Exam 4 Prep Us Combined- Pharm

A client is taking spironolactone (Aldactone) for edema. The nurse identifies the client's potassium level is 5.4 mEq/L. With this finding which question would be most appropriate for the nurse to ask? "Are you experiencing any leg cramps?" "Is your urine dark?" "Do you use a salt substitute?" "Are you weighing yourself daily?"

"Do you use a salt substitute?" The client is experiencing hyperkalemia. Spironolactone (Aldactone) is a potassium-sparing diuretic. It is important to ask about dietary intake of potassium (including salt substitutes since many contain potassium). Daily weight, urine color, and leg cramps are not related to hyperkalemia.

After teaching a client about prescribed statin therapy, the nurse determines that additional teaching is needed when the client makes which statement? "I should take the dose around bedtime." "I should report any problems with muscle pain or weakness." "I can take the drug with grapefruit juice." "I need to be careful when I'm out in the sun."

"I can take the drug with grapefruit juice."

A nurse is teaching a 45-year-old client about the sublingual nitroglycerin that the health care provider has prescribed for management of stable angina. Which statement by the client indicates that the client understands the teaching session? "I will take the nitroglycerin whenever I eat, to help with the absorption of the medication." "I will take the nitroglycerin twice a day." "I will take the nitroglycerin once a week to improve my ability to exercise." "I will use the nitroglycerin if I experience chest pain."

"I will use the nitroglycerin if I experience chest pain."

A client is prescribed sublingual nitroglycerin for treatment of angina. The nurse instructs the client to do what if chest pain occurs? "If the medication burns or causes a headache, get a new prescription." "The pills are usually good for 12 to 18 months after the prescription is filled." "Use the nitroglycerin if your chest pain doesn't subside on its own in 3 minutes." "If the chest pain doesn't go away after three tablets are given 5 minutes apart, call 911."

"If the chest pain doesn't go away after three tablets are given 5 minutes apart, call 911."

A nurse is preparing to administer hydroxyzine to the nauseated client. Which is included in the teaching plan about the medication? "The drug will aid in making you feel less nauseated by stimulating your intestines." "The medication may make you feel more alert, like coffee." "I will mix this medication with applesauce to help you feel better." "This medication will help with the nausea by making you drowsy."

"This medication will help with the nausea by making you drowsy."

A postoperative surgical client, prescribed twice-daily administration of docusate sodium, is concerned about developing diarrhea. What should the nurse teach the client about docusate sodium? "You'll usually have a bowel movement within 2 to 3 hours of taking this." "This drug will help you pass regular stools while you're in the hospital, but you should not take it for more than 5 days." "This medication will cause your bowels to contract more strongly than they normally do." "This medication will only soften your stools over the next couple of days."

"This medication will only soften your stools over the next couple of days."

he nurse identifies the therapeutic range for digoxin as: 2 to 3 ng/mL. 0.8 to 2 ng/mL. 3 to 4 ng/mL. 0.1 to 0.9 ng/mL.

0.8 to 2 ng/mL

The nurse should counsel a client to discontinue use of over-the-counter antidiarrheals and seek treatment from a health care provider if diarrhea persists for how long? 1 day 7 days 12 hours 2 days

2 days

The nurse is conducting a first aid class and informs the class that in the case of acute, nonspecific diarrhea in adults where fluid losses are not severe, clients usually need only simple replacement of fluids and electrolytes lost in the stool. The nurse instructs the class to drink how much fluid during the first 24 hours? 0.5 to 1 L of clear liquids 1 to 2 L of clear liquids 2 to 3 L of clear liquids 3 to 4 L of clear liquids

2 to 3 L of clear liquids

A male client has called the clinic because he is taking digoxin and is concerned about his pulse rate. The nurse should tell the client to hold the medication if he reports a pulse rate of: 84 beats/minute. 52 beats/minute. 66 beats/minute. 78 beats/minute.

52 beats/minute.

The 5-HT3 receptor blocker, palonosetron, is especially suited for administration to which client? A 16 year old experiencing intractable hiccoughs An 8 year old receiving radiation therapy A 10 month old experiencing vomiting after chemotherapy A 79 year who is recovering from hip surgery

A 10 month old experiencing vomiting after chemotherapy

A nurse is preparing a teaching plan for a client with edema who is prescribed a diuretic. Which teaching should the nurse prioritize? Administer early in the day. Gradually increase the dosage. Encourage exercise. Decrease fluid intake.

Administer early in the day. The drug should be administered early in the day to prevent any nighttime sleep disturbance caused by increased urination. Asking the client to decrease fluid intake may contribute to fluid and electrolyte imbalance. The drug should be used as directed without the client making any adjustments to the dosage. The client should remain as active as possible, depending on their overall condition; however, exercise is not a priority in this situation.

