FINAL EXAM For Pharm Practice questions

A nurse administered an antibiotic 10 min ago to a client who is now reporting wheezing and swelling of the eyelids. Which of the following actions should the nurse perform first?

Administer EPI SubQ Evidence-based practice indicates the nurse should first administer epinephrine, a catecholamine, which constricts blood vessels, increases cardiac output, and dilates bronchiole passages. Epinephrine is the first-line medication to administer for anaphylaxis and can be administered subcutaneously or via an IV or endotracheal tube. Other early signs of anaphylaxis are often related to the skin, characterized by warmth, redness, itching, hives, and swelling of the head and neck.

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

Administer the albuterol inhaler prior to using the beclomethasone inhaler.

You are instructing a pt who has a new prescription for cetirizine. Which of the following information should you be sure to include?

Administer the drug prophylactically during allergy seasons. this med is a 2nd generation Antihistamine used primarily to relieve s/s associated w/ seasonal allergic rhinitis.

A nurse is reviewing the medication history of a client who has mild intermittent asthma. The nurse should anticipate a prescription for which of the following inhalers for the client?

Albuterol Sulfate

A nurse is monitoring a client who has asthma, takes albuterol, and recently started taking propranolol to treat a cardiovascular disorder. The client reports that the albuterol has been less effective. Which of the following factors should the nurse identify as a possible explanation for this change?

Detrimental inhibitory interaction A detrimental inhibitory interaction can occur with the concurrent use of propranolol and albuterol. When a client takes propranolol and albuterol together, propranolol can interfere with albuterol's therapeutic effects.

A nurse is teaching a client who has a new prescription for methotrexate. The nurse should instruct the client to monitor for manifestations of which of the following conditions?

Gout An adverse effect of methotrexate is hyperuricemia, which causes gout. The nurse should instruct the client to drink plenty of fluids to minimize this effect, and to report edema or pain in the joints.

Metoclopramide therapeutic use

Nausea/Vomiting

For which of the following reasons should a nurse instruct a client to avoid taking guaifenesin with combination over-the-counter cold products?

Over-the-counter cold products can also contain guaifenesin. Many combination over-the-counter cold products contain guaifenesin. A client taking both might be taking excessive amounts of the drug. Combination products also contain multiple drugs to treat different manifestations, some of which the client might not have. All drugs have potential adverse effects, so the client should use only those drugs required to treat existing symptoms and only in the recommended amounts.

Which of the following information should you include when teaching a pt about the use of an albuterol inhaler for asthma management?

Use It periodically to prevent exercise-induced asthma.

Dimenhydrinate Therapeutic Use

motion sickness

For which of the following reasons should a client attach a spacer to a metered-dose inhaler?

​To increase the amount of drug delivered to the lungs A spacer increases the amount of drug that reaches the lungs.

A nurse is caring for four clients who have peptic ulcer disease. The nurse should identify misoprostol is contraindicated for which of the following clients?

A client who is pregnant *misoprostol can induce labor and is contraindicated in pregnancy.

You are about to administer diphenoxylate plus atropine to a pt to reduce diarrhea. Which drugs should you have available to treat an overdose of this drug combination?

Naloxone

A nurse is caring for a client who is taking codeine. The nurse should identify that which of the following assessments is priority to make?

Respirations The greatest risk to clients who are taking codeine, an opioid agonist, is severe respiratory depression. Therefore, the respiratory rate is the priority assessment.

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

Take the drug once a day in the evening. Montelukast, a leukotriene modifier, is most effective when taken once per day in the evening.

A nurse is caring for a client who has severe asthma and allergic rhinitis. The client is taking theophylline. Which of the following medications should the nurse identify as being incompatible with theophylline?

