NCLEX PHARM PRACTICE LPN

A client who is experiencing nausea related to chemotherapy is being discharged with a prescription for ondansetron. The nurse should include which of the following information when reinforcing discharge teaching? "This medication may cause involuntary hand movements." "Avoid driving while taking this medication." "Use caution if taking Tylenol." "Take this medication after each chemotherapy treatment."

"Avoid driving while taking this medication." Adverse effects of ondansetron include headache and dizziness. The client should avoid driving or using heavy machinery.

A nurse is reinforcing teaching with a client who is using phenylephrine nasal spray three times daily and reports rebound congestion. Which of the following instructions should the nurse include to reduce the effects of rebound congestion? "Decrease the frequency to twice daily." "Continue use for one more week." "Discontinue use in the left nostril, then in the right nostril." "Add oxymetazoline nasal spray to relieve symptoms."

"Discontinue use in the left nostril, then in the right nostril." Discontinuing the drug one nostril at a time can overcome rebound congestion.

A nurse is reinforcing teaching about benzodiazepine withdrawal with an older adult client who discontinued takeing lorazepam after taking it for 3 months. Which of the following instructions should the nurse include? "Increase your fiber intake with each meal." "Have someone assist you with ADLs." "Watch for increased drowsiness." "Limit your daily fluid intake to 1,500 mL."

"Have someone assist you with ADLs." Lorazepam withdrawal causes tremors and dizziness, making ADLs difficult to perform.

A nurse in a community health clinic is preparing to administer the varicella immunization to a young adult female client who has not previously had chickenpox or its vaccine. The nurse should withhold the immunization and collect additional data when the client makes which of the following statements? "I am allergic to neomycin." "I am taking antibiotics for my acne." "My irritable bowel syndrome has been acting up the last few days." "I have been taking an oral contraceptive for the last 6 months."

"I am allergic to neomycin." A hypersensitivity to neomycin is a contraindication for receiving the varicella vaccine.

a nurse is collecting data from a client who received a tetanus and diphtheria toxoids and acellular pertussis vaccine (Tdap) booster immunization the previous day. Which of the following client statements should alert the nurse to a potentially serious adverse effect of the vaccine? "I have a fever of 101" "I have a complete lack of appetite" "I've been feeling a little dazed and confused" "my are is a bit red and puffy at the injection site"

"I have been feeling a little dazed and confused" although rare, clients can develop neurological symptoms that progress to acute encephalopathy after this immunization

A nurse is reinforcing teaching with a client who has a new prescription for regular insulin. Which of the following statements by the client indicates an understanding of the teaching? "I should eat right after I give myself an insulin injection" "I should roll the vial gently prior to drawing up the insulin" "I should identify that the insulin is clear prior to drawing it up" "I should inject the insulin deep into the muscle"

"I should identify that the insulin is clear prior to drawing it up" Regular insulin is clear therefore, there are no particles to disperse. cloudy insulin indicates contamination.

A nurse is reinforcing teaching with a client who is prescribed a scopolamine patch for motion sickness. Which of the following client statements indicates an understanding of the teaching? "I may have a runny nose during therapy." "I should replace the patch every day." "I may experience diarrhea as a potential side effect." "I should place the patch behind my ear."

"I should place the patch behind my ear." The client should place the scopolamine patch behind the ear.

A nurse is reinforcing teaching with a client who has a new prescription for a beclomethasone inhaler. Which of the following client statements indicates an understanding of the teaching? "I should avoid rinsing my mouth after each use." "I will hold my breath for 10 seconds after administering the medication." "I should wait 30 seconds between puffs." "I will clean my inhaler weekly with soapy water."

"I will hold my breath for 10 seconds after administering the medication." The nurse should instruct the client to hold his breath for 5 to 10 seconds after administering the medication and then exhale slowly. This allows the medication to be absorbed in the client's lungs.

A nurse is reinforcing teaching with a client who has a prescription for alendronate. Which of the following client responses indicates an understanding of the teaching? "I will take the medication with my breakfast." "I will take the medication with 1 tablespoon of an antacid." "I will lie down for 30 minutes after taking the medication." "I will take the medication with 8 ounces of water."

"I will take the medication with 8 ounces of water." Clients should take alendronate on an empty stomach with 240 mL (8 oz) of water to make sure that it does not lodge in the esophagus, which can result in esophageal ulcerations.

