FINAL - ATI

A health care professional is caring for a patient who is taking ciprofloxacin (Cipro) to treat a urinary tract infection and has rheumatoid arthritis, for which he takes prednisolone (Prelone). Recognizing the adverse effects of ciprofloxacin, the health care professional should tell the patient to report which of the following? a. tachycardia b. hair loss c. insomnia d. tendon pain

d. tendon pain Ciprofloxacin, a fluoroquinolone, can cause tendon rupture, most often of the Achilles tendon. This adverse effect is especially common for older adults or clients who take glucocorticoids, such as prednisolone. The nurse should tell the client to report tendon pain and stop taking the drug.

A nurse is caring for a client who asks about acetaminophen. the nurse should identify that acetaminophen is indicated for which of the following conditions? A. To reduce fever B. To decrease inflammation C. To relieve mild pain D. To promote sedation E. To alleviate anxiety

A, C

A nurse is caring for a client who is receiving vincristine to treat lung cancer. The nurse should monitor the client and recognize which of the following manifestations as an indication that the client is experiencing an adverse reaction to the drug. A. Weak hand grasps B. Constricted pupils C. Bradycardia D. Crackles

A. Weak hand grasps Vincristine, a vinca alkaloid, can cause peripheral neuropathy. The nurse should monitor deep-tendon reflexes and the strength and movement of the hands and feet. The nurse should instruct the client to report paresthesia or reduced sensation in the hands or feet.

A nurse is caring for a client who has a new order for prednisone for long term treatment of rheumatoid arthritis. The nurse should monitor the client for which of the following adverse drug reactions? A. Pulmonary embolism B. Hepatitis C. Bone loss D. Breast cancer

C. Bone loss Prednisone, a glucocorticoid, can cause osteoporosis, especially with long-term use. Clients who are taking the drug should increase weight-bearing activity and report back pain. The nurse should monitor the client's bone density.

A primary care provider is considering the various pharmacologic options for a patient who has a gynecologic infection and a history of alcohol use disorder. Which of the following medications can cause a reaction similar to disulfiram (Antabuse) if the patient drinks alcohol while taking it? (Select all that apply.) a. nitrofurantoin b. amoxicillin c. aztreonam d. cefotetan e. metronidazole

D, E Cefotetan, a second-generation cephalosporin, and Metrondiazole, an antiparasitic drug, can cause a reaction similar to what disulfiram causes when clients consume alcohol. This reaction manifests as nausea, severe vomiting, headache, weakness, and hypotension.

A health care professional is caring for a patient who is about to begin taking ketoconazole to treat a fungal infection. The health care professional should tell the patient to report which of the following adverse effects of the drug? a. tingling in the hands and feet b. joint pain c. swelling of hands or feet d. excessive sweating

c. swelling of hands or feet Itraconazole, an azole antifungal drug, can cause edema, which can also indicate heart dysfunction, and should be monitored closely.

A nurse is teaching a client who has a new prescription for tramadol. Which should the nurse include (SATA)? A. Increase fiber and fluid intake. B. Take the drug with food. C. Avoid driving after taking the drug. D. Change positions gradually. E. Reduce exercise level temporarily.

A, B, C, D - Tramadol can cause constipation and dry mouth. - Tramadol can cause nausea and vomiting. Clients should take the drug with food or milk and lie down if feeling nauseated. - Tramadol can cause sedation, drowsiness, and dizziness.

A nurse is caring for a client who is receiving morphine to relieve severe pain. The nurse should monitor the client for which of the following adverse reactions? A. Diarrhea B. Urinary retention C. Respiratory depression D. Sedation E. Orthostatic hypotension

B, C, D, E

A nurse is teaching a client who has a new prescription for prednisone. Which of the following should the nurse include? A. Reduce the dose during periods of stress. B. Discontinue the drug gradually. C. Report illness or infection. D. Increase intake of calcium and vitamin D. E. Monitor for signs of gastric bleeding.

B, C, D, E Prednisone, a glucocorticoid, can cause bone loss and reduced calcium absorption.

A nurse in a provider's office receives a call from a client who has been taking penicillin V 3x daily and reports abdominal cramping w/bloody diarrhea for several days. Which of the following instructions should the nurse give the client? a. "Bring in a stool sample for testing." b. "Take the drug only twice daily." c. "Use an over-the-counter anti-diarrheal medication." d. "Return to the clinic for blood work."

a. "Bring in a stool sample for testing." Abdominal cramping and bloody diarrhea can be caused by an overgrowth of the organism Clostridium difficile. The client should bring a stool sample in to be tested for the presence of this organism.

A health care professional is caring for a patient who is about to begin taking metronidazole (Flagyl) to treat an anaerobic intra-abdominal bacterial infection. The health care professional should recognize that cautious use of the drug is indicated if the patient also has which of the following? a. seizure disorder b. hearing loss c. asthma d. anemia

a. seizure disorder Metronidazole, an antiparasitic drug, can cause ataxia, vertigo, and seizures. It requires cautious use with clients who have a history of seizure activity, liver or renal failure, or heart failure.