Zafirlukast The nurse should identify that zafirlukast is a leukotriene receptor antagonist prescribed for asthma maintenance. Concurrent use of zafirlukast along with theophylline suppresses the metabolism of theophylline, which can lead to toxicity. Therefore, another medication should be used.

omeprazole therapeutic use

duodenal Ulcer

A nurse is planning teaching for a client who has been prescribed metoclopramide to treat diarrhea. Which of the following statements should the nurse plan to include?

"Avoid driving or activities requiring alertness." Metoclopramide can cause drowsiness and dizziness. The client should avoid driving or activities requiring alertness while taking the drug.

A nurse is teaching a client who is taking prednisone for an acute asthma exacerbation. Which of the following instructions should the nurse include?

"Avoid taking nonsteroidal anti-inflammatory drugs." Gastric protective measures are essential for clients who are taking oral glucocorticoids. Anti-inflammatory drugs can cause GI bleeding, so clients should not take them concurrently with prednisone.

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

"Expect this medication to smell like rotten eggs." The nurse should take actions and instruct the client that acetylcysteine has a sulfur content that causes a rotten-egg odor

A nurse is monitoring a client who received diphenoxylate-atropine. Which of the following statements by the client should indicate to the nurse that the medication has been effective?

"I have not had a bowel movement today." The nurse should identify that diphenoxylate-atropine is an opioid used to treat diarrhea. The therapeutic response of this medication is a decrease in the frequency of watery stools due to reduced motility of the intestinal lining.

A nurse is teaching a female client 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?

"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 (FDA). 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 with chronic bronchitis about administering acetylcysteine using a hand-held nebulizer (HHN). Which of the following client statements indicates an understanding of the teaching?

"I should try to cough productively just before I begin the treatment." A productive cough prior to beginning the treatment will clear sputum from lung surfaces, allowing better absorption of the medication.

A nurse is teaching a client who has a new prescription for sucralfate for a duodenal ulcer. Which of the following client statements indicates an understanding of the teaching?

"I should wait at least 30 minutes before taking this medication after I take an antacid." The nurse should recognize that antacids can raise the gastric pH above 4, which can interfere with the effects of sucralfate. To minimize these interactions, sucralfate should be taken at least 30 minutes apart from antacids.

A nurse is teaching a client about the adverse effects of omeprazole. Which of the following client statements indicates an understanding of the teaching?

"If I experience severe diarrhea, I will call my doctor." Clients who experience diarrhea while taking omeprazole or other proton pump inhibitors (PPIs) should report this finding to the provider immediately. Omeprazole and other PPIs are associated with a dose-related increase in the risk of infection with Clostridium difficile, which is a bacterium that can cause severe diarrhea.

A nurse is providing teaching to a client who has chronic constipation and a new prescription for psyllium. Which of the following instructions should the nurse provide?

"Mix this medication with water and follow with an additional glass of liquid." The nurse should direct the client to administer the medication mixed in a full glass of water or juice followed by an additional glass of liquid. The client should also be instructed to increase intake of fluids to help decrease constipation.

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

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

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?

"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 ulcer to heal

A nurse is teaching a client who will begin taking aluminum hydroxide. Which of the following information should the nurse include in the teaching?

"Take this medication two hours before or after other medications."

A nurse is providing teaching to a client who has a prescription for famotidine to treat a gastric ulcer. Which of the following statements should the nurse include in the teaching?

"This medication is less effective for people who smoke." The nurse should instruct the client that smoking interferes with the effectiveness of famotidine. If a client taking famotidine smokes, the nurse should encourage the client to quit smoking or, if unable quit, to avoid smoking after the last dose of the day.

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

"Tremors are an adverse effect of this medication." * Tremors can occur due to excessive stimulation of beta2 receptors of skeletal muscles.

A nurse is teaching a client who has a new prescription for sulfasalazine. Which of the following statements should the nurse make?

"Use sunscreen and protective clothing while taking sulfasalazine to prevent sunburn." Photosensitivity is a possible adverse effect of sulfasalazine that makes the skin sensitive to light. The nurse should instruct the client to wear sunscreen and protective clothing when outdoors to prevent burning.