All of the following are centrally acting antiemetics EXCEPT Adsorbents Anticholinergics Antihistamines Serotonin (5-HT3) receptor blockers Phenothiazines

Adsorbents

The patient has called the office to see if using bismuth subsalicylate will work to treat simple diarrhea. The nurse knows this will be a safe and effective treatment for diarrhea unless the patient has: Hypertension Hypothyroidism Urinary retention Allergy to aspirin

Allergy to aspirin

The nurse on the telemetry unit is preparing to administer propranolol 10 mg orally to a 54-year-old male client with recent myocardial infarction and history of hypertension. Click to highlight the findings in the Nurse's Note that require immediate attention prior to administration of propranolol. Apical pulse 58 beats/min and regular, blood pressure 88/58 mm Hg lying in bed , respiratory rate 16 breaths/min , temperature 97.2°F (36.2°C) orally . Lungs clear to auscultation bilaterally. Alert and oriented to time, place, and person. Reports feeling lightheaded while lying in bed . Dorsalis pedis and posterior tibial pulses strong bilaterally , with no pedal edema noted. No jugular venous distention noted. S1 and S2 heart sounds auscultated .

Apical pulse 58 beats/min blood pressure 88/58 mm Hg lying in bed , Reports feeling lightheaded while lying in bed

client is taking atorvastatin calcium to reduce serum cholesterol. Which aspect of client teaching is most important? Call the health care provider if muscle pain develops. Eat two eggs per day to increase protein stores. Decrease the dose if lethargy occurs. It is acceptable to eat saturated fats.

Call the health care provider if muscle pain develops.

Constipation is a frequent problem. The nurse knows that which of these statements regarding constipation is correct? Dietary fiber causes constipation. Constipation is defined as the absence of daily bowel movements. Opioid drugs relieve constipation. Constipation is characterized by hard, dry stools.

Constipation is characterized by hard, dry stools.

A client is being treated for heart failure. What assessment finding would the nurse interpret as most indicative of improved health status? Decreased pitting edema Improved sensorium Increased skin turgor Heart rate of 52

Decreased pitting edema

Diphenoxylate with atropine sulfate resolves diarrhea by what mechanism of action? Inhibiting cellular division in causative bacteria Absorbing toxins Binding with fecal material to increase bulk Decreasing intestinal motility

Decreasing intestinal motility

The health care provider has prescribed a class IV calcium channel blocker for a client diagnosed with acute supraventricular tachycardia. Which drug does this nurse expect to be prescribed? Chlorambucil Midazolam hydrochloride Diltiazem Bethanechol chloride

Diltiazem

A patient who experiences frequent constipation asks the nurse for advice regarding which agent would be best for long-term daily use? The nurse will respond that the best for daily use is which of the following? Bisacodyl (Dulcolax) Mineral oil Docusate (Colace) Milk of magnesia

Docusate (Colace)

A female client is receiving chemotherapy to treat her cancer. Several antiemetics have been prescribed, and each has been unsuccessful in treating her nausea and vomiting. The health care provider chooses to prescribe what cannabinoid drug to manage her symptoms? Dronabinol Fosaprepitant Ondansetron Scopolamine

Dronabinol

A client should be instructed to take sublingual NTG how often if he experiences chest pain? Every 2 minutes times 5 Every 5 minutes times 3 Every 10 minutes times 5 Every 1 minute times 3

Every 5 minutes times 3

An older adult client who resides in a care facility has been prescribed antihypertensives for the first time following many years of generally good health. When administering the first dose of the prescribed antihypertensive medication to an older adult, the nurse should recognize the related risk to which possible side effect? Falls Acute confusion Impaired oxygenation Infection

Falls

The nurse is caring for a 19-month-old child who has been hospitalized with dehydration secondary to nausea and vomiting. The nurse is aware that promethazine will not be used for this client because it can cause what in children under the age of 2? Fatal hypertension and subsequent cerebral vascular accident Fatal hypovolemia secondary to hemorrhage Fatal respiratory depression Life-threatening cardiac arrhythmias

Fatal respiratory depression

The nurse instructs a male client to administer his alpha1-adrenergic receptor blocking agent at night. What does this practice help to minimize? Hypoglycemic reaction Postural hypertension Hyperglycemic reaction First-dose phenomenon

First-dose phenomenon

A nurse is caring for a client prescribed nicotinic acid for hyperlipidemia. The nurse would assess the client for which findings as a possibility? Flushing of the skin Dyspnea Tachycardia Weakness