A patient who is taking tetracycline orally to treat a chlamydia infection contacts the health care professional to report severe blood-tinged diarrhea. Recognizing the adverse effects of tetracycline, the health care professional should suspect which of the following? a. hemorrhoids b. clostridium difficile-associated diarrhea c. diverticular disease d. small bowel obstruction

b. clostridium difficile-associated diarrhea Severe diarrhea, often containing mucus and blood, can indicate Clostridium difficile-associated diarrhea. Treatment includes stopping drug therapy and replacing fluids and electrolytes. Clients should immediately report severe diarrhea and blood in the stools.

A health care professional is caring for a patient who is about to begin take isoniazid (INH) to treat tuberculosis. The health care professional should tell the patient to report which of the following adverse effects of the drug? (Select all that apply.) a. Jaundice b. numbness of the hands c. dizziness d. hearing loss e. oral ulcers

A, B, C - Isoniazid, an antimycobacterial drug, can cause liver toxicity, especially in clients who abuse alcohol. The nurse should monitor liver enzymes during therapy and instruct the client to report indications of liver damage, such as jaundice, abdominal pain, and fatigue. - Isoniazid can cause peripheral neuropathy. The nurse should instruct the client to report numbness, pain, or tingling in the hands or feet. Administering pyridoxine (vitamin B6) can help minimize these effects. - Isoniazid can cause dizziness, ataxia, and seizures. The nurse should instruct the client to report these CNS effects.

A nurse is preparing a client who has a new prescription for maraviroc therapy. The nurse should instruct the client to report which of the following adverse effects. (Select all that apply). A. Paresthesia B. Cough C. Tinnitus D. Jaundice E. Fever

A, B, D, E - Maraviroc, a chemokine receptor 5 antagonist, can cause paresthesia, dizziness, and musculoskeletal pain. - Maraviroc can cause a cough and upper respiratory infection. - Maraviroc can cause liver damage. The nurse should instruct the client to report an allergic reaction, such as a rash, because it can precede liver damage, manifested as jaundice or abdominal pain. - Maraviroc can cause a fever and sinus infection.

A nurse is caring for a client who is taking naloxone to treat acute morphine toxicity. the nurse should monitor for these adverse reactions (SATA) A. Increased respiratory rate B. Increased pain C. Thrombophlebitis D. Ventricular arrhythmias E. Hypertension

A, B, D, E - Naloxone treats respiratory depression, but it can cause hyperventilation. - Naloxone reverses the analgesic effects of opioids and can cause increased pain and discomfort. - It can also cause ventricular arrhythmias and hypertension.

A nurse is caring for a client who is taking acetaminophen at regular intervals for mild discomfort. The nurse should tell the client to report which of the following early indications of acetaminophen toxicity? (SATA) A. Diaphoresis B. Palpitations C. Shortness of breath D. Nausea E. Diarrhea

A, D, E Acetaminophen toxicity can cause lethargy, nausea, vomiting, diaphoresis, anorexia, and, eventually, liver damage. Clients should follow the dosage guidelines on the labels of over-the-counter drugs carefully to avoid toxicity.

A nurse is teaching a client who has a new diagnosis of breast cancer about the drug tamoxifen. The nurse should tell the client that which of the following conditions is a contraindication for taking tamoxifen? A. Deep-vein thrombosis B. COPD C. Diabetes mellitus D. Alcohol use disorder

A. Deep-vein thrombosis Tamoxifen, an estrogen receptor blocker, can cause thromboembolism. Its use requires cautious use with clients who have deep-vein thrombosis.

A nurse is teaching a client who is taking allopurinol about minimizing adverse effects. Which of the following instructions should the nurse include? A. Eat a small meal before taking the drug. B. Suck on hard candy or chew gum. C. Take a stool softener daily. D. Avoid the use of NSAIDs.

A. Eat a small meal before taking the drug. Taking allopurinol after eating a meal or drinking a glass of milk can prevent stomach upset.

A nurse is reviewing the drug list for a client who has a new order for allopurinol. Which drugs interact with allopurinol? A. Warfarin B. Ibuprofen C. Insulin D. Furosemide

A. Warfarin Allopurinol can increase the effectiveness of warfarin. A lower dosage of warfarin might be required.

A nurse is caring for a client who has a new prescription for butorphanol. The nurse should monitor client for the following adverse drug reactions? A. Infection B. Nausea C. Tachycardia D. Dizziness E. Headache

B, D, E

A nurse is preparing to administer amphotericin B IV to a patient who has a systemic fungal infection. Which of the following drugs should the health care professional administer prior to the infusion to prevent or minimize adverse reactions during amphotericin B administration? (Select all that apply.) A. Aspirin B. Hydrocortisone C. Acetaminophen D. Diphenhydramine E. Ibuprofen

C, D - Infusion reactions to amphotericin B IV, such as fever, chills, nausea, and headache, start 1 to 2 hr after the infusion begins and subside within 4 hr. The nurse can help prevent these effects by administering acetaminophen prior to the infusion. - The nurse can help prevent adverse reactions by administering diphenhydramine prior to the infusion.