A nurse is providing discharge teaching to a client who had a bleeding duodenal ulcer and has been prescribed omeprazole. Which of the following statements should the nurse include in the teaching?

"You should take this medication before breakfast every day." Clients who have active duodenal ulcer or gastric reflux disease should take omeprazole once daily before a meal (usually breakfast) because the medication is less effective when taken with food.

A nurse is caring for a client who is taking diphenhydramine for allergies. The client reports, "I feel sleepy during the day." Which of the following responses should the nurse make?

"You should try antihistamines with non-sedative effects." The nurse should tell the client to try second-generation antihistamines that have no sedative effect, as these are large molecules with low lipid solubility that cannot cross the blood-brain barrier. Diphenhydramine is a first-generation antihistamine and has a common adverse effect of sedation.

A nurse is teaching a client about Famotidine. Which of the following are adverse effects of Famotidine?

- Enlargement of breast tissue - Confusion - Decreased sperm count The nurse should instruct the client about potential adverse effects of Famotidine can include gynecomastia, confusion, and impotence

A nurse is planning to administer ondansetron to a client. For which of the following adverse effects of ondansetron should the nurse monitor?

- Headache - Diarrhea -Prolonged QT interval

A nurse is planning care for a client who is receiving chemotherapy and has a new prescription for ondansetron. Which of the following actions should the nurse plan to take? (Select all that apply.)

- Infuse the drug 30 min prior to chemotherapy - Infuse the drug slowly over 15 min - Repeat the dose 4 hr after chemotherapy

A nurse is administering sulfasalazine to a client. Which of the following data should the nurse collect to help identify an adverse drug reaction? (Select all that apply.)

- Skin integrity. Sulfasalazine can cause a skin rash, so the nurse should check the client's skin for rashes. The drug can also cause nausea. If the client reports nausea, the nurse should suggest taking the drug with food or water. - Temperature. Sulfasalazine can cause a fever, so the nurse should check the client's temperature and treat fever with an antipyretic. - CBC Sulfasalazine can cause hematologic disorders, such as agranulocytosis and hemolytic and macrocytic anemia. The nurse should check the client's CBC periodically during therapy and tell the client to report sore throat or fatigue.

You are obtaining a health hx from a pt who to start using a new ipratropium inhaler. Which of the following information from the pt's hx alerts you to take further action?

- Urinary retention -Glaucoma Ipratropium us a anticholinergic drug that may worsen drying conditions.

A pt is starting therapy with psyllium. You explain ton the pt that psyllium will have which therapeutic effect?

-Relieve Constipation -Reduce Diarrhea *This bulk laxative, treats constipation and reduces diarrhea by increasing bulk to create soft, formed stools. It helps pts w/ diverticulosis, irritable bowel syndrome, and fecal ostomies.

A nurse is providing teaching to a client who is about to start taking psyllium to treat constipation. Which of the following instructions should the nurse include? (Select all that apply.)

-Take the drug with at least 8 oz (237 mL) of fluid. To prevent esophageal obstruction, clients should take psyllium with at least 8 oz of fluid; and after mixing the powdered form, clients should drink it immediately. - Increase fluid and fiber intake. The nurse should tell the client to increase activity, fluid intake, and fiber intake, and to keep track of bowel function. -Bowels are formed and are seen in 1-3 days

A nurse is teaching a client about ipratropium. The nurse should include that this drug has which of the following adverse effects?

-Urinary Retention -Dry mouth *& other drying effects

A nurse is caring for a client who is having difficulty mobilizing thick respiratory secretions. Which of the following drugs should the nurse expect to administer to the client?

Acetylcysteine Acetylcysteine is a mucolytic that loosens thick respiratory secretions.

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?

Albuterol Albuterol is a short-acting beta-2 adrenergic agonist that is used to provide immediate relief for an acute asthma attack. One or two puffs every 4 to 6 hours PRN is the usually prescribed dose for a school-age child. If higher or more frequent doses are needed, the provider should evaluate the client for worsening asthma.

