking Amiodarone to treat Atrial Fibrillation. Which of the following findings is a manifestation of Amiodarone toxicity?

Productive cough

A nurse is caring for a hospitalized client who is receiving IV heparin for a deep‑vein thrombosis. The client begins vomiting blood. After the heparin has been stopped, which of the following medications should the nurse prepare to administer?

Protamine

A nurse is caring for a client who has Diabetes Mellitus, Pulmonary Tuberculosis, and a new prescription for Isoniazid. Which of the following supplements should the nurse expect to administer to prevent an adverse effect of INH?

Pyridoxine

A nurse is teaching clients in an outpatient facility about the use of Insulin to treat type 1 Diabetes Mellitus. For which of the following types of insulin should the nurse tell the clients to expect a peak effect 1 to 5 hr after administration?

Regular insulin

A nurse is teaching a client who has a new prescription for Nitroglycerin transdermal patch for Angina Pectoris. Which of the following instructions should the nurse include?

Remove the patch each evening.

A nurse is assessing a client who is taking Digoxin to treat heart failure. Which of the following findings is a manifestation of digoxin toxicity?

Report of anorexia

A nurse in an emergency department is performing an admission assessment for a client who has severe Aspirin toxicity. Which of the following findings should the nurse expect?

Respiratory depression

A nurse is teaching a group of new parents about immunizations. The nurse should instruct the parents that the series for which of the following vaccines is completed prior to the first birthday?

Rotavirus vaccine

A nurse is caring for a client who receives a local anesthetic of Lidocaine during the repair of a skin laceration. For which of the following adverse reactions should the nurse monitor the client?

Seizures

A nurse in an emergency unit is reviewing the medical record of a client who is being evaluated for angle‑closure Glaucoma. Which of the following findings are indicative of this condition?

Severe pain around eyes

A nurse is caring for a client who has a new prescription for Calcitonin‑salmon for Osteoporosis. Which of the following tests should the nurse tell the client to expect before beginning this medication?

Skin test for allergy to the medication

A nurse is providing instruction to a client who has a new prescription for Calcitonin‑salmon for postmenopausal Osteoporosis. Which of the following instructions should the nurse include in the teaching?

Skin test for allergy to the medication

A nurse is providing teaching for a client who has a new prescription for Metformin. Which of the following adverse effects of Metformin should the nurse instruct the client to report to the provider?

Somnolence

A nurse is planning discharge teaching for a female client who has a new prescription for Trimethoprim‑sulfamethoxazole. Which of the following information should the nurse include?

Take it on an empty stomach

A nurse is teaching a client who has Osteoporosis and a new prescription for Alendronate. Which of the following instructions should the nurse provide? (Select all that apply.)

Take medication in the morning before eating. Drink an 8 oz glass of water with each tablet. Avoid lying down after taking this medication

A nurse is providing information to a client who has a new prescription for Hydrochlorothiazide. Which of the following information should the nurse include?

Take the medication with food.

A nurse is providing teaching to a client who is starting Simvastatin. Which of the following information should the nurse include in the teaching?

Take this medication in the evening

A nurse is teaching a client who is beginning highly active antiretroviral therapy (HAART) for HIV infection about ways to prevent medication resistance. Which of the following information should the nurse teach the client about resistance?

Taking medication at the same times daily without missing doses minimizes resistance.

A nurse is caring for an older adult client in a long‑term care facility who has Hypothyroidism and a new prescription for Levothyroxine. Which of the following dosage schedules should the nurse expect for this client?

The client will start on a low dose, which will be gradually increased

A nurse is caring for a client who has a new prescription for Oxytocin to stimulate uterine contractions. Which of the following interventions should the nurse make? (Select all that apply.)

Use an infusion pump for medication administration. Obtain vital signs frequently and with every dosage change. . Monitor fetal heart rate continuously

A nurse is preparing to initiate IV therapy for an older adult client. Which of the following actions should the nurse plan to take?

The nurse should distend the veins using a blood pressure cuff to reduce overfilling of the vein,which can result in a hematoma)

A nurse is caring for a client who has a new prescription for Adalimumab for Rheumatoid Arthritis. Based on the route of administration of Adalimumab, which of the following should the nurse plan to monitor?

The subcutaneous site for redness following injection

A nurse is teaching a client about preventing Otitis Externa. Which of the following instructions should the nurse include?