Flushing of the skin

A client has edema of the lower extremities with crackles in the lung bases. What diuretic is most likely to be prescribed for a client assessed with lower extremity edema and bilateral lung crackles? Spironolactone Furosemide Mannitol Hydrochlorothiazide

Furosemide

The client has crackles in the lower lobes of the lungs, an audible S3, and pitting edema in the feet and ankles. What condition is the client most likely experiencing? Myocardial infarction Liver disease Pneumonia Heart failure

Heart failure

A resident of a long-term care facility receives 12.5 mg metoprolol (Lopressor) at 8 AM and 8 PM daily. Before administering this drug, the nurse should perform and document what assessment findings? Heart rate and blood pressure Level of consciousness and pain level Oxygen saturation and respiratory rate Temperature and respiratory rate

Heart rate and blood pressure

The nurse is caring for a client experiencing an acute angina attack. Sublingual nitroglycerin has been administered. The nurse assesses the client's vital signs for which reason? Identify hypotension. Evaluate for recurrent pain. Reassure client that they are okay. Confirm report of headache.

Identify hypotension.

A group of students are reviewing the actions of laxatives on the GI tract. The students demonstrate understanding when they state what about bulk stimulants? Allow formation of a slippery coat on the intestinal contents Increase the fluid in the intestinal contents Directly stimulate the nerve plexus in the intestinal wall Selectively antagonize opioid binding

Increase the fluid in the intestinal contents

A primary health care provider has prescribed a loop diuretic for hypertension in a client with diabetes mellitus. Which assessment should the nurse prioritize? Sudden increase in weight Increased blood glucose levels Occurrence of gout attacks Sudden pain in the joints

Increased blood glucose levels

A newly admitted 58-year-old client has a diagnosis of alcohol abuse and chronic liver failure. The health care provider suspects the client has hepatic encephalopathy. The client tells reports not having a bowel movement in 5 days. What laxative can this client take to lower serum ammonia levels? Sorbitol Lactulose Docusate sodium Polyethylene glycol-electrolyte solution

Lactulose

The nurse is preparing to teach a group of middle-aged clients ways to reduce hypertension. Which instruction(s) should the nurse point out during this session? Select all that apply. Increase sodium intake. Lose weight. Stop smoking. Reduce stress. Decrease exercise.

Lose weight. Stop smoking. Reduce stress.

The nurse is teaching a client about diphenoxylate with atropine sulfate which has been prescribed for treatment of acute diarrhea. For which adverse effect should the nurse teach the client to anticipate? Bradycardia Diaphoresis Increased appetite Nausea

Nausea

A client has begun taking cholestyramine. Which are noted as the most common adverse effects? Nausea, flatulence, and constipation Hiccups, nasal congestion, and dizziness Fatigue and mental disorientation Increased appetite and blood pressure

Nausea, flatulence, and constipation

The nurse is providing teaching to a client who is at risk for hyperlipidemia. The nurse knows that which risk factors can be controlled or modified? Gender, obesity, family history, and smoking Inactivity, stress, gender, and smoking Obesity, inactivity, diet, and smoking Stress, family history, and obesity

Obesity, inactivity, diet, and smoking

A 1-year-old child is experiencing diarrhea. What should the parents be instructed to administer? Diphenoxylate (Lomotil) Psyllium (Metamucil) Oral rehydration solutions Octreotide (Sandostatin)

Oral rehydration solutions

Which would a nurse expect to assess if a client is experiencing right-sided heart failure? Dyspnea Peripheral edema Wheezing Hemoptysis

Peripheral edema

The pharmacology instructor is discussing effects on the heart of different medication. What is the term the instructor would use to describe the effect of a medication that increases the force of the contractions of the heart? Positive inotropic Negative dromotropic Positive chronotropic Negative inotropic

Positive inotropic

A client is advised to use a bulk-forming laxative to alleviate constipation. The nurse will recommend: mineral oil. Psyllium (Metamucil). milk of magnesia. Docusate (Colace).

Psyllium (Metamucil).