A nurse is teaching a client who has a prescription for albuterol via inhaler and fluticasone via inhaler for asthma management. For which of the following reasons should the nurse instruct the client to use the albuterol inhaler before using the fluticasone inhaler?

Albuterol will increase the absorption of fluticasone. Albuterol, an inhaled, short-acting beta2 agonist, causes bronchodilation, which will increase the absorption of fluticasone, an inhaled glucocorticoid.

A nurse is caring for a client who is taking allopurinol to treat gout and has a new prescription for azathioprine to treat ulcerative colitis. For which of the following reasons should the nurse clarify these prescriptions with the provider?

Allopurinol delays the conversion of azathioprine and can lead to toxicity. Allopurinol delays the conversion of azathioprine to an inactive form and can lead to toxicity. If used concurrently, the dose of azathioprine must be reduced.

A nurse is teaching a client who takes phenytoin and has a new prescription for sucralfate tablets. Which of the following instructions should the nurse include?

Allow a 2-hr interval between these medications. Sucralfate can interfere with the absorption of phenytoin, so the client should allow a 2-hr interval between the sucralfate and phenytoin

A nurse is teaching a client about using intranasal glucocorticoids. Which of the following instructions should the nurse give?

Allow at least 2 weeks for the full therapeutic effect. It can take 2 or 3 weeks to see the full therapeutic effect of intranasal glucocorticoids.

A nurse is caring for a client who has peptic ulcer disease. The nurse should monitor the client's phosphorus levels when administering which of the following drugs?

Aluminum hydroxide Antacids that contain aluminum, such as aluminum hydroxide, can cause hypophosphatemia because of aluminum's ability to bind with phosphate and decrease its absorption. The nurse should monitor the client's phosphorus levels while administering this drug.

A nurse is caring for a client who has a new prescription for famotidine to treat GERD. The nurse should instruct the client to wait at least 1 hr between taking famotidine and which of the following over-the-counter drugs?

Antacids Antacids can decrease the absorption of famotidine, a histamine2-receptor antagonist. The nurse should instruct the client to wait at least 1 hr between taking famotidine and taking an antacid.

A nurse is caring for a client who has a dry nonproductive cough. Which of the following types of medication should the nurse recommend?

Antitussive Antitussives suppress the cough reflex.

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?

Aspirate to check for IV patency before administering the diphenhydramine It is important to confirm IV patency prior to administering an IV bolus. Some medications cause severe tissue damage when inadvertently administered into tissue rather than into a vein.

A nurse should recognize that sulfasalazine is contraindicated for clients who have which of the following conditions?

Aspirin Sensitivity Any sensitivity to salicylates, sulfonamides, or trimethoprim is a contraindication for the use of sulfasalazine, a 5-aminosalicylate. This is because intestinal bacteria metabolize the drug into 5-aminosalicylic acid, a salicylate. Aspirin is also a salicylate.

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

Avoid activities that require alertness. Loperamide, an opioid agonist, can cause sedation and dizziness. The nurse should instruct the client to avoid taking it before activities that require alertness.

A nurse is caring for a client who is receiving IV famotidine. Which of the following adverse effects should the nurse report to the provider immediately?

Bloody stools When using the urgent vs nonurgent approach to client care, the nurse should determine that the priority finding is bloody stools because adverse effects of treatment with famotidine might include blood dyscrasias (e.g. thrombocytopenia), which can lead to bleeding. This finding should be reported to the provider immediately.

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?

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

A nurse is caring for a client who takes sulfasalazine twice daily for rheumatoid arthritis. Which of the following values should the nurse review prior to the administration of the medication?

Complete blood count The nurse should identify that sulfasalazine can cause bone marrow suppression, which can lead to agranulocytosis, hemolytic anemia, and macrocytic anemia. As a result, the client's complete blood count should be periodically monitored, and the nurse should review it prior to administering this medication.