Tip the head to the side to remove water from the ears after showering

A nurse is preparing to administer Cyclophosphamide IV to a client who has Hodgkin's disease. Which of the following medications should the nurse expect to administer concurrently with the chemotherapy to prevent an adverse effect of Cyclophosphamide?

Uroprotectant agent, such as mesna

A nurse is caring for an older adult client who has a new prescription for Digoxin and takes multiple other medications. The nurse should recognize that concurrent use of which of the following medications places the client at risk for Digoxin toxicity?

Verapamil

A nurse is completing an assessment of a client's current medications. The client states she also takes Gingko Biloba. Which of the following medications is contraindicated for a client taking Gingko Biloba?

Warfarin

A nurse assessing a client's IV catheter insertion site notes a hematoma. Which of the following actions should the nurse take? (Select all that apply.)

Warm compresses Elevation of the arm helps reduce edema

A nurse is teaching an adolescent client who has a new prescription for Clomipramine for OCD. Which of the following instructions should the nurse include to minimize an adverse effect of his medication?

Wearing sunglasses when outdoors

A nurse is teaching a client who has a prescription for long‑term use of oral prednisone for treatment of chronic asthma. The nurse should instruct the client to monitor for which of the following adverse effects of this medication?

Weight gain

A nurse is preparing to administer a transfusion of 300 mL of pooled platelets for a client who has severe Thrombocytopenia. The nurse should plan to administer the transfusion over which of the following time frames?

Within 30 min/unit

A nurse is teaching a client who has breast cancer about Tamoxifen. Which of the following adverse effects of tamoxifen should the nurse discuss with the client?

abnormal uterine bleeding

A nurse is admitting a toddler to the hospital after an Acetaminophen overdose. Which of the following medications should the nurse anticipate administering to this client?

acetylcysteine

A nurse is reviewing the health record of a client who asks about using Propranolol to treat hypertension. The nurse should recognize which of the following conditions is a contraindication for taking propranolol?

asthma

A nurse manager is reviewing the facility's policies for IV therapy with the members of his team. The nurse manager should remind the team that which of the following techniques helps minimize the risk of catheter embolism?

avoid reinserting the needle into an IV catheter. This action can result in severing the end of the catheter and consequently cause a catheter embolism

A nurse reviewing a client's medication history notes an allergy to Sulfonamides. This allergy is a contraindication for taking which of the following medications? (Select all that apply.)

hydrochlorothiazide glyburide furosemide

A nurse is caring for a client who is taking for Somatropin to stimulate growth. The nurse should plan to monitor the client's urine for which of the following?

calcium

A nurse is monitoring a client who takes aspirin 81 mg PO daily. The nurse should identify which of the following manifestations as adverse effects of daily aspirin therapy? (Select all that apply.)

coffee‑ground emesis Tinnitus Nausea

A nurse is teaching a client who has a new prescription for digoxin to treat heart failure. Which of the following instructions should the nurse include in the teaching?

contact the provider for a heart rate less than 60/min

A nurse is providing teaching to a female client who is taking Testosterone to treat advanced breast cancer. The nurse should tell the client that which of the following are adverse effects of this medication? (Select all that apply.)

deepening voice weight gain facial hair

A nurse is preparing to perform a follow‑up assessment on a client who takes Chlorpromazine for the treatment of Schizophrenia. The nurse should expect to find the greatest improvement in which of the following manifestations? (Select all that apply.)

disorganized speech. bizarre behavior hallucinations

A nurse is assessing a client who has salicylism. Which of the following findings should the nurse expect? (Select all that apply.)

dizziness tinnitus headache

A nurse is infusing IV Amphotericin B to a client who has a systemic fungal infection. The nurse should monitor the client for which of the following adverse effects of this medication?

fever

A nurse is reviewing a new prescription for Ondansetron 4 mg PO PRN for nausea and vomiting for a client who has Hyperemesis Gravidarum. The nurse should clarify which of the following parts of the prescription with the provider?

frequency

A nurse is teaching a client who has a new prescription for Ramelteon. The nurse should instruct the client to avoid which of the following foods while taking this medication?

fried chicken

A nurse is reviewing the health care record of a client who reports urinary incontinence and asks about a prescription for Oxybutynin. The nurse should recognize that Oxybutynin is contraindicated in the presence of which of the following conditions?

