chapter 6

A client is experiencing acute alcohol withdrawal. What medication does the nurse anticipate the prescriber to order?

chlordiazepoxide

Which drug would be classified as a hallucinogen?

PCP

A client has been prescribed a selective serotonin reuptake inhibitor (SSRI) to treat depression. The regular use of which herbal supplement requires intervention by the nurse?

St. John's wort

The nurse should plan care with the goal of preventing which primary signs of alcohol withdrawal?

delirium tremens

A nurse is working in the emergency department and is assigned to a client brought in by family members. The family thinks that the client is on methamphetamine. The nurse should assess for:

hypertension

The nurse caring for a client suspected of ketamine abuse should focus on what characteristic behavior?

sensory hallucinations

The nurse is assessing a client and is asking about the client's current medication regimen. The client states, "I'm not taking anything that you need a prescription to get." What is the nurse's best response?

"Which drugs do you take that don't require a prescription?"

A client has been deemed a candidate for methadone therapy. What instruction should the nurse provide when preparing the client for this treatment plan?

"You'll need to come to the clinic to get your daily dose of methadone."

Clients often do not mention the use of alternative therapies to the health care provider. Which is a likely reason they do not discuss alternative therapies? Select all that apply.

- Clients think that if a product is "natural," including it in a list of medications does not make sense. - Clients fear that the health care provider will not approve of any alternative therapies.

Despite the insurance coverage a patient may have for prescription medications, it is often necessary for the health care provider to choose a drug therapy based on the costs of the drugs available. Which of the following factors should not be considered by a health care provider when prescribing a drug? Select all that apply.

- Have patients share medications among family members as long as the same drug and dosage have been ordered. - Ask patients to stop buying expensive fresh produce and lean meats in order to be able to budget for medications.

What are accurate regarding herbal remedies? (Select all that apply.)

- Herbal remedies can interact with prescription drugs. - Clients often do not mention their use to health care providers. - Herbal remedies produce unexpected effects.

Access to information has become so broad over the last decade that consumers are often overwhelmed with details, facts, and choices that affect their health care. What factors have influenced how a client approaches the health care provider when it comes to prescriptions? Select all that apply.

- Internet - media - alternative therapy

It is often necessary for the health care provider to choose a drug therapy based on the costs of the drugs available. Which factors may be considered by a health care provider when prescribing a drug? Select all that apply.

- Teach clients not to cut drugs in half in order to save on costs. - Elderly clients may have a fixed income, so choosing a generic over a brand name drug for them may be ideal.

A post-surgical client is being discharged home with a prescription for analgesics and antibiotics. During discharge education, what should the nurse do? (Select all that apply.)

- Teach the client the purpose of each medication. - Teach the client about potential adverse effects. - Assess the client's knowledge of the medications. - Assess the client's ability to pay for each medication.

Off-label use refers to uses of a drug that are not part of the stated therapeutic indications for which the drug was approved by the Food and Drug Administration. With the liability issues surrounding many of these drugs, the nurse should be aware of certain factors in order to ensure patient safety. Select all that apply.

- Why the patient is taking this drug - For what purpose is the drug being given - Which potential problems may arise after taking this drug

Off-label use refers to uses of a drug that are not part of the stated therapeutic indications for which the drug was approved by the FDA. When a nurse is using a medication for its off label use, the nurse should be very cognizant of certain factors in order to ensure patient safety. Select all that apply.

- its potential for problems - Clear about the intended use - Why the drug is being given

Which data would be helpful in determining the accuracy of information found on the Internet? (Select all that apply.)

- navigation - contributors - dates - reliability

The client explains to the nurse that the client prefers to use alternative therapies in addition to the traditional Western therapy. What does the nurse understand is included in alternative therapy? (Select all that apply.)

- vitamins - supplements of basic food elements - minerals - herbs and botanicals

A nurse is watching television and sees an ad for a drug. The drug's indication is mentioned in the ad. Which would the nurse identify as also being required to include in the ad? (Select all that apply.)

-adverse effects -precautions -contraindications

Which website extension represents a professional group?

.org

Cimetidine (Tagamet) is an OTC drug used to treat:

heartburn

The nurse is caring for a client with migraines who has been prescribed fluoxetine. The nurse has questioned the provider about the prescription, stating, "The client has no history of depression that I'm aware of, so why is she starting Prozac?" The provider replies, "It's an off-label use." What is the nurse's best action?

Assess the client and administer the client's fluoxetine as prescribed.

How should the nurse best assess the client for physical dependence on alcohol?

Assess the client for signs and symptoms of alcohol withdrawal.

The emergency department nurse is admitting a young adult client who denies the use of prescription or over-the-counter medications, but who admits to using cocaine and ecstasy. How should the nurse best follow up this assessment finding?

Assess the frequency of use and document the findings.

The triage nurse in the emergency department admits a client in distress. The client's parents attribute the client's distress to amphetamine use. What assessment finding would bestcorroborate this parent's suspicion?

Blood pressure 196/117 mm Hg

A client was prescribed an oral antibiotic but was unable to tolerate the medication due to adverse effects. The client asks the nurse what to do with the remaining medication. What is the nurse's best recommendation?

Bring the medication to a pharmacy that accepts unused medications.

A group of students asks an instructor about where to find the most up-to-date information on biological weapons. What would the instructor recommend?

Centers for Disease Control

Which practice has contributed to the problem of resistant bacteria?

Clients saving remaining antibiotics for the next time they feel sick

Which of the following statements about today's health care consumers would the nurse recognize as false?

Consumers are reluctant to use over-the-counter and alternative therapies.