A nurse is teaching a client about the use of beclomethasone to treat asthma. The nurse should explain that the drug has which of the following therapeutic effects?

Decreases inflammation Beclomethasone, an intranasal glucocorticoid, treats asthma by reducing inflammation.

A nurse is assessing a client who was administered ondansetron IV 1 hr ago. Which of the following findings should the nurse recognize as an adverse effect of this drug?

Dizziness Dizziness and lightheadedness are the most common adverse effects of ondansetron.

A nurse is teaching an adult client about diphenhydramine. The nurse should inform the client to expect which of the following adverse effects while taking this drug?

Drowsiness The most common adverse effect of diphenhydramine, a first-generation antihistamine, is drowsiness.

You should monitor a pt taking dextromethorphan because of the potential for which of the following?

Drug abuse this medication can cause euphoria & hallucinations at high doses & there is a risk for the potential of abuse.

A nurse is teaching a client who has a new prescription for diphenhydramine for allergic rhinitis. The nurse should instruct the client to monitor for which of the following manifestations as an adverse effect of this medication?

Dry mouth Urinary retention The client should also monitor for drowsiness. The medication may be taken at night for this reason.

You should recognize that which of the following is a c/I for taking codeine?

Emphysema This medication is unsafe for pts w/ decreased respiratory reserve like emphysema or asthma.

A nurse is teaching a client who has severe generalized rheumatoid arthritis and is scheduled to start taking prednisone for long-term therapy. The nurse should instruct the client to report which of the following as an adverse effect of prednisone?

Gastric Ulceration The nurse should instruct the client to monitor for gastric ulceration as an adverse effect of the long-term use of prednisone. Other adverse effects of this medication include osteoporosis and adrenal suppression.

A nurse is preparing to administer phenylephrine to a client. The nurse should identify that that which of the following manifestations is an adverse effect of this drug?

Headache Oral sympathomimetics stimulate the adrenergic receptors, causing blood vessel constriction, which can cause nervousness, headache, blurred vision, and tremors

Sulfasalazine therapeutic use

Inflammatory Bowel Disease

A nurse should recognize that diphenoxylate/atropine should be used with caution for a client who has which of the following conditions?

Inflammatory bowel disease Diphenoxylate is an opioid, which can cause the severe complication of toxic megacolon in clients who have inflammatory bowel disease. The nurse should have the client monitor the consistency and frequency of stools throughout therapy.

A nurse is providing teaching to a newly licensed nurse about metoclopramide. The nurse should highlight that which of the following conditions is a contraindication to this medication?

Intestinal obstruction Metoclopramide reduces nausea and vomiting by increasing gastric motility and promoting gastric emptying. It is contraindicated for a client who has an intestinal obstruction or perforation.

A nurse is providing teaching to a client who has ulcerative colitis and a new prescription for sulfasalazine. The nurse should instruct the client to monitor for which of the following adverse effects of this medication?

Jaundice Sulfasalazine can cause a yellow discoloration of the skin and yellow/orange discoloration of the urine. The nurse should instruct the client to notify the provider if these occur.

A nurse is reviewing the medical record of a client who has a new prescription for famotidine. The nurse should recognize that which of the following drugs interacts with famotidine?

Ketoconazole Famotidine reduces the absorption of ketoconazole.

A nurse is caring for an older adult client who has kidney disease and a new prescription for famotidine. The nurse should instruct the client to report which of the following manifestations?

Lethargy Famotidine is a histamine2 receptor antagonist, which can potentially cross the blood-brain barrier. Older adult clients who have kidney impairments are at risk for central nervous system (CNS) effects such as lethargy, depression, confusion, and seizures. The nurse should instruct the client to report these manifestations to their provider.

You should instruct a pt using phenylephrine spray for nasal congestion to do which of the following to avoid rebound congestion?