glaucoma

A nurse is providing information to a client who has early Parkinson's disease and a new prescription for pramipexole. The nurse should instruct the client to monitor for which of the following adverse effects of this medication?

hallucinations

A nurse is planning to administer Ondansetron IV for an older adult client who has a history of diabetes mellitus and cardiac myopathy and is receiving chemotherapy for cancer. For which of the following adverse effects of ondansetron should the nurse monitor? (Select all that apply.)

headache Diarrhea prolonged QT interval

A nurse is planning to administer a first dose of Captopril to a client who has hypertension. Which of the following medications can intensify first dose hypotension? (Select all that apply.)

hydrochlorothiazide Clonidine Aliskiren

A nurse is caring for a client who has a new prescription for Niacin to reduce cholesterol. The nurse should monitor for which of the following findings as an adverse effect of Niacin? (Select all that apply.)

hyperglycemia Flushing of the skin jaundice

A nurse is monitoring a client who is receiving Epoetin alfa for adverse effects. The nurse should identify which of the following findings as an adverse effect of this medication? (Select all that apply)

hypertension headache

A nurse is providing teaching to a client who will start Alfuzosin for treatment of Benign Prostatic Hyperplasia. The nurse should instruct the client that which of the following is an adverse effect of this medication?

hypotension

A nurse is providing instructions to a client who has been experiencing Insomnia and has a new prescription for Temazepam. The nurse should inform the client that which of the following manifestations are adverse effects of temazepam? (Select all that apply.)

incoordination Sleep driving amnesia

A nurse is administering a Dopamine infusion at a low dose to a client who has severe heart failure. Which of the following findings is an expected effect of this medication?

increased myocardial contractility

A nurse is teaching a client about the a new prescription for Celecoxib. Which of the following information should the nurse include in the teaching?

increased risk for a myocardial infarction

A nurse is caring for a client who has increased liver enzymes and is taking herbal supplements. Which of the following herbal supplements should the nurse report to the provider?

kava

A nurse is preparing information for the unit's nurses about the effectiveness of antimicrobial therapy for clients who have bacterial infections. Which of the following host factors should the nurse include as conditions that affect antimicrobial effectiveness? (Select all that apply.)

meningitis pacemaker endocarditis

A nurse is caring for a client who is prescribed Isosorbide Mononitrate for chronic stable Angina and develops reflex tachycardia. Which of the following medications should the nurse expect to administer?

metoprolol

A nurse is caring for a client who is being treated with Interferon alfa‑2b for Malignant Melanoma. For which of the following adverse effects should the nurse monitor? (Select all that apply.)

muscle aches Peripheral neuropathy Depression

A nurse is caring for a client who states she has been taking Phenylephrine nasal drops for the past 10 days for Sinusitis. The nurse should assess the client for which of the following adverse effects of this medication?

nasal congestion

A nurse is instructing a client who has a new prescription for Timolol how to insert eye drops. The nurse should instruct the client to press on which of the following areas to prevent systemic absorption of the medication?

nasolacrimal duct

A nurse is caring for a client who is undergoing preparation for extensive colorectal surgery. Which of the following oral antibiotics should the nurse expect to administer specifically to suppress normal flora in the GI tract?

neomycin

A nurse is administering Amitriptyline to a client who is experiencing cancer pain. For which of the following adverse effects should the nurse monitor?

orthostatic hypotension

A nurse is caring for a client who is receiving daily doses of Oprelvekin. Which of the following laboratory values should the nurse monitor to determine effectiveness of this medication?

platelet count

A nurse is caring for a client who has a new prescription for Enfuvirtide to treat HIV infection. The nurse should monitor the client for which of the adverse reactions of this medication? (Select all that apply.)

pneumonia Localized Enfuvirtide hypotension

A nurse is caring for a client who is starting a course of gentamicin IV for a serious respiratory infection. For which of the following manifestations should the nurse monitor as an adverse effect of this medication? (Select all that apply.)

pruritus hematuria muscle weakness Vertigo

A 12‑month‑old child just received the first measles, mumps, and rubella (mmR) vaccine. For which of the following possible reactions to this vaccine should the nurse teach the parents to monitor? (Select all that apply.)