A nurse should recognize that enfuvirtide can be prescribed to clients who have which of the following conditions? A. Advanced prostate cancer B. Primary brain tumors C. Advanced HIV D. Metastatic ovarian cancer

C. Advanced HIV Enfuvirtide, a fusion inhibitor, treats HIV that is advanced or resistant to other types of treatment. The nurse should always administer the drug with other antiretroviral drugs.

A nurse is caring for a client who has a new rx for acyclovir to treat a herpes simplex infection. Which of the following lab values should the nurse monitor for this client? a. Prothrombin time b. Hct c. BUN d. Aspartate aminotransferase

C. BUN Acyclovir, an antiviral drug, can cause renal toxicity due to drug accumulation in renal tubules. The nurse should monitor the client's urine output, BUN, and creatinine levels, and increase fluid intake to hydrate and flush the kidneys.

A nurse is caring for a group of postoperative clients. the nurse should identify that morphine is contraindicated for which of the following? A. A client who had a mastectomy B. A client who had a knee arthroplasty C. A client who had a colectomy D. A client who had a cholecystectomy

D. A client who had a cholecystectomy Morphine can cause biliary colic. It should not be administered to a client who has just had biliary tract surgery, such as a cholecystectomy.

A nurse is reviewing the MR of a client who reports taking acetaminophen at home. The nurse should identify that which of the following client conditions is a contraindication for acetaminophen? A. Asthma B. Diabetes mellitus C. Heart failure D. Alcohol use disorder

D. Alcohol use disorder Acetaminophen can cause liver toxicity. Clients who have a history of alcohol use disorder should not take acetaminophen.

A nurse is caring for a child who has a viral infection. The nurse should identify that which of the following drugs can increase the risk of Reye syndrome in children who have viral infection? A. Butorphanol B. Acetaminophen C. Tramdol D. Aspirin

D. Aspirin Aspirin can increase the risk for Reye syndrome in children who have a viral infection, particularly chickenpox or influenza. Manifestations of Reye syndrome include lethargy and persistent vomiting.

A nurse should recognize that maraviroc is used in the treatment of which of the following conditions? A. Diabetes mellitus B. Meningeal infection C. Pancreatitis D. Chemokine receptor 5 (CCR5)-tropic HIV-1

D. Chemokine receptor 5 (CCR5)-tropic HIV-1 Maraviroc, a CCR5 antagonist, acts by binding to CCR5 and preventing HIV-1 from entering the cell. It is used in the treatment of clients who have CCR5-tropic HIV-1.

A nurse is caring for a client who has a new prescription for intrathecal cytarabine therapy to treat meningeal leukemia. The nurse should inform the client that they will also receive which of the following drugs to reduce the risk of neurotoxicity? A. Diphenhydramine B. Leucovorin C. Folic acid D. Dexamethasone

D. Dexamethasone Clients who have a prescription for the intrathecal form of cytarabine should also receive dexamethasone, a glucocorticoid, to help decrease the inflammation of the arachnoid that the drug can cause. IV dexamethasone reduces the client's risk for neurotoxicity.

A nurse should recognize that raltegravir is used to treat clients who have which of the following conditions? A. Hairy cell leukemia B. Thyroid cancer C. Kaposi's sarcoma D. Resistant HIV

D. Resistant HIV Raltegravir, an integrase inhibitor, along with other antiretroviral drugs, treats HIV that is resistant to other drugs. The nurse should administer raltegravir with other antiretroviral drugs.

A nurse is caring for a client who has a new prescription for ritonavir and zidovudine therapy to treat HIV-1. The nurse should inform the client that zidovudine is prescribed with ritonavir for which of the following reasons? A. To prevent an infusion reaction B. To increase platelet production C. To protect healthy cells from the toxic effects of ritonavir D. To prevent drug resistance

D. To prevent drug resistance The nurse should explain that zidovudine, a nucleoside reverse transcriptase inhibitor, is administered along with ritonavir, a protease inhibitor, to reduce the risk for drug resistance and to increase drug effectiveness. Monotherapy with zidovudine quickly results in drug resistance, as is also the case with monotherapy with ritonavir.

A nurse is caring for a client who has a new prescription for delavirdine therapy to treat HIV-1. The nurse should instruct the client to report which of the following adverse reactions to this drug? A. Rash B. Insomnia C. Rhinitis D. Alopecia

Rash Delavirdine, a non-nucleoside reverse transcriptase inhibitor, can cause a rash. The nurse should instruct the client to report a rash, which can occur 1 to 3 weeks after therapy, because it can develop into Stevens-Johnson syndrome, a potentially life-threatening complication.