Limit the drug's use to 3-5 days. This medication is a topical sympathomimetic which should be used short term to prevent rebound congestion.

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

Metoclopramide This medication is a dopamine antagonist that is administered diabetic gastroparesis.

A nurse is caring for a client who has been taking phenylephrine nasal drops for the past 10 days for sinusitis. The nurse should assess the client for which of the following manifestations as an adverse effect of this medication?

Nasal congestion When used for over 5 days, rebound nasal congestion can occur when taking nasal sympathomimetic medications (phenylephrine).

A nurse is teaching a client about albuterol. The nurse should instruct the client to monitor for and report which of the following as an adverse effect of this drug?

Palpitations Although not common at therapeutic doses, beta2 agonists can cause cardiac stimulation, resulting in chest pain, palpitations, hypertension, and arrhythmias.

A nurse should identify that dextromethorphan can have which of the following effects when combined with morphine?

Potentiation of depression of CNS actions Combining dextromethorphan with an opioid, such as morphine, increases the risk for decreased respirations and other depressed CNS responses.

A nurse is assigned to care for several clients who are postoperative. The client taking which of the following medications is at risk of delayed wound healing?

Prednisone to treat persistent arthritis exacerbations Prednisone is a corticosteroid that is associated with delayed wound healing. Clients who have arthritis often require high doses of prednisone to help resolve exacerbations.

A nurse is teaching a client about the use of antihistamines to treat allergic rhinitis. The nurse should explain that these drugs are effective because they perform which of the following actions?

Prevent histamine from binding to receptors Antihistamines treat allergic rhinitis and reduce swelling by blocking histamine from binding to the receptor sites.

A nurse is teaching a client who recently had a myocardial infarction and has a new prescription for docusate sodium. The nurse should inform the client that docusate sodium has which of the following therapeutic effects?

Prevents straining Docusate sodium, a stool softener, prevents straining during defecation and prevents the elevation in blood pressure that can result from straining. It also helps relieve constipation and reduces the painful elimination of hard stools.

A nurse is caring for a client at 39 weeks of gestation who has gestational hypertension. The client has a new prescription for misoprostol for cervical ripening and induction of labor. Which of the following findings in the client's medical history should the nurse identify as increasing the client's risk of complications due to the use of this medication?

Previous cesarean delivery The nurse should identify that misoprostol is a prostaglandin that promotes cervical ripening. An adverse effect of misoprostol is uterine tachysystole (excessively frequent uterine contractions). Therefore, this medication should be used with extreme caution and is contraindicated in clients who have experienced a previous cesarean delivery.

A nurse is caring for a client who is experiencing an acute asthma exacerbation. Which of the following medications should the nurse identify as being contraindicated for this client?

Propanolol The nurse should identify that a client who is experiencing an acute asthma exacerbation requires the use of a beta2-agonist to alleviate bronchospasm and relax the client's airway. Therefore, propranolol is contraindicated for this client. Propranolol is a beta-blocker that is used to treat cardiac conditions, including hypertension. Blocking the beta receptors prevents the action of beta2-agonists such as albuterol

Which of the following information indicates that a pt taking theophylline needs further instruction?

Pt drinks 2 cups of coffee each morning. Caffeine may increase CNS stimulation, causing nervousness, insomnia, and tremors. It may also increase cardiac stimulation and cause tachycardia.

A nurse is teaching a client about the use of an expectorant to treat a cough. The nurse should include that an expectorant has which of the following therapeutic effects?

Reduces surface tension Expectorants act by reducing the surface tension and viscosity of respiratory secretions. This results in thinning thick mucus, making it easier to cough out of the lungs and drain out of the nose and sinuses.

A nurse is preparing a discharge teaching plan for a client who is scheduled to begin long-term oral prednisone for asthma. Which of the following instructions should the nurse include in the plan?