The nurse should know that lactulose achieves a therapeutic effect by which means? Pulling water into the intestinal lumen by osmotic pressure Decreasing the viscosity of intestinal contents in the duodenum Relaxing the muscle tone of the ileocecal valve and anal sphincter Irritating the intestinal mucous membrane

Pulling water into the intestinal lumen by osmotic pressure

A patient, admitted to a health care facility with cardiac arrhythmia, is prescribed propranolol. Which factor should the nurse closely monitor as a part of the ongoing assessment during the therapy? Tendon reflexes Visual acuity Pulse rate Hydration

Pulse rate

The client has been prescribed diphenoxylate with atropine (Lomotil) for diarrhea. The nurse recognizes that this drug is effective against diarrhea because of which action? Slows peristalsis by acting on the smooth muscles of the intestine Decreases GI secretions Anti-inflammatory effects allowing absorption of fluids Antimicrobial effects

Slows peristalsis by acting on the smooth muscles of the intestine

A patient is advised to use a cathartic to relieve constipation. The nurse knows that cathartics include which of the following? Surfactants Bulk-forming agents Lubricants Stimulants

Stimulants

A client began taking hydrochlorothiazide 1 week ago and is reporting occasional dizziness when standing up quickly from sitting or lying. What is the nurse's best action? Arrange for the client's potassium levels to be assessed as soon as possible. Tell the client to withhold the medication until the client can be assessed by the primary health care provider. Educate the client about the need for bed rest until the body adjusts to the new medication. Teach the client about the blood pressure effects of the medication and relevant safety measures.

Teach the client about the blood pressure effects of the medication and relevant safety measures.

The nurse has a prescription to administer a saline cathartic to a client who has a history of congestive heart failure (CHF). Why is this type of cathartic contraindicated with this client? The client is at risk for excess fluid volume. The client is at risk for hyperphosphatemia. The client is at risk for hypomagnesemia. The client is at risk for hypochloremia.

The client is at risk for excess fluid volume.

A client with moderately elevated lipid levels requests immediate pharmacotherapy for dyslipidemia. The nurse explains that a period of intensive diet therapy and lifestyle modification will be utilized before drug therapy is considered based on what rationale? Continued therapeutic lifestyle changes during drug therapy will guarantee success. The needed lifestyle changes are usually easy for most people to achieve. Therapeutic lifestyle changes are the preferred method for lowering blood lipids. Therapeutic lifestyle changes work only when used in conjunction with medications.

Therapeutic lifestyle changes are the preferred method for lowering blood lipids.

A male client has been receiving promethazine for nausea that occurred following chemotherapy. Recently it has been discovered that this client has developed liver dysfunction. The nurse anticipates that the health care provider will do what to treat this client's nausea? Increase the dose of the medication. Maintain the current dose of the medication. Decrease the dose of the medication. Use an alternative medication.

Use an alternative medication.

A middle-aged client, frustrated by increasingly frequent episodes of constipation, is highly reluctant to take medications. What nonpharmacologic measure should the nurse recommend? Adoption of a low-fat diet Daily consumption of 6 to 8 L of fluids Use of a ginger or ginseng supplement Use of a fiber supplement

Use of a fiber supplement

In what client circumstance would the use of a bulk-forming laxative be contraindicated? acute abdominal pain currently prescribed vitamin B supplements a history of hemorrhoids inability to ambulate independently

acute abdominal pain

The nurse is caring for a client who has been prescribed an antiarrhythmic agent. What nursing assessment should the nurse prioritize? breath sounds and respiratory rate activity level and exercise tolerance mental status apical heart rate and blood pressure

apical heart rate and blood pressure

The nurse is conducting a pre-colonoscopy class and knows that polyethylene glycol- electrolyte solution will be contraindicated for the client with which condition? Oral stomatitis Chronic constipation Gastresophageal reflux disease Colitis

colitis

The nurse is caring for a client with peripheral edema and has just begun taking a diuretic. What assessment should the nurse use to evaluate the effectiveness of this medication? Select all that apply. daily weights urine output inspection of the lower extremities level of consciousness chest auscultation

daily weights urine output inspection of the lower extremities

The nurse administers loperamide to a client. The nurse expects to decrease the client's number and liquidity of stool by what mechanism? blocking the chemoreceptor trigger zone (CTZ) absorbing toxins decreasing intestinal motility binding with fecal material to increase bulk

decreasing intestinal motility

A community health nurse is conducting a health promotion session with a group from a local seniors' center. The nurse has addressed the issue of laxative overuse in this population. The nurse should highlight what consequence of the overuse of laxatives? Abdominal pain Impaired absorption of water-soluble vitamins Fecal incontinence Dependence

dependence

The nurse should educate the client prescribed a stimulant cathartic to be alert for which common adverse effect? Rectal bleeding Nausea Vomiting Diarrhea

diarrhea

A client being treated for hypokalemia has a medication history that includes propranolol, digoxin, and warfarin. When the client reports nausea, abdominal discomfort, and visual changes, the nurse suspects what as the causative factor? myocardial infarction digitalis toxicity acute renal failure heart failure

digitalis toxicity

The nurse is caring for a client with diarrhea who has been prescribed diphenoxylate with atropine and is observing the client for which adverse effects of this drug? Bradycardia Dizziness Polyuria Paleness of the face

dizziness

The nurse is providing education to a client who has been prescribed captopril. What common adverse effect would the nurse mention in the teaching? rhinitis dry cough photosensitivity rash to the trunk and extremities

dry cough

The nurse administers hydroxyzine to a client with nausea. After administration, the nurse should monitor for what adverse effect? Hypertonic muscle tone Thrombocytopenia Palpitations Dry mouth

dry mouth

A client has been prescribed ramipril 5 mg PO daily with the scheduled dose due at 08:00. After reviewing the client's most recent blood work, the nurse should consider withholding the dose because of what laboratory finding? low sodium levels elevated neutrophil levels elevated potassium levels low hemoglobin levels

elevated potassium levels

A nurse is teaching a group of older adults about nonpharmacologic strategies for preventing constipation. The nurse should recommend what practices? Select all that apply. engaging in frequent physical exercise reserving at least 8 hours nightly to assure adequate sleep drinking 6 to 10 glasses of fluid each day introducing organic foods into the daily diet consuming a high-fiber diet

engaging in frequent physical exercise drinking 6 to 10 glasses of fluid each day consuming a high-fiber diet

A 77-year-old patient has a long-standing history of hypertension, a health problem that is being treated with metoprolol and a thiazide diuretic. Before administering the 8 AM dose of these medications, what assessments should the nurse perform and document? (Select all that apply.) Temperature Heart rate Blood pressure Oxygen saturation Respiratory rate

heart rate blood pressure

The nurse is discussing antihypertensive medications with a group of clients. Which element will the nurse identify as responsible for regulating the pressure in the cardiovascular system? Select all that apply. preload pulse pressure total peripheral resistance heart rate stroke volume

heart rate stroke volume total peripheral resistance

You are preparing to administer a saline cathartic when the patient mentions that they have CHF. You know that saline cathartics are contraindicated for clients with congestive heart failure due to what adverse effect? Hypernatremia Hypochloremia Hyperphosphatemia Hypomagnesemia

hypernatremia

A client is admitted to the emergency department with pulmonary edema. What diuretic does the nurse expect the health care provider to prescribe to achieve rapid therapeutic effect? Thiazide Loop diuretic Potassium-sparing diuretic Osmotic diuretic

loop diuretic

A 75-year-old client is prescribed magnesium hydroxide for constipation. The nurse's assessment reveals that the client is being treated for rheumatoid arthritis and hypertension. The client is in assisted living and is on a low-sodium diet. Before the magnesium hydroxide therapy begins, it will be most important for the nurse to assess the client's: diet. activity level. home environment. medication history.

medication history.

A client reports taking antihistamines to treat nausea. The nurse correctly suspects that the nausea results from what trigger? radiation therapy. drugs. surgery. motion sickness.

motion sickness.

The nurse in the outpatient chemotherapy center is preparing to administer aprepitant, as part of a combination antiemetic therapy, to a 54-year-old male client prior to infusion of a highly emetic chemotherapy infusion. Drag words from the choices below to fill in each blank in the following sentence. The nurse will administer ________, __________ and ___________ along with aprepitant to treat nausea and vomiting in this client. Medication Choices olanzapine ondansetron hydroxyzine diphenhydramine scopolamine dexamethasone

ondansetron olanzapine dexamethasone

The nurse is caring for a client who is experiencing pulmonary edema. The client is treated with furosemide. What will the nurse monitor most closely? bone narrow function calcium levels potassium levels sodium levels

potassium levels

Which would the nurse explain is the pacemaker of the heart? Bundle of His AV node Purkinje fibers SA node

sa node

Before taking a flight across the country, a client with a history of motion sickness asks the health care provider for medication to control nausea. For which medication will the nurse anticipate providing teaching? scopolamine dronabinol nabilone olanzapine

scopolamine

While teaching a patient about sublingual nitroglycerin, the nurse explains proper use and storage. When the patient asks whether the medication ever expires, the nurse should respond that it: should be replaced annually. should be replaced every six months. should be replaced monthly. has an indefinite shelf life.

should be replaced every six months.

The nurse is preparing to administer sublingual nitroglycerin to a client for the first time. What effect might the client experience right after administration? nervousness or paresthesia drowsiness or blurred vision tinnitus or diplopia throbbing headache or dizziness

throbbing headache or dizziness

The nurse is teaching a client about hypertension. Nonpharmacologic methods to decrease blood pressure would include which? weight loss and decreased salt intake. increased exercise activity and fat intake. decreased water intake and decreased potassium intake. stress reduction techniques and high fat intake.

weight loss and decreased salt intake.