A nurse is reinforcing discharge teaching with a client who is to begin self-administration of insulin. Which of the following statements indicates an understanding of the teaching? "I will store the vial I am currently using in the refrigerator." "I'll put my used needles in an empty metal coffee can." "I'll be sure to massage the spot where I gave my shot." "I will replace the cap on the needle after I give my shot."

"I'll put my used needles in an empty metal coffee can." The client should discard used needles in a puncture-proof container such as a metal coffee can to prevent accidental exposure to bloodborne pathogens. -massaging will effect absorption rate

a nurse is reinforcing teaching with a client who is about to start using an ipratropium inhaler to treat exercise induced bronchospasm. which of the following statements by the client should alert the nurse to intervene? "I usually have a glass of red wine with dinner" "I'll make sure I use the inhaler 4 times a day" "I'll rinse my mouth after I use the inhaler" "I've always been allergic to peanuts"

"I've always been allergic to peanuts" Preparations of this medication could contain peanuts or soy lecithin rinsing the mouth is appropriate because this medication can leave a bitter taste in the mouth

A nurse is reinforcing teaching with a client who has type 2 diabetes mellitus and is to start therapy with pioglitazone. The client asks the nurse how the medication works. Which of the following is an appropriate response? "This medication will trigger your body to make more insulin." "Your body will decrease the amount of glucose that it makes." "Your body should become more sensitive to insulin." "This medication will delay the absorption of sugar from your gastrointestinal tract."

"Your body should become more sensitive to insulin." Pioglitazone is an oral antidiabetic agent that works by increasing the body's sensitivity to insulin.

A nurse is reinforcing teaching with the parent of a 14-year-old client regarding administration of bivalent human papillomavirus vaccine (HPV2). Which of the following should the nurse include in the teaching? "Your daughter will receive three doses of this immunization over 6 months." "Your daughter can receive this immunization up to age 16." "Your daughter cannot receive this immunization if she has an egg allergy." "Your daughter may experience missed periods after receiving this immunization."

"Your daughter will receive three doses of this immunization over 6 months." Clients should receive three doses of HPV2 over a 6-month period.

A nurse is caring for a client who is prescribed an IM injection of penicillin G benzathine. The client asks why the injection must be given IM instead of through his IV line. Which of the following is the correct response by the nurse? "The medication is more rapidly absorbed when given IM." "Your medication can't be given IV because it is not water-soluble." "You will experience less discomfort with an IM injection." "An IM injection allows more precise control of the medication level in your blood."

"Your medication can't be given IV because it is not water-soluble." Medications cannot be administered IV if they are not water-soluble.

An older adult client who has terminal cancer reports pain at a level of 5 using a 0 to 10 pain scale. The client has a prescription for morphine orally 15 mg every 4 hr. The client's children are concerned that the client is receiving too much of the medication. Which of the following is an appropriate response by the nurse? "Clients who receive this medication orally have a lower risk for addiction." "Because this medication is given on a fixed schedule, additional doses will not be needed." "Your mother's dose should remain constant to prevent breakthrough pain." "Your mother's medication will be changed after a week to decrease adverse effects."

"Your mother's dose should remain constant to prevent breakthrough pain." Fixed or scheduled dosing around the clock offers the best pain control for clients who have severe and persistent pain.

A nurse is reinforcing teaching with a client who is to set therapy with nitroglycerin transdermal patch. Which of the following statements by the client indicates an understanding of the teaching? "while using the patch, I will be careful when rising from a chair" "I should leave the patch in place for 24 hours" "I should apply the patch to the same location each time" "I will apply a new patch if I have chest pain"

"while using the patch, I will be careful hen rising from a chair" NTG can cause orthostatic hypotension, which causes dizziness

a nurse is reinforcing teaching about nicotine polacrilex gum with a client who smokes 3 packs a day. Which of the following statements should the nurse include in the teaching? "you can drink caffeinated beverages while chewing gum" "you can chew 2 pieces of gum I you have the urge to smoke" "you should chew the gum for a full 30 minutes before discarding" "you should wait 5 minutes after eating to chew the gum"

"you should chew the gum for a full 30 minutes before discarding" the full dose of nicotine occurs within 15-30 minutes caffeinated beverages decrease the nicotine absorption and nicotine increases metabolism of caffein

A provider prescribes phenobarbital 3 mg/kg twice a day for a child who has a history of seizures. The child weighs 44 lb. The nurse has on hand phenobarbital elixir 20 mg/5 mL. How many mL should the nurse plan to administer with each dose? (Round the answer to the nearest whole number. Use a leading zero if applicable. Do not use a trailing zero.)