Schedule the medication on alternate days to decrease adverse effects. Some of the adverse effects caused by long-term glucocorticoid therapy (e.g. suppression of the adrenal gland) can be avoided by using alternate-day therapy.

A nurse is teaching a client who has a new prescription for dextromethorphan to suppress a cough. The nurse should instruct the client to monitor for which of the following manifestations as an adverse effect of this medication?

Sedation Advise the client to avoid activities that require alertness.

A nurse is monitoring plasma drug levels in a client who is taking theophylline. Which of the following findings should the nurse expect to see if the client's drug level indicates toxicity?

Seizures Seizures are likely when plasma drug levels of theophylline, a methylxanthine, are higher than 30 mcg/mL, which indicates toxicity.

A nurse receives a new prescription for omeprazole for one of their clients. After reviewing information in the drug guide, provide the therapeutic uses for this medication.

Short-term therapy of gastric and duodenal ulcers, erosive esophagitis, and Gerd. Treatment should be limited to 4 to 8 weeks. Approved for long-term therapy of hypersecretory conditions. Prevention of stress ulcers for at-risk clients experiencing acute events.

A Pt is about to start taking sulfasalazine (Azulfidine) to treat IBD. You should instruct the Pt to watch for and report which of the following adverse effects of this drug? (Select all that apply.) A. Dry mouth B. Fever C. Joint pain D. Constipation E. Sore throat

Sore throat Fever *Sulfasalazine is an anti-inflammatory drug that can cause blood dyscrasias such as agranulocytosis & hemolytic & macrocytic anemia.

A nurse is providing teaching to a client who has rheumatoid arthritis and a prescription for long-term prednisone therapy. The nurse should instruct the client to monitor for which of the following adverse effects?

Stress fractures Prednisone can cause demineralization of the bones and can lead to osteoporosis and stress fractures.

A nurse is caring for a client who is taking phenytoin for a seizure disorder and has a new prescription for sucralfate to treat a duodenal ulcer. The nurse should instruct the client to take the drugs at least 2 hr apart for which of the following reasons?

Sucralfate interferes with the absorption of phenytoin. Sucralfate decreases the absorption of phenytoin. The nurse should instruct the client to allow at least 2 hr between taking the two drugs and should monitor the client's phenytoin levels.

A nurse is providing teaching to a client who has a new prescription for omeprazole to treat a duodenal ulcer. Which of the following instructions should the nurse include?

Swallow the capsules whole. Omeprazole, a proton pump inhibitor, is unstable in stomach acid. The nurse should instruct the client to swallow the capsules or tablets whole and not to crush or chew the capsules or tablets.

A nurse is reviewing the medication history of a client who has asthma. Which of the following medication combinations should the nurse identify as incompatible?

Theophylline & Zileuton The nurse should identify that zileuton, a leukotriene modifier, impairs the metabolism of certain medications. Concurrent use of zileuton with theophylline can cause toxicity due to elevated theophylline, which is a systemic methylxanthine used to relax the smooth muscles of the airway. Therefore, these medications are incompatible when used together.

A nurse is teaching a client about the use of a mucolytic to treat a cough. The nurse should include that a mucolytic has which of the following therapeutic effects?

Thins and loosens mucus Mucolytics make mucus less viscous to increase a cough's productivity.

A nurse is assessing a client who takes oral theophylline for chronic bronchitis relief. The nurse should recognize that which of the following findings indicates toxicity to theophylline?

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 client about ipratropium. Which of the following instructions should the nurse include?

Wait 5 min between using the drug and another inhaled drug. Ipratropium, an inhaled anticholinergic, requires a 5-min wait between its administration and that of another inhaled drug to allow for bronchodilation to take effect.

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

Weight gain *Weight gain and fluid retention are adverse effects of oral prednisone due to the effect of sodium and water retention. N

You should advise a pt who is taking beclomethasone oral inhaler to watch for which of the following possible indications of an adverse effect of this drug?

White coating in the mouth.