ATI Questions

A nurse is caring for a client who is receiving bleomycin IV to treat lymphoma. Which of the following assessments is the nurse's priority? a. pulmonary function b. CBC c. urinary output d. peripheral edema

a. pulmonary function the nurse should apply the safety and risk-reduction priority-setting framework, which assigns priority to the factor or situation posing the greatest safety risk to the client.

A nurse is caring for a client who has atrial fibrillation and is scheduled for cardioversion. The nurse should anticipate a prescription from the provider for which of the following medications for this procedure? a. amlodipine b. diltiazem c. nifedipine d. lidocaine

b. diltiazem the nurse should anticipate a prescription for diltiazem, which blocks calcium channels in the heart and blood vessels, thereby lowering blood pressure. also, it is an antiarrhythmic medication that is used during cardioversion to treat atrial fibrillation

A nurse is providing teaching to a client who has type 2 diabetes mellitus and a new prescription for metformin. Which of the following adverse effects of metformin should the nurse instruct the client to watch for and report to the provider? a. weight gain b. myalgia c. hypoglycemia d. severe constipation

b. myalgia

A nurse is teaching a client who has type 2 diabetes mellitus about storing unopened vials of insulin. Which of the following pieces of information should the nurse include in the teaching? a. store the vials in the freezer b. store the vials at room temperature c. store the vials by a window d. store the vials in the refrigerator

d. stores the vials in the refrigerator the nurse should tell the client to store unopened vials of insulin in the refrigerator. the client can use the unopened vials of insulin up to the printed expiration date

A nurse is caring for a client who has a prescription for an oral contraceptive to prevent pregnancy. The nurse should identify that which of the following actions is the purpose of this medication? a. inhibition of ovulation b. thinning of the endometrial lining c. inhibition of luteinizing hormone d. thinning of cervical mucus

a. inhibition of ovulation the nurse should identify should identify that this medication inhibits ovulation to prevent pregnancy

A nurse is caring for a client who takes a combination oral contraceptive. Which of the following findings should indicate to the nurse that the client is experiencing a deficiency of estrogen in the OC? a. mid-cycle breakthrough bleeding or spotting b. breast tenderness c. migraine headaches d. nausea

a. mid-cycling breakthrough bleeding or spotting if a client has mid-cycle breakthrough bleeding or spotting while taking a combination OC, the nurse should recognize that the OC is deficient in the amount of estrogen for the client

A nurse is caring for a client who is at 28 week gestation and is experiencing preterm labor. Which of the following medications should the nurse plan to administer? a. oxytocin b. nifedipine c. dinoprostone d. misoprostol

b. nifedipine Nifedipine is a tocolytic medication that is administered to stop preterm labor

A nurse is caring for a client who has a dry nonproductive cough. Which of the following types of medication should the nurse recommend? a. expectorant b. mucolytic c. bronchodilatory d. antitussive

d. antitussive Antitussives suppress the cough reflex

A nurse in a provider's office is assessing a client who has been taking feverfew. Which of the following statements by the client indicates a therapeutic effect of the supplement? a. "I am having fewer migraine headaches since I started taking feverfew." b. "My memory seems to be getting better since I started taking feverfew." c. "I have fewer infections when I take feverfew." d. "I have not had another urinary tract infection since starting feverfew."

a. "I am having fewer migraine headaches since I started taking feverfew." Feverfew is an herb that is used for the prophylaxis of migraine headache. It can reduce the frequency of migraines and decrease the severity of accompanying manifestations such as nausea and photophobia

A nurse is teaching a client who has a prescription for scopolamine patches for the treatment of motion sickness. Which of the following client statements should indicate to the nurse that the teaching has been effective? a. "I should apply this patch behind my ear." b. "this patch should be replaced every 7 days." c. "before putting on my patch, I should wipe the area with an alcohol swab." d. "I can use a second patch if a single patch is not effective."

a. "I should apply this patch behind my ear." The nurse should identify that scopolamine patches should be applied behind the ear

A nurse is teaching about adverse effects of ergotamine with a client who has migraine headache. Which of the following client statements should indicate an understanding of the teaching? a. "If I overuse this medication, I might become addicted to it." b. "This medication is okay to use during pregnancy." c. "Tingling in my fingers and toes is an adverse effect that goes away with continued use." d. "I will experience restlessness as an adverse effect when I begin taking this medication."