A nurse is reviewing a client's prescriptions prior to administering gentamicin to the client to treat a systemic infection. The nurse should clarify the use of gentamicin with the provider if the client is taking which of the following drugs? a. Ethacrynic acid b. Diphenhydramine c. Acetaminophen d. Levothyroxine

a. Ethacrynic acid Gentamicin, an aminoglycoside, and ethacrynic acid, a loop diuretic, are ototoxic drugs. The nurse should identify that concurrent use increases the client's risk for hearing loss.

A nurse is caring for a client who has a prescription for rifampin to treat TB. The nurse should expect the provider to prescribe which of the following drugs to the client to prevent possible resistance to rifampin? a. Gentamicin b. Vancomycin c. Isoniazid d. Metronidazole

c. Isoniazid Isoniazid is used to treat tuberculosis and reduces the possibility of resistance to rifampin when combined with the drug. Drug resistance can develop quickly if the client only takes rifampin.

A health care professional is caring for a patient who is about to begin gentamicin therapy to treat an infection. The health care professional should monitor the patient for which of the following? a. bowel function b. peripheral pulses c. urine output d. level of consciousness

c. urine output Gentamicin, an aminoglycoside, can cause nephrotoxicity. The nurse should monitor the client's BUN and creatinine levels and for an increased output of diluted urine. It is also essential to monitor serum gentamicin levels and maintain a therapeutic range.

A nurse is providing teaching for a client who takes an oral contraceptive and is about to begin rifampin therapy to treat TB. Which of the following instructions should the nurse include? a. Increase the rifampin dose. b. Increase the oral contraceptive dose. c. Allow 2 hr between taking the two drugs. d. Use a non-hormonal form of contraception.

d. Use a non-hormonal form of contraception. Rifampin, an antimycobacterial drug, can increase the metabolism of oral contraceptives, reducing their effectiveness. Clients who are taking oral contraceptives and rifampin should use additional, non-hormonal contraceptive methods to prevent an unwanted pregnancy.

A primary care provider is prescribing drug therapy for a patient whose sputum culture results indicate methicillin-resistant Staphylococcus aureus (MRSA). Which of the following drugs should be administered? a. Trimethoprim/sulfamethoxazole (Bactrim) b. Tetracycline c. cephalexin d. vancomycin

d. vancomycin Vancomycin, a potentially toxic antibiotic, is used primarily to treat serious infections in clients who are allergic to penicillin or whose infecting bacteria are resistant to penicillin, such as MRSA. The term methicillin-resistant refers generally to a lack of susceptibility to methicillin (no longer prescribed), all penicillins, cephalosporins, tetracyclines, beta-lactams, and many other antimicrobial drugs.

A nurse is planning care for a client who has started taking prednisone. Which of the following interventions should the nurse include? A. Monitor the client's blood glucose. B. Administer an antacid 30 min prior to prednisone. C. Administer aspirin rather than NSAIDs if the client has pain. D. Monitor the client for hyperkalemia.

A. Monitor the client's blood glucose. Prednisone can cause hyperglycemia.

A nurse is caring for a client who is an opioid dep. and has a new prescription for butorphanol. The nurse should monitor the client for which of the following manifestations of abstinence syndrome (SATA)? A. Bronchospasm B. Vomiting C. Peripheral edema D. Abdominal cramps E. Hypertension

B, D, E

A health care professional is caring for a patient who is about to begin taking nitrofurantoin (Macrodantin) to treat a urinary tract infection. The health care professional should tell the patient to report which of the following adverse effects of the drugs? a. constipation b. dark brown urine c. cough d. tremors

c. cough Nitrofurantoin, a urinary tract antiseptic, can cause cough, shortness of breath, chest pain, and fever. These adverse effects can indicate an acute allergic reaction and require immediate discontinuation of drug therapy.

When administering oral erythromycin to a client who has acute diphtheria, a nurse should monitor for which of the following adverse effects? a. Hypothermia b. Blurred vision c. Constipation d. Cardiac dysrhythmias

d. Cardiac dysrhythmias Erythromycin, a macrolide, can cause ECG changes, including a prolonged QT interval, and put the client at risk for a potentially fatal ventricular dysrhythmia. The nurse should monitor the client's ECG and tell the client to report palpitations, fainting, or dizziness. The drug is contraindicated for clients who have a history of QT prolongation.

A primary care provider should prescribe a lower dose of aztreonam (Azactam) for a patient who has a respiratory tract infection and also has which of the following? a. glaucoma b. closed-head injury c. heart failure d. renal impairment

d. renal impairment Aztreonam, a monobactam, requires cautious use with clients who have renal dysfunction because it is excreted in the urine. Renal impairment could affect the excretion of aztreonam, allowing the level of the drug to accumulate. The nurse should report this finding to the provider, so the provider can prescribe a lower dose for the client or prescribe a different antimicrobial drug.