15ml

A nurse is caring for a client who has a prescription for phenytoin 50 mg PO. Available is phenytoin suspension 125 mg/5 mL. How many mL should the nurse administer? (Round the answer to the nearest whole number. Use a leading zero if applicable. Do not use a trailing zero.)

2

A nurse is caring for a client who is receiving IV therapy. The provider prescribes an increase in the client's infusion rate from 1 L over 10 hr to 1 L over 8 hr. What is the hourly increase in the infusion rate in mL? (Round the answer to the nearest whole number. Use a leading zero if applicable. Do not use a trailing zero.)

25ml/hr

A nurse is preparing to administer diphenhydramine 50 mg PO at 2200 to a client who has difficulty swallowing pills and capsules. Available is diphenhydramine syrup 12.5 mg/5 mL PO. Which of the following nursing actions requires the completion of an incident report? Giving the medication at 2140 Administering the medication with grapefruit juice Giving the medication when the client's apical pulse is 58/min Administering 25 mL of the syrup

Administering 25 mL of the syrup This dose is higher than the client should receive. The correct dosage is 20 mL. Administering an incorrect amount of medication to a client requires completion of an incident report.

A nurse is collecting data prior to administering digoxin to a client. For which of the following findings should the nurse withhold this medication and notify the provider? Digoxin level 0.7 ng/mL Blood pressure 142/80 mm Hg Potassium 4.4 mEq/L Apical pulse 52/min

Apical pulse 52/min The nurse should check the client's apical pulse prior to administering digoxin because it decreases the heart rate and improves contractility. If the client's heart rate is below 60/min, the nurse should withhold the dose and notify the provider.

A nurse is monitoring a client who is 2 hr postoperative and just received an opioid analgesic. Which of the following actions should provide the nurse with the best data to determine the client's need for analgesia? Observe the client for signs of restlessness. Monitor the client for facial grimacing. Watch the client for signs of decreased mobility. Ask the client to rate her pain level.

Ask the client to rate her pain level. Asking the client to rate her pain level will provide a verbal report of pain, which is the best indicator of the need for pain medication.

A nurse is reviewing the medical record of a client who has a new prescription for dimenhydrinate to treat motion sickness. Which of the following disorders in the client's medical record should the nurse report to the provider as a contraindication? Major depresive disorder Diabetes mellitus Benign prostatic hyperplasia Meniere's disease

Benign prostatic hyperplasia Clients who have benign prostatic hyperplasia may have urinary hesitancy and retention and therefore should not take dimenhydrinate due to the anticholinergic adverse effects of the medication.

A nurse is reinforcing teaching with a client who is to start therapy with nifedipine. The nurse should instruct the client that the medication decreases which of the following? Blood pressure Heart rate Nasal congestion Bladder spasms

Blood pressure Nifedipine causes vasodilation, resulting in decreased blood pressure.

A nurse is caring for a client who is receiving a combination of antiretroviral medications for HIV. Which of the following laboratory tests will indicate the status of the client's immune system? Enzyme-linked immunosorbent assay (ELISA) CD4 T-cell count OraQuick rapid HIV-1 antibody test Western blot assay

CD4 T-cell count This test indicates the status of the client's immune system. A rise in CD4 T-cell counts indicates return of immune function for the client who has HIV.

A client who has Pseudomonas aeruginosa is admitted to the hospital and is started on a therapeutic dose of gentamicin. When reviewing the medical history of the client, which of the following should cause the nurse to notify the primary care provider? History of alcohol use disorder Chronic renal insufficiency Type 2 diabetes mellitus Allergy to penicillin

Chronic renal insufficiency Gentamicin is nephrotoxic. Therefore, it is important for the nurse to notify the provider in order to monitor the client's BUN and serum creatinine levels.

A nurse is caring for a client who has a new prescription for baclofen for multiple sclerosis. Which of the following findings indicates to the nurse that the medication is having a therapeutic effect? Decreased muscle spasticity Increased urinary output Increased mental alertness Decreased heart rate

Decreased muscle spasticity Baclofen is an antispasmodic that decreases muscle spasticity in clients