a. "If I overuse this medication, I might become addicted to it." The client should take the ergotamine according to the prescribed dose and should only take the medication when needed to avoid developing a physical dependence

A nurse is planning care for a client who is receiving gentamicin IM and has a new prescription to obtain gentamicin peak and trough levels. At which of the following times should the nurse plan to obtain a blood sample to evaluate the gentamicin peak? a. 1 hour after administering the IM injection b. just before administering the IM injection c. 12 hours after the last IM injection d. 30 minutes after administering the IM injection

a. 1 hour after administering the IM injection timing is important when drawing blood samples for aminoglycoside levels. the nurse should obtain blood samples for peak levels 1 hour after administering an IM injection or 30 minutes after completing an IV infusion

A charge nurse is teaching a newly licensed nurse about the purpose of a client being prescribed a transdermal fentanyl patch. Which of the following clients should the charge nurse include in the teaching as a client who requires this medication? a. a client who is opioid tolerant b. a client who has difficulty swallowing c. a client who has severe intermittent pain d. a client who is postoperative following abdominal surgery

a. a client who is opioid tolerant the charge nurse should include in the teaching that a client who is opioid tolerant can be prescribed a fentanyl patch to manage pain

A nurse is teaching a group of nurses about the manifestations of progestin deficiency for clients who take a combination oral contraceptive. Which of the following findings should the nurse include in the teaching as an indication of progestin deficiency? a. amenorrhea b. weight gain c. depression d. acne

a. amenorrhea A client who takes a combination OC and has a progestin deficiency can have amenorrhea. Increasing the OC dose of progestin can result in a more regular menstrual cycle

A nurse is teaching a group of nurses about the manifestations of progestin deficiency for clients who take a combination oral contraceptive. Which of the following findings should the nurse include in the teaching as an indication of progestin deficiency? a. amenorrhea b. weight gain c. depression d. acnea

a. amenorrhea a client who takes a combination OC and has a progestin deficiency can have amenorrhea. increasing the OC dose of progestin can result in a more regular menstrual cycle

A nurse is preparing to administer medications to a client who is NPO and is receiving enteral feedings through an NG tube. Which of the following prescriptions should the nurse clarify with the provider? a. aspirin EC 325 mg per NG tube daily b. atorvastatin 40 mg per NG tube daily c. propranolol 20 mg per NG tube daily d. sucralfate 2 g oral suspension per NG tube BID

a. aspirin EC325 mg per NG tube daily the nurse should clarify the prescription for aspirin EC 325 mg per NG tube daily, as enteric-coated tablets should not be crushed

Which of the following conditions should the nurse identify as an adverse effect of this medication? a. bradycardia b. jaundice c. low blood pressure d. dark urine

a. bradycardia the nurse should identify that an adverse effect of QT interval medication is bradycardia. This medication should be used with caution for clients who have hypotension or heart failure, older adult clients, or clients who have low potassium or magnesium levels

A nurse is planning discharge teaching for a client who has major depressive disorder and a new prescription for phenelzine. Which of the following foods should the nurse include in the plan as safe for the client to consume while taking phenelzine? a. broiled beef steak b. macaroni and cheese c. pepperoni pizza d. smoked salmon

a. broiled beef steak Phenelzine, an MAOI is an antidepressant. This medication interacts with a variety of foods to produce a hypertensive crisis. Beef steak and other meats that are fresh do not interact with phenelzine and are safe to consume

A nurse is caring for a client who take Ginkgo biloba daily at home. Which of the following effects should the nurse expect from the use of this herbal supplement? a. decreased platelet aggregation b. prevention of migraine headaches c. increased risk of deep vein thrombosis d. lowered cholesterol and triglyceride levels

a. decreased platelet aggregation Ginkgo biloba can decrease platelet aggregation by inhibiting the ability of platelets to clump together. the nurse and the client should discuss the potential increase in bleeding tendencies when taking Ginkgo biloba and other antiplatelet aggregates, such as NSAIDs and clopidogrel