rash Swollen glands bruising

A nurse on a medical‑surgical unit administers a hypnotic medication to an older adult client at 2100. The next morning, the client is drowsy and wants to sleep instead of eating breakfast. Which of the following factors should the nurse identify as a possible reason for the client's drowsiness?

reduced hepatic function

A nurse is teaching a client who has a new prescription for Omeprazole for management of heartburn. Which of the following information should the nurse include in the teaching?

reduces gastric acid secretion

A nurse reviewing a client's health record notes a new prescription for Lisinopril 10 mg PO once every day. The nurse should identify this as which of the following types of prescription?

routine

A nurse is caring for a client who is admitted to undergo a surgical procedure. Which of the following preexisting conditions can be a contraindication for the use of Ketamine as an intravenous anesthetic?

schizophrenia

A nurse is teaching a client who has a new prescription for Dextromethorphan to suppress a cough. The nurse should instruct the client to monitor for which of the following adverse effects of this medication?

sedation

A nurse is caring for a client who has a UTI and a history of recurrence of this type of infection. The client asks why the provider has not yet prescribed an antibiotic. The nurse should explain that the provider has to wait for the results of which of the following laboratory tests to identify which antibiotic to prescribe?

sensitivity

A nurse is administering IV Amphotericin B to a client who has a systemic fungal infection. The nurse should monitor which of the following laboratory values? (Select all that apply.)

serum potassium Hematocrit serum creatinine

A nurse is providing instructions about the use of laxatives to a client who has heart failure. The nurse should tell the client he should avoid which of the following laxatives?

sodium phosphate

A nurse is transfusing a unit of packed Red blood cells (PRBCs) for a client who has Anemia due to Chemotherapy. The client reports a sudden headache and chills. The client's temperature is 2° F higher than her baseline. In addition to notifying the provider, which of the following actions should the nurse take? (Select all that apply.)

stop the transfusion remove the blood bag and tubing from the client's IV catheter. Obtain a urine specimen

A nurse is teaching the parents of a child who has a new prescription for Desipramine. The nurse should instruct the parents that which of the following adverse effects is the priority to report to the provider?

suicidal thoughts

A nurse is providing instructions to a client who has a prescription for Amoxicillin and Clarithromycin to treat a Peptic Ulcer. Which of the following information should the nurse include in the teaching?

take these medications with food

A nurse is teaching a client who has a new prescription for Levodopa/Carbidopa for Parkinson's disease. Which of the following instructions should the nurse include?

take this medication with food

A nurse is explaining the mechanism of action of combination oral contraceptives to a group of clients. The nurse should tell the clients that which of the following actions occur with the use of combination oral contraceptives? (Select all that apply.)

thickening of the cervical mucus alter the lining of the endometrial lining inhibiting ovulation

A nurse is caring for a client who has a new prescription for Valproic Acid. The nurse should instruct the client that while taking this medication he will need to have which of the following laboratory tests completed periodically? (Select all that apply.)

thrombocyte count amylase Liver function tests

A nurse is reviewing the health care record of a client who is asking about conjugated equine estrogens. The nurse should inform the client this medication is contraindicated in which of the following conditions?

thrombophlebitis

A nurse is preparing to administer an Opioid agonist to a client who has acute pain. Which of the following complications should the nurse monitor?

urinary retention

A nurse is admitting a client and completing a preassessment before administering medications. Which of the following data should the nurse include in the preassessment? (Select all that apply.)

use of herbal products current health status food allergies

A nurse is obtaining a medication history from a client who is to receive Imipenem‑cilastatin IV to treat an infection. Which of the following medications the client also receives puts him at risk for a medication interaction?

valproic acid

A nurse is taking a history for a client who reports that he is taking Aspirin about four times daily for a sprained wrist. Which of the following prescribed medications taken by the client is contraindicated with aspirin?

warfarin

A nurse is assessing a client who has taken Procainamide to treat dysrhythmias for the last 12 months. The nurse should assess the client for which of the following adverse effects of this medication? (Select all that apply.)

widened QRS complex easy bruising swollen joints

A nurse is planning to administer Morphine IV to a client who is postoperative. Which of the following actions should the nurse take?

withhold all opioids if the respiratory rate is 12/min or less

A nurse is preparing to administer an IM dose of penicillin to a client who has a new prescription. The client states she took penicillin 3 years ago and developed a rash. Which of the following actions should the nurse take?

withhold the medication


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