A client has been diagnosed with heart failure and has been prescribed a calcium channel blocker. The client tells that nurse that it will be a major challenge to afford the medication and states, "I might see if I can find the pills cheaper from an online pharmacy in another country." What is the nurse's most appropriate action?

Educate the client about the potential risks involved in buying medications online.

A client with newly diagnosed hypertension has received a prescription from the care provider reading "Vasotec 5 mg PO daily." The client has expressed concern to the nurse about the possible cost of the medication. What is the nurse's best action?

Encourage the client to inquire about purchasing a generic equivalent.

A client asks a nurse about using the Internet to obtain drugs at a cheaper price. The nurse should recommend the client access what site for additional information regarding this practice?

Food and Drug Administration

A woman comes to the emergency department reporting that she thinks she was date raped. She states that she cannot remember anything and is extremely sleepy. "I think someone put something in my drink." What drug should the nurse suspect was most likely to be put in her drink?

Gamma hydroxybutyrate

The nurse admitted a client who overdosed on an unknown drug. The fact that the client appears to be experiencing psychosis should suggest what possible drug to the nurse?

LSD

What action should the nurse take when identifying that a client regularly self-medicates with herbal supplements?

Notify the healthcare provider of the client's use of herbs.

When describing off-label use, what would the nurse need to keep in mind?

Off-label drug use may lead to the discovery of a new use for the drug.

A client has brought in a magazine advertisement for a medication and has asked the nurse to arrange a prescription for it. When addressing the client's request, what is the nurse's bestaction?

Provide factual, understandable information that meets the client's learning needs.

A client reports that, "The alcohol treatment programs I've tried in the past have only helped for a little and then I start drinking again." This statement best describes which type of alcohol-related behavior?

Psychological dependence

A 70-year-old with a history of atrial fibrillation has been admitted with a lower gastrointestinal bleed. During the nurse's admission assessment, the nurse realizes that the client has been taking ginkgo biloba supplements in addition to prescribed warfarin, a combination that has resulted in bleeding. What nursing diagnosis should the nurse identify when planning this client's care?

Risk for Injury related to drug interactions of vitamins, herbs, or food intake with prescribed drug therapy

A client was prescribed a three-month supply of an oral antidepressant but the drug was discontinued shortly thereafter due to adverse effects. What should the nurse advise the client to do with the remaining pills?

Take them to a pharmacy that is designated to accept old medications.

Which entity or act classifies herbal products, vitamins, and minerals as "dietary supplements"?

The Dietary Supplement Health and Education Act of 1994

When discussing the various reasons why clients may order drugs via the Internet from other countries, which would be least likely?

The drugs are the same as those the client would get at home.

Which of the following teaching points about herbal therapies is inaccurate?

The results of available testing involve large groups of people.

What should the nurse include when teaching a client about herbal therapies?

The results of available testing often involve only a small number of people.

A client has been prescribed a diuretic and asked the health care provider to write a prescription for twice the daily dose so that the client could split each pill and reduce costs. The nurse should:

caution the client that this practice can lead to inconsistent doses.

The nurse who is working in the emergency department admits a 14-year-old who is exhibiting blurred vision, confusion, impaired breathing, muscle twitches, irregular heartbeat, and excessive sweating. The client's friends says the client bought a lot of cough syrup and has been drinking it all day. The nurse understands that the client has overdosed on what over-the-counter medication?

dextromethorphan

A client reports that taking St. John's wort. When reviewing the client's medication history, what would be a cause of concern?

digoxin

A nurse has admitted a client diagnosed with substance abuse intoxication to the unit. The nursing assessment will first be directed toward data regarding:

drug use.

The home care nurse is paying a schedule visit to an older adult client who has a complex mediation regimen. The nurse should prioritize what action related to the client's medications during this visit?

educating the client about the management of possible adverse effects

Which aspect of medical care is an overriding concern of a health maintenance organization (HMO)?

financial

A 40-year-old client has become interested in alternative therapy as a means to maintain and enhance health. However, the client has developed hypertension and will be prescribed an antihypertensive agent. The nurse's health history reveals that the client eats a balanced diet, swims regularly, and occasionally takes an over-the-counter medication for allergies. A priority assessment for the nurse will be to determine:

if the client is taking herbal or botanical medications regularly.

What responsibility does the nurse hold related to protecting the public from bioterrorism?

maintaining currency about potential bioterrorism agents

Minoxidil was originally marketed for the treatment of hypertension. Many men, and some women, using the pill form of the drug discovered they had hair growth as the result of hair follicle function returning to their scalp. When this was found in a number of cases, the pharmaceutical company began marketing a spray form of the drug for hair regrowth for bald men. This is an example of:

off-label use.

Heroin is classified as which type of street drug?

opioid

The nurse is caring for a client who has strong beliefs about the effectiveness of a specific alternative therapy. The nurse recognizes the effectiveness of this therapy is increased by what effect?

placebo effect

When caring for a client with alcohol dependence who is prescribed a benzodiazepine, which side effects is it most important that the nurse monitor for?

sedation

A client, admitted for the treatment of a fracture, has a history of heavy alcohol use. What event should suggest the implementation of pharmacologic treatment for alcohol withdrawal?

signs/symptoms of withdrawal are noted

The nurse is admitting a client who has been on a three-day binge of methamphetamine. The nurse should anticipate what sign or symptom?

tachycardia

When describing the characteristics of the client who comes into the health care system today, which would most likely apply?

the use of a complex array of OTC and alternative therapies

What would be most appropriate to teach a client about over-the-counter drugs?

they are safe when you use them as directed.