A nurse is caring for a client who has a new prescription for cisplatin to treat testicular cancer. The nurse should instruct the client to report which of the following adverse effects? (Select all that apply). A. Paresthesia B. Sore throat C. Flank pain D. Tinnitus E. Conjunctivitis

A, B, C, D - Cisplatin, a platinum compound, can cause peripheral neuropathy. The nurse should tell the client to report numbness, tingling, or decreased sensation in the hands or feet. - Cisplatin can cause bone marrow depression. The nurse should tell the client to report fever, sore throat, bruising, or fatigue. - Cisplatin can cause kidney toxicity. Prior to therapy, the nurse should hydrate the client with 1 to 2 L of IV fluid and continue for 24 hr following therapy to flush the kidneys and help prevent kidney toxicity. - Cisplatin can cause ototoxicity. The nurse should monitor the client's hearing and instruct the client to report hearing loss, vertigo, or tinnitus.

A nurse is assessing a client following trastuzumab infusion to treat metastatic breast cancer. Which of the following should the nurse recognize as an indication that the client is experiencing an adverse reaction to the drug. (Select all that apply). A. Wheezing B. Dysrhythmias C. Hypotension D. Fever E. Ascites

A, B, C, D - Trastuzumab, a monoclonal antibody, can cause a severe allergic reaction, manifesting as hives, bronchospasm, dyspnea, and wheezing. The nurse should have epinephrine ready to treat anaphylaxis. - Trastuzumab can cause cardiotoxicity, manifesting as ventricular dysfunction, heart failure, and dysrhythmias. The nurse should monitor the client's ECG. - Trastuzumab can cause a severe allergic reaction, manifesting as hives, dyspnea, hypotension, and hypoxia. The nurse should have epinephrine ready to treat anaphylaxis. - Trastuzumab can cause flu-like reactions, manifesting as fever, chills, nausea, and headache. The nurse should monitor the client's temperature.

A nurse is caring for a client who is about to begin taking aspirin. The nurse should instruct the client to report which manifestations of salicylism? A. Fever B. Tinnitus C. Diaphoresis D. Thrombophlebitis E. Dizziness

A, B, C, E - Late manifestations of acute aspirin poisoning, or salicylism, include fever. - Tinnitus, or ringing or buzzing in the ears, can indicate salicylism. - Sweating and headache can indicate salicylism. - Dizziness can indicate salicylism

A nurse is teaching a client who has a new prescription for mercaptopurine to treat leukemia. Which of the following instructions should the nurse include? (Select all that apply). A. Use contraception if pregnancy is a risk. B. Perform oral hygiene frequently. C. Avoid activities that require mental alertness. D. Perform hand hygiene frequently. E. Avoid activities that can cause injury.

A, B, D, E - Mercaptopurine, a purine analog, is a pregnancy risk category D drug. - Mercaptopurine can cause stomatitis. The nurse should instruct the client to perform frequent oral hygiene to help prevent or minimize this adverse effect. - Mercaptopurine can cause neutropenia. The nurse should instruct the client to wash hands thoroughly or use an alcohol-based hand rub frequently and to avoid crowds and contact with people who have communicable infections. - Mercaptopurine can cause thrombocytopenia. The nurse should monitor the client's CBC throughout treatment and instruct the client to avoid activities that can cause injury and report any unexplained bruising or bleeding.

A nurse is preparing to administer paclitaxel IV to a client who has ovarian cancer. Which of the following actions should the nurse take. (Select all that apply). A. Give the client an antihistamine. B. Infuse the drug over 1 hr. C. Administer the drug through non-PVC tubing. D. Use an in-line filter. E. Add heparin to the paclitaxel solution.

A, C, D - Prior to administering paclitaxel, an antimitotic drug, the nurse should give the client an antihistamine, such as diphenhydramine, a proton-pump inhibitor, such as cimetidine, and a glucocorticoid, such as dexamethasone, to prevent a hypersensitivity reaction.

A nurse is preparing to administer enfuvirtide to a client. Which of the following actions should the nurse plan to perform. (Select all that apply). A. Administer the drug subcutaneously. B. Discard the unused portion. C. Roll the vial gently to reconstitute the solution. D. Inject the solution at room temperature. E. Expect a cloudy solution.

A, C, D - The nurse should administer enfuvirtide, a fusion inhibitor, subcutaneously, twice per day. - The nurse can store unused solutions of enfuvirtide in a refrigerator up to 24 hr but should restore it to room temperature before injection.

A nurse is teaching a client who has a new prescription for imatinib to treat chronic myeloid leukemia. Which of the following instructions should the nurse include? (Select all that apply). A. Clean fruits and vegetables thoroughly. B. Increase calcium intake. C. Weigh yourself daily. D. Perform hand hygiene frequently. E. Avoid grapefruit and grapefruit juice.