A nurse is caring for a client who has asthma and advanced rheumatoid arthritis and deformity of the hands. The nurse should anticipate that the client will receive which of the following medication-delivery devices for the treatment of asthma? a. dry -powder inhaler b. metered dose inhaler with spacer c. respimat d. nebulizer

a. dry-powder inhaler the nurse should identify that DPIs do not require hand-breath coordination and are easier to use for clients who have deformities of the hands

A nurse is caring for a client who has a new prescription for levothyroxine to treat hypothyroidism. Which of the following findings should the nurse identify as an indication that the client requires intervention? a. heart rate 106/min b. dry skin c. oral temperature 98.2 d. lethargy

a. heart rate 106/min Tachycardia can be a manifestations of hyperthyroidism, possibly due to excessive hormone replacement. The client might require a lower dosage of levothyroxine

A nurse is preparing to administer dantrolene to a client who has muscle spasticity. Which of the following findings from the client's medical history should the nurse identify as a contraindication to the administration of this medication? a. history of cirrhosis b. history of multiple sclerosis c. history of cerebral palsy d. history of malignant hyperthermia

a. history of cirrhosis the nurse should identify that dantrolene is contraindicated for client who have active liver disease because it is hepatotoxic and can cause liver failure. liver function tests are monitored for clients throughout treatment with this medication

A nurse is caring for a client who is experiencing an acute gout attack. The nurse should anticipate a prescription from the provider for which of the following medications? a. naproxen b. pegloticase c. probenecid d. allopurinol

a. naproxen the nurse should anticipate that the provider will prescribe an NSAID such as naproxen. this type of medication is recommended as the first choice of treatment for relieving the manifestations of an acute gout attack

A nurse is caring for a client who received spinal anesthesia 30 minutes ago. The client reports feeling dizzy, and the nurse notes that the client's blood pressure is 84/54 mmHg. Which of the following actions should the nurse take? a. place the client in the head-down position b. assess the placement of the catheter c. prepare to administer and IV reversal agent d. assist the client in passive range of motion movements

a. place the client in the head-down position the nurse should identify the client is experiencing an adverse effect from receiving the spinal anesthesia.

A nurse is caring for a client who received spinal anesthesia 30 minutes ago. The client reports felling dizzy, and the nurse notes that the client's blood pressure is 84/54 mmHg. Which of the following actions should the nurse take? a. place the client in the head-down position b. assess the placement of the catheter c. prepare to administer an IV reversal agent d. assist the client in passive range of motion movements

a. place the client in the head-down position the nurse should identify the client is experiencing an adverse effect from receiving the spinal anesthesia. Hypotension is the common adverse effect of spinal anesthesia due to the loss of venous tone and decreased venous return to the heart.

A nurse is caring for a client who received naloxone for a suspected opioid overdose. Which of the following findings should the nurse identify as an adverse effect of this medication? a. report of pain b. respiratory rate 8/min c. report of numbness d. report of abdominal cramping and diarrhea

a. report of pain The nurse should identify that naloxone is used to reverse the effects of an opioid overdose administration for pain, sedation euphoria, and respiratory depression. Excess doses of naloxone can cause the return of pain but can improve the client's respiratory rate

A nurse is caring for a client who received naloxone for a suspected opioid overdose. Which of the following findings should the nurse identify as an adverse effects of this medication? a. report of pain b. respiratory rate 8/min c. report of numbness d. report of abdominal cramping and diarrhea

a. report of pain the nurse should identify that naloxone is used to reversed the effects of an opioid overdose administered for pain, sedation euphoria, and respiratory depression. excess dose of naloxone can cause the return of pain but can improve the client's respiratory rate.

A nurse is caring for a client who has asthma and requires long-term treatment. The nurse should identify that which of the following medications used for long-term treatment places the client at an increased risk of asthma-related death? a. salmeterol b. fluticasone c. budesonide d. theophylline

a. salmeterol The nurse should identify that salmeterol is a long-acting beta2-agonist. When this medication is used alone for the long-term treatment of asthma, this class of medication increases the client's risk of asthma-related death. To decrease this risk, the client should be prescribed both a long-acting beta2-agonist along with an inhaled corticosteriod

A nurse is caring for a client who is developing acute pulmonary edema and has a new prescription for furosemide 40 mg IV bolus. The nurse should plan to administer the medication using which of the following methods? a. undiluted administered over 2 min b. diluted administered over 20 min c. undiluted administered as rapidly as possible d. diluted administered over 5 min

a. undiluted over 2 min the nurse should plan to administer low-dose furosemide therapy at a rate of 20 mg/min or a dose of 40 mg over 2 min

A nurse is administering a client's first dose of sucralfate. Which of the following explanations should the nurse provide about the action of sucralfate? a. "Sucralfate decreases gastric acid secretions." b. "Sucralfate forms a gel-like substance that protects ulcers." c. "Sucralfate inativates Helicobacter pylori." d. "Sucralfate inhibits the production of gastric acid."

b. "Sucralfate forms a gel-like substance that protects ulcers." the primary action of sucralfate is the formation of a gel-like protectant that adheres to the ulcer surface. this protective mechanism lasts for 6 hours and allows the ulver to heal

A nurse is preparing to administer meperidine 100 mg IM to a client who has a BMI of 23. Which of the following needle lengths should the nurse use to administer the medication? a. 1/2 inch b. 1 1/2 inch c. 2 1/2 inch d. 3 inch

b. 1 1/2 inch in general, needle lengths for IM injection are 1-1 1/2 inches, unless the client is obese. a BMI of 23 is considered to be an optimal weight

A nurse is evaluating how a client who is pregnant is responding to a medication. Which of the following physiological effects of pregnancy should the nurse take into consideration? a. increased intestinal transit rate b. accelerated excretion of fluids c. reduced renal blood flow d. decreased hepatic metabolism

b. accelerated excretion of fluids there are physiological changes in the kidneys with pregnancy, including accelerated excretion from increased renal blood flow

A nurse is teaching a client who is using topical lidocaine about preventing systemic toxicity. Which of the following pieces of information should the nurse include about the application of topical lidocaine? a. apply a dressing after covering the affected areas with topical lidocaine b. apply topical lidocaine to affected areas that are intact c. apply topical lidocaine in a thick layer to affected areas d. apply topical lidocaine frequently to large affected areas

b. apply topical lidocaine to affected areas that are intact

A nurse in a postpartum unit is caring for a client who plans to breastfeed her newborn exclusively. The client has a prescription for depot medroxyprogesterone acetate. At which of the following times should the nurse schedule the client to receive the first dose of the medication? a. after 3 months postpartum b. at 6 weeks postpartum c. within the first 5 days postpartum d. during the first week of the first postpartum menstrual cycle

b. at 6 weeks postpartum the nurse should tell the client that the first dose should be administered at 6 weeks postpartum if the client is exclusively breastfeeding and after ensuring the client is not pregnant

A nurse is caring for a client who has bronchitis and a prescription for a mucolytic agent. Which of the following findings should the nurse identify as an adverse effect of this type of medication? a. fluid overload b. bronchospasms c. electrolyte imbalance d. tachycardia

b. bronchospasm The nurse should identify that bronchospasm is an adverse reaction to a mucolytic agent. Mucolytic agents such as hypertonic saline solution or acetylcysteine can irritate the airways, resulting in bronchospasm while producing a cough and thinning mucus secretions

A nurse is caring for a client with Alzheimer's disease who has a new prescription for memantine. Which of the following laboratory results should the nurse identify as increasing the client's risk for decreased clearance of the medication? a. alanine aminotransferase (ALT) 30 units/L b. creatinin clearance 35mL/min c. HbA1c 5% d. BMI 31

b. creatinine clearance 35mL/min creatinine clearance is an estimate of the glomerular filtration rate and the kidney's ability to filter waste. A creatinine clearance of 35mL/min indicates moderate renal impairment.

A nurse is caring for a client who is taking acarbose to treat type 2 diabetes mellitus. For which of the following adverse effects of this medication should the nurse monitor the client? a. insomnia b. diarrhea c. joint pain d. polycythemia

b. diarrhea the most common adverse effects of acarbose, an alpha-glucosidase inhibitor, are gastrointestinal. they include diarrhea, abdominal distention and cramping, and flatulence.

A nurse is admitting a client who has atrial fibrillation with a heart rate of 155/min. The nurse should anticipate a prescription from the provider for which of the following medications? a. atropine b. diltiazem c. epinephrine d. vasopressin

b. diltiazem The nurse should anticipate the provider to prescribe diltiazem for a client who is experiencing atrial fibrillation. Diltiazem is an antiarrhythmic agent that reduces the ventricular rate in atrial fibrillation

A nurse is reviewing the medical record for a client who has a migraine and a prescription for sumatriptan. Which of the following factors in the client's medical history should the nurse identify as a contraindication to receiving sumatriptan? a. renal impairment b. ischemic heart disease c. severe osteoporosis d. cirrhosis

b. ischemic heart disease The nurse should identify that ischemic heart disease is a contraindication to receiving sumatriptan. Sumatriptan is a serotonin receptor agonist that can cause vasoconstriction and coronary vasospasm. This medication is also contraindicated in clients who had a myocardial infarction or client who have coronary artery disease, uncontrolled hypertension, or other types of heart disease

A nurse is caring for a client who is preterm labor and has a new prescription for nifedipine. The client states she is concerned because her father takes nifedipine for his angina pectoris. The nurse should explain that nifedipine works for client who are pregnant through which of the following mechanisms? a. it decreases the incidence of bacterial vaginosis, thus preventing uterine contractions b. it inhibits uterine contractions by blocking the entry of calcium into uterine cells c. it decreases activity within the CNS, which regulates all smooth muscle d. it stimulates beta-2 receptors in the uterus, which decreases the frequency of contractions

b. it inhibits uterine contractions by blocking the entry of calcium into uterine cells nifedipine, a calcium channel blocker, causes uterine relaxation by blocking the flow of calcium to the myometrial cells of the uterus.

A nurse is reviewing the medication administration record of a client who has impaired swallowing. The nurse should crush the medication when administering which of the following prescriptions? a. aspirin EC 80 mg PO daily b. levothyroxine 75 mcg PO q AM before breakfast c. metformin XR 500 mg PO daily d. nitroglycerin 0.3 mg SL PRN chest pain, may repeat q 5 min for 2 additional doses

b. levothyroxine 75 mcg PO q AM before breakfast levothyroxine can be crushed because it is not extended-release, sublingual, or enteric-coated. if crushed, the medication should be mixed with 5-10 mL of water

A nurse is caring for a client who has a new prescription for ergotamine. The nurse should recognize that ergotamine is administered to treat which of the following conditions? a. Raynaud's phenomenon b. migraine headache c. ulcerative colitis d. anemia

b. migraine headaches Ergotamine prevents or stops a migraine headache by blocking alpha-adrenergic receptors in the cranial peripheral vascular smooth muscle, which causes vasoconstriction of dilated cerebral blood vessels

A nurse is reinforcing teaching with a newly licensed nurse about contraindications to vaccines. Which of the following examples should the nurse provide as a true contraindication for all vaccines? a. previous local reaction to an injectable vaccine b. moderate illness without a fever c. recent exposure to an infectious disease d. family history of an allergy to penicillin

b. moderate illness without a fever The nurse should identify that a client who has a moderate or severe illness with or without a fever has a true contraindication to receiving a vaccine. The nurse should postpone the immunization until the client has recovered from the illness

A nurse is caring for a client who is taking glucocorticoids. The nurse should monitor the client for which of the following adverse effects of the medication? a. weight loss b. peptic ulcer c. hyperkalemia d. dipolpia

b. peptic ulcer The nurse should monitor this client who is taking glucocorticoids for peptic ulcer disease due to irritation of the gastric mucosa. The nurse should periodically check the client's stool for occult blood and instruct the client to contact the provider if any black tarry stools occur

A nurse is caring for a client who has cystic fibrosis and has a prescription for high-dose ibuprofen daily. The nurse should identify that which of the following is an expected outcome for the client receiving this medication? a. thinned pulmonary secretions that are retained in the airways b. slowed progression of pulmonary damage c. potentiated action of bronchodilator therapy d. decreased risk of fevers associated with CF

b. slowed progression of pulmonary damage the nurse should identify that clients who have CF are prescribed high-dose ibuprofen, which is an NSAID, to slow the progression of pulmonary damage by suppressing the inflammatory response that causes pulmonary damage. CF is a genetic disorder that primarily affects the lungs, pancreas, and sweat glands.