A, C, D, E - Imatinib, a targeted antineoplastic drug, can cause bone marrow suppression. Avoid getting sick. - Imatinib can cause fluid retention and weight gain. - Grapefruit and grapefruit juice can cause the blood levels of imatinib to be higher than normal.

A nurse is instructing a client how to self-administer enfuvirtide. Which of the following instructions should the nurse include? A. "Allow the vial to sit until the solution is completely clear and without particulates." B. "After reconstituting with sterile water, vigorously shake the vial to mix the solution." C. "Use the medication immediately upon removing from the refrigerator." D. "Use the same location for five injections before rotating to a new site."

A. "Allow the vial to sit until the solution is completely clear and without particulates." When administering enfuvirtide, the client should inject sterile water to reconstitute it and gently roll the vial between the hands. Then, the client should let the vial sit until the solution is completely clear and without particulates, which might take up to 45 min. The client should allow the vial to warm to room temperature before the injection and refrigerate any unused portion.

A nurse is teaching a client about immunizations. Which of the following information should the nurse include about the teaching? A. "You should receive a tetanus booster every 10 years." B. "You should not receive the influenza immunization if you have a common cold." C. "You do not have to receive the shingles vaccine if you have received two doses of the varicella virus vaccine." D. "As long as you don't have risk factors, you will start receiving the pneumococcal vaccine when you are 50 years old."

A. "You should receive a tetanus booster every 10 years."

A nurse is teaching a guardian of a child about the recommended age range to receive the human papillomavirus (HPV) vaccine. Which of the following age ranges should the nurse include? A. 11 to 12 years old B. 7 to 9 years old C. 13 to 15 years old D. 15 to 17 years old

A. 11 to 12 years old Three doses of the vaccine for HPV are recommended for adolescents ages 11 to 12 years old.

A nurse is preparing to administer the measles, mumps, and rubella (MMR) vaccine to a child. The nurse should recognize that the MMR vaccine provides which of the following types of immunity? A. Artificial active immunity B. Active C. Passive D. Artificial passive immunity

A. Artificial active immunity The nurse should recognize that the MMR vaccine provides artificial active immunity to the child. A vaccine contains a form of the disease that is live, attenuated, or killed, which will allow the body to build up an active immunity against the disease.

A nurse is teaching a client who has a new prescription for allopurinol. Which of the following instructions should be included? A. Avoid driving or activities that require mental alertness. B. Avoid crushing the tablets. C. Limit fluid intake during therapy. D. Limit potassium while taking allopurinol.

A. Avoid driving or activities that require mental alertness. Allopurinol can cause drowsiness.

A nurse is teaching the guardian of a 4- month- old infant about recommended immunizations for the infant. Which of the following immunizations should the nurse include? A. Haemophilus influenzae type B vaccine (Hib) B. Varicella vaccine C. Meningococcal conjugate vaccine (MCV4) D. Tetanus-diphtheria-acelluar pertussis vaccine (Tdap)

A. Haemophilus influenzae type B vaccine (Hib) The nurse should inform the guardian that the Haemophilus influenzae type B vaccine (Hib) is recommended for infants and children to prevent a serious type of meningitis commonly seen in young children.

A nurse is caring for a client who is prescribed zidovudine. Which of the following laboratory values should the nurse report to the provider? A. Hemoglobin 7.1 g/dL B. RBC count 5.2/mm3 C. Neutrophil 57% D. Triglycerides 125 mg/dL

A. Hemoglobin 7.1 g/dL The provider might consider dose reduction, discontinuation of therapy, or blood transfusions if the client's hemoglobin is less than 7.5 g/dL or has a reduction of greater than 25% from baseline.

A nurse is teaching a client about recommended immunizations. Which of the following immunizations should the nurse recommend the client receive starting at 50 years of age? A. Herpes zoster vaccine B. Human papillomavirus vaccine (HPV) C. Pneumococcal vaccine D. Haemophilus influenzae type B vaccine (Hib)

A. Herpes zoster vaccine The herpes zoster, or shingles vaccine, is recommended for adults older than 50 years of age.

A nurse is teaching a client about maraviroc. Which of the following instructions should the nurse include? A. It is important to report any noticeable rash immediately as it might indicate an issue with your liver B. "Make sure you take this medication without any other medications first thing in the morning. C. "You might experience flu-like symptoms for which you can take any over-the-counter medication." D. "The side effects of this medication are minimal, so you can continue to work and drive as normal."

A. It is important to report any noticeable rash immediately as it might indicate an issue with your liver Hepatic injury can manifest as a rash in clients who take maraviroc and should be reported to the provider regardless of how mild it appears.

A nurse is considering drug therapy options for a client who has metastatic breast cancer that is positive for human epidermal growth factor receptor 2 (HER2). Which of the following drugs should the nurse expect the provider to prescribe? A. Trastuzumab B. Imatinib C. Leuprolide D. Flutamide

A. Trastuzumab Trastuzumab, a monoclonal antibody and a pregnancy risk category D drug, treats and helps control the cell growth of metastatic breast cancer with tumors that overexpress HER2. This form of breast cancer accounts for up to 30% of metastatic breast tumors.

A nurse is teaching a client who has a new prescription for allopurinol. The nurse should instruct the client to report which of the following adverse drug reactions? (SATA) A. Palpitations B. Sore throat C. Vertigo D. Bruising E. Vision changes

B, C, D, E - Allopurinol, an antigout drug, can cause agranulocytosis. The nurse should monitor the client's WBC count, and instruct the client to report fever or sore throat. - Allopurinol, an antigout drug, can cause drowsiness and vertigo. The nurse should instruct the client to report these adverse effects and avoid activities that require mental alertness until they know how the drug will affect them. - Allopurinol, an antigout drug, can cause thrombocytopenia. The nurse should monitor the client's platelet count and instruct the client to report any bleeding or bruising. - Allopurinol, an antigout drug, can cause cataracts with extended use. The nurse should instruct the client to report vision changes, such as cloudiness or halos around lights, and have eye examinations at recommended intervals.

A nurse is caring for a client who takes low dose aspirin to prevent cardiovascular events. The client asks the nurse about taking ibuprofen to treat rheumatoid arthritis. Which of the following responses should the nurse make? A. "Ibuprofen will increase your risk for developing salicylism." B. "Ibuprofen will reduce the cardioprotective effects of low-dose aspirin." C. "Low-dose aspirin will reduce the anti-inflammatory effects of ibuprofen." D. "Low-dose aspirin will reduce the analgesic effects of ibuprofen."

B. "Ibuprofen will reduce the cardioprotective effects of low-dose aspirin." Ibuprofen, an NSAID, reduces the cardioprotective effects of low-dose aspirin. Clients taking low-dose aspirin for its ability to decrease platelet aggregation should not take ibuprofen.

A nurse is caring for a client who has a new prescription for celecoxib. the nurse should tell the client to report which of the following adverse drug reactions? A. Tinnitus B. Chest pain C. Constipation D. Diaphoresis

B. Chest pain Celecoxib, a COX-2 inhibitor, can cause cardiovascular or cerebrovascular events. Clients should report chest pain, shortness of breath, headache, numbness, weakness, or confusion. Providers should prescribe the lowest effective dosage of the drug for the shortest time period possible.

A nurse is caring for a patient who is taking allopurinol to treat gout. the nurse should monitor the patient for which on the following manifestations of hypersensitivity syndrome? A. Muscle pain B. Fever C. Anxiety D. Tremors

B. Fever Allopurinol, an antigout drug, can cause hypersensitivity syndrome. The nurse should monitor the client for rash, itching, or fever, as manifestations of hypersensitivity syndrome, which can lead to renal or liver dysfunction. Clients who develop this type of reaction should stop taking the drug.

A nurse is reviewing the medical record of a client who has a new prescription for tramadol. the nurse should identify which conditions is a contraindication of tramadol? A. Hyperthyroidism B. Seizure disorder C. Rheumatoid arthritis D. Urinary incontinence

B. Seizure disorder Tramadol, a nonopioid analgesic, can cause seizure activity. Clients who have seizure disorders, head injuries, or increased intracranial pressure should not take tramadol.

A nurse is caring for a client who has a new prescription for topotecan therapy to treat resistant, small-cell lung cancer. The nurse should advise the client against taking which of the following types of over-the-counter drugs while receiving the therapy? A. Folic acid B. St. John's wort C. Ibuprofen D. Aluminum hydroxide

C. Ibuprofen NSAIDs, anticoagulants, and antiplatelet drugs increase the client's risk for bleeding while receiving topotecan, a topoisomerase inhibitor. The nurse should advise the client against taking aspirin, ibuprofen, and other NSAIDs during therapy.

A nurse is reviewing the MR of a client who has a new prescription for celecoxib. the nurse should identify that which of the following conditions is a contraindication to celecoxib? A. Rheumatoid arthritis B. Ankylosing spondylitis C. Sulfonamide allergy D. Adrenocortical insufficiency

C. Sulfonamide allergy Clients who are allergic to sulfonamides can have severe allergic reactions to celecoxib, a COX-2 inhibitor. Clients who are allergic to salicylates can also react adversely to celecoxib.

A nurse is caring for a client who has a prescription for aspirin to treat an ankle sprain, The nurse should instruct patient to report the following adverse drug reactions? A. Polyuria B. Bone pain C. Weight gain D. Infection

C. Weight gain Aspirin use can cause renal impairment, which can result in the retention of salt and water. Clients should report reduced urine output, weight gain, edema, or bloating. The nurse should monitor BUN and creatinine levels and stop aspirin therapy for clients who develop signs of renal dysfunction.

A nurse is caring for a client who's currently takes furosemide and has a new prescription for prednisone. The nurse should monitor the client for which of the following manifestations current concurrent use of the two drugs? A. Hypercalcemia B. Hypoglycemia C. Hypothermia D. Hypokalemia

D. Hypokalemia Prednisone, a glucocorticoid, can cause hypokalemia. The risk for this electrolyte imbalance increases when the client is taking potassium-depleting diuretics, such as furosemide. The nurse should clarify the prescription with the provider and monitor the client's potassium levels.

A health care professional is caring for a patient who is taking warfarin (Coumadin) and is about to begin taking trimethoprim/sulfamethoxazole (Bactrim) to treat a urinary tract infection. The health care professional should question the drug regimen because taking these two drugs concurrently can increase the patient's risk for which of the following? a. bleeding b. thrombosis c. ECG changes d. ototoxicity

a. bleeding Trimethoprim/sulfamethoxazole, a sulfonamide combination, can increase the effects of warfarin and increase the client's risk for bleeding. The nurse should request another prescription to treat the infection, or, if the client decides to take the drug, ask the provider to prescribe a lower warfarin dose and monitor prothrombin time carefully. The client should report any sign of bleeding, such as easy or unexplained bruising.

A patient who is taking ciprofloxacin to treat a respiratory tract infection contacts the health care professional to report dyspepsia. The health care care professional should recommend which of the following instructions? a. take an antacid at least 2 hr after taking the drug b. take the drug with a cup of coffee c. take an ion supplement with the drug d. drink 8 oz of milk with the drug

a. take an antacid at least 2 hr after taking the drug The nurse should recommend that the client take an antacid to relieve the dyspepsia at least 2 hr after taking ciprofloxacin, a fluoroquinolone. This is because antacids decrease the absorption of the drug.

A nurse in a provider's office receives a call from a client who was recently hospitalized and treated with imipenem IV for a bacterial infection and reports an inability to eat due to mouth pain. The nurse should identify that the client might be experiencing which of the following as an adverse effect of this drug? a. Malabsorption b. Superinfection c. Anorexia d. Dental caries

b. Superinfection Imipenem, a carbapenem, can cause the superinfection Candida albicans in the mouth, throat, or vagina. It can also cause glossitis, an inflammation or infection of the tongue. Clients taking the drug should report any mouth pain or vaginal discharge and itching because they might require treatment with an antifungal drug.

A nurse is caring for a patient who has a new dx of bacterial meningitis. The nurse should expect the provider to prescribe a drug from which of the following classifications of antibiotics? a. First genertion cephalosporins b. Third generation cephalosporins c. Monobactams d. Macrolides

b. Third generation cephalosporins Later generation cephalosporins are used to treat infections that cross the blood-brain barrier, and third-generation are specifically prescribed to treat bacterial meningitis.

Which of the following drugs should a provider prescribe for a patient who has streptococcal pharyngitis and is allergic to penicillin? a. nafcillin b. azithromycin c. cephalexin d. amoxicillin/clavulanic acid

b. azithromycin Azithromycin, a macrolide, is an acceptable alternative to penicillin for patients who have bacterial infections and are allergic to penicillin. The medication is effective against many gram-positive and gram-negative bacteria and is used for streptococcal pharyngitis.

A health care professional is caring for a patient who is about to begin receiving acyclovir (Zovirax) IV to treat a viral infection. The health care professional should recognize that cautions use of the drug is essential if the patient also has which of the following? a. heart failure b. dehydration c. asthma d. tinnitus

b. dehydration Acyclovir, an antiviral drug, can cause renal toxicity, especially in clients who are dehydrated. Hydration during and after IV infusion of the drug can help prevent crystalluria.

A patient who is taking amoxicillin to treat a respiratory infection contacts the health care professional to report a rash and wheezing. Which of the following instructions should the health care professional provide? a. wait 1 hr and contact the provider if there is no improvement b. skip today's dose of amoxicillin and resume taking the drug tomorrow c. call emergency services immediately d. take an NSAID to reduce the skin and airway inflammation

c. call emergency services immediately Amoxicillin can cause a severe anaphylactic reaction. A client who has difficulty breathing should call emergency services and seek immediate care. The client will need to be treated with epinephrine and an antihistamine, such as diphenhydramine, to treat an anaphylactic reaction.

A nurse is administering cefotetan IV to a client to treat an intra-abdominal infection. The nurse notes that the IV insertion site is warm, edematous, and painful to the touch. Which of the following actions should the nurse take? a. decrease the rate of the cefotetan infusion. b. administer diphenhydramine to the client. c. request a prescription for another antibiotic. d. stop the cefotetan infusion.

d. stop the cefotetan infusion. The nurse should stop the infusion, remove the IV catheter, assess for tissue damage, and treat the client accordingly. The nurse should then initiate IV access via another site, continuing cefotetan therapy according to prescribed parameters.