A nurse is reviewing the laboratory report for a client who is taking tobramycin and notes that the peak blood level is 9.3 mcg/mL. Which of the following actions should the nurse take? a. administer half of the prescribed dosage at the client's next scheduled dose b. tell the client that the medication seems to be appropriate c. advise the client to drink more water throughout the day d. ask if the client has been experiencing any peripheral neuropathy

b. tell the client that the medication seems to be appropriate A therapeutic peak level of 9.3 mcg/mL is within the expected range of 5-10 mcg/mL. The nurse should recognize that that this laboratory result indicates the client is receiving a sufficient dose of the medication to promote therapeutic effects and a reduction in the manifestations of infection

A nurse is reviewing a new prescription for fexofenadine for a 7-year old client who has seasonal allergies. Which of the following findings should the nurse clarify with the provider? a. the prescription says to avoid taking the medicine with orange juice b. the prescription says to take standard tablets c. the prescription says to take 30 mg twice daily d. the prescription says to administer the medicine orally

b. the prescription says to take standard tablets the nurse should identify that this 7-year-old client has been prescribed a standard tablet, which is appropriate for client 12 years and older

A nurse is assessing a client who take oral theophylline for chronic bronchitis relief. The nurse should recognize that which of the following findings indicates toxicity to theophylline? a. constipation b. tremors c. fatigue d. bradycardia

b. tremors theophylline is a xanthine-derivative bronchodilator. an early manifestation of toxicity is CNS stimulation, often seen as tremors. seizures can occur if blood levels continue to rise

A nurse is teaching a female who has a new prescription for misoprostol to treat peptic ulcer disease. Which of the following client statements should indicate to the nurse that the teaching was effective? a. "I should avoid taking NSAIDs while using this medication." b. "Misoprostol is used to treat stress-induced gastric ulcers." c. "I should avoid becoming pregnant while taking this medication." d. "This medication is also used to treat dysmenorrhea."

c. "I should avoid becoming pregnant while taking this medication." The nurse should identify that misoprostol is contraindicated during pregnancy and is classified as pregnancy risk category X by the Food and Drug Administration. It has the potential to stimulate uterine contractions, and the use of misoprostol during pregnancy has been known to cause partial or complete expulsion of the developing fetus.

A nurse is providing teaching to a client who has postmenopausal osteoporosis and a new prescription for intranasal calcitonin-salmon. Which of the following statement by the client indicates an understanding of the teaching? a. "I will administer a spray into each nostril daily." b. "I should expect nasal bleeding for the first week." c. "I will need to depress the side arm to activate the pump." d. "I should expect to take this medication for a short-term course of treatment."

c. "I will need to depress the side arm to activate the pump." The nurse should instruct the client to activate the pump for the initial use by holding the bottle upright and depressing both white side arms toward the bottle 6 time

A nurse is teaching a client who has a new prescription for warfarin. Which of the following statements should the nurse identify as an indication that the client understands the instructions? a. "I'll use a safety razor to shave each day." b. "I'll be sure to eat lots of spinach." c. "I'll avoid contact sports like football." d. "I'll take ibuprofen if I get a headache."

c. "I'll avoid contact sports like football." the most common adverse effect of taking anticoagulants is bleeding. therefore, the client should avoid any activities that have a high risk of causing injury, such as contact sports

A nurse is preparing to administer warfarin to a client who has a new onset of atrial fibrillation. The client asks the nurse, "What should this medication do?" Which of the following responses should the nurse make? a. "It helps your heart return to a normal rhythm." b. "It dissolves blood clots." c. "It can reduce your risk of having a stroke." d. "It helps to prevent bleeding in atrial fibrillation."

c. "It can reduce your risk of having a stroke." the nurse should identify that atrial fibrillation increases the client's risk of having a stroke due to clot forming in the atrium. warfarin can prevent clot formation when used long-term, which will reduce the client's risk of having a stroke.

A nurse is planning care for a client who is postoperative and scheduled to ambulate. At which of the following times should the nurse plan to administer PO morphine to the client for peak analgesic effect during the ambulation? a. 3-4 hr before ambulation b. 10-15 min prior to ambulation c. 60-90 min prior to ambulation d. immediately before ambulation

c. 60-90 min prior to ambulation the peak effect of PO morphine takes 60-90 minutes to occur.

A nurse is caring for a client who has COPD and has been taking fluticasone via inhaler for many years. Which of the following findings should the nurse identify as an adverse effect of long-term use of this medication? a. glomerular filtration rate <60 b. ALT 82 units/L c. anorexia and weakness d. varicose veins in the lower extremities

c. anorexia and weakness The nurse should identify adrenal insufficiency as an adverse effect of the long-term use of an inhaled corticosteroid such as fluticasone. Manifestations can include anorexia, weakness, nausea, hypotension, and hypoglycemia

A nurse is caring for a client who has COPD and has been taking fluticasone via inhaler for many years. Which of the following findings should the nurse identify as an adverse effect of the long-term use of this medication? a. glomerular filtration rate (GFR) less than 60 b. alanine aminotransferase (ALT) 82 units/L c. anorexia and weakness d. varicose veins in the lower extremities

c. anorexia and weakness the nurse should identify adrenal insufficiency as an adverse effect of long-term use of an inhaled corticosteroid such fluticasone

A nurse is reviewing the medication administration record of a client who is receiving an opioid medication for pain. Which of the following prescriptions should the nurse clarify with the provider? a. metoprolol b. ondansetron c. lorazepam d. nalaxone

c. lorazepam The nurse should identify that lorazepam can cause central nervous system depression, which can result in increased respiratory depression and sedation when administered with an opioid. The nurse should clarify the prescription with the provider

A nurse is caring for a client who has brought to the emergency department by friends after a reported heroin overdose. Which of the following findings should the nurse expect to assess? a. temperature 102.6 b. respiratory rate 30/min c. pinpoint pupils d. severe abdominal cramping

c. pinpoint pupils pinpoint pupils are an expected finding in opioid toxicity. increased pupil size is seen in opioid withdrawal

A nurse is providing teaching to the parents of a child who has a new prescription for lamotrigine for a seizure disorder. The nurse should instruct the parents that which of the following adverse effects is the priority to report to the provider? a. diplopia b. dizziness c. rash d. headache

c. rash

A nurse is teaching self-administration of NPH insulin to a client who has type 2 diabetes mellitus. Which of the following instructions should the nurse include? a. alternate injecting doses between the abdomen and the thigh b. shake the vial before withdrawing the dosage c. rotate injection site within the same area d. discard the vial if the insulin is cloudy

c. rotate injection sites within the same area to prevent lipodystrophy, the client should rotate injection site and keep them about 2.5 cm apart within the same anatomical area

A nurse is assessing a client who has heart failure and is receiving digoxin. Which of the following findings should indicate to the nurse the client is experiencing digoxin toxicity? a. suppression of dysrhythmias b. increased atrioventricular conduction c. visual disturbances d. weight gain

c. visual disturbances The nurse should recognize that nausea, vomiting, abdominal discomfort, fatigue, and visual disturbances are common manifestations that can indicate that the client is experiencing digoxin toxicity

A nurse is caring for a client who takes warfarin 2.5 mg PO daily and has an INR of 6.2. The nurse should anticipate a prescription from the provider for which of the following medications? a. protamine sulfate b. fondaparinux c. vitamin K d. bivalirudin

c. vitamin K The nurse should anticipate the provider to prescribe vitamin K for a client who has an INR of 6.2. Vitamin K antagonizes warfarin's actions, which can reserve warfarin-induced inhibition of clotting factor synthesis

A nurse is teaching a client who has a new prescription for disulfiram to treat alcohol use disorder. Which of the following statements by the client indicates an understanding of the teaching? a. "If I have a strong urge to drink alcohol, I should skip my dose for that day." b. "Even when I'm not drinking alcohol, adverse effects can include seizures." c. "Medication therapy can begin as soon as I enter the detoxification program." d. "I should check the labels of my skin care products, medications, and food for alcohol."

d. I should check the labels of my skin-care products, medications, and food for alcohol The client should check all products for the presence of alcohol when taking disulfiram. The nurse should inform the client that 7 mL of alcohol is needed to precipitate adverse effects of the medication. Alcohol can be found in cough syrups, vinegar, and sauces. It might also be applied to the skin in aftershave and cologne

A nurse is providing teaching to the parents of a school-age child with asthma about medications for bronchospasm. Which of the following inhaled medications should the nurse instruct the parents to use to relieve an acute asthma attack? a. salmetrol b. cromolyn c. fluticasone d. albuterol

d. albuterol

A nurse is planning to administer diphenhydramine 50 mg via IV bolus to a client who is having an allergic reaction. The client has an IV infusion containing a medication that is incompatible with diphenhydramine in solution. Which of the following actions should the nurse take? a. choose an IV port for IV bolus injection of diphenhydramine to the client's hanging IV bag b. flush the IV tubing with 2 mL of 0.9% sodium chloride before and after administering diphenhydramine c. allow the IV infusion to keep running while administering the diphenhydramine via IV bolus d. aspirate to check for IV patency before administering the diphenhydramine

d. aspirate to check for IV patency before administering the diphenhydramine

A nurse is administering oral hydroxyzine to a client. Which of the following adverse effects should the nurse instruct client to expect? a. diarrhea b. anxiety c. nausea and vomiting d. dry mouth

d. dry mouth

A nurse is administering oral hydroxyzine to a client. Which of the following adverse effects should the nurse instruct the client to expect? a. diarrhea b. anxiety c. nausea and vomiting d. dry mouth

d. dry mouth hydroxyzine has anticholinergic properties. dry mouth is a common adverse effect of this medication. the nurse should instruct the client to take sips of water or suck hard candies to minimize this effect.

A nurse is caring for a client who has a vitamin K deficiency. Which of the following manifestations should the nurse expect? a. irregular bone formation b. abnormal movements c. blurred vision d. excessive bruising

d. excessive bruising The nurse should identify that excessive bruising can indicate bleeding under the skin. Vitamin K is needed by clotting factors to coagulate the blood. Therefore, a client who has deficiency in vitamin K is at risk for excessive bruising and bleeding

A nurse is preparing to administer oxytocin to a client who is at 41 weeks gestation and is experiencing ineffective labor. Which of the following actions should the nurse plan to take? a. place the oxytocin from a pre-filled syringe into the posterior fornix of the vagina every 10 min until effective labor occurs b. check the client's blood pressure and pulse every1 5 min while induction of labor is occuring c. stop oxytocin for contractions that continue for more than 30 sec d. increase the dose of oxytocin to obtain uterine contractions that occur every 2-3 min

d. increase the dose of oxytocin the dose of oxytocin to obtain uterine contractions that occur every 2-3 min effective uterine contractions should occur every 2-3 minutes

A charge nurse is monitoring a newly licensed nurse who is caring for a postoperative client who is receiving morphine through a PCA pump. Which of the following actions by the newly licensed nurse repairs intervention? a. instructing the client to administer a PCA dose prior to a dressing change b. providing increased fluids while the client is using the PCA pump c. informing the client's partner that only the client should administer the PCA doses d. maintaining the client on best rest while the PCA pump is in use

d. maintaining the client on bed rest while the PCA pump is in use use of a PCA pump does not prevent ambulation following surgery. early ambulation should be encouraged. the nurse should instruct the client to sit at the side of the bed prior to standing to reduce the risks of orthostatic hypotension and falls

A nurse is caring for a client who has a new prescription for amphotericin B. The nurse should plan to monitor the client for which of the following adverse effects? a. hyperkalemia b. hypertension c. constipation d. nephrotoxicity

d. nephrotoxicity Amphotericin B is an antifungal medication used to treat severe fungal infections; however, it can cause nephrotoxicity. The nurse should monitor the client's creatinine every 3-4 days and increase fluid intake. The dosage of amphotericin B should be reduced if the client's creatinine is 3.5 mg/dL or greater

A nurse is caring for a client who has cancer involving the lumbar vertebrae and has been prescribed gabapentin. Which of the following therapeutic effects should the nurse identify for the client when taking this medication? a. reduced cancer-related bone pain b. decreased anxiety and insomnia c. decreased inflammatory response to cancer tumors d. reduced cramping, aching, and burring neuropathic pain

d. reduced cramping, aching, and burning neuropathic pain the nurse should identify that gabapentin is administered to treat neuropathic pain that is sharp and darting. the medication can also decrease cramping, aching, and burning pain and suppress spontaneous neuronal firing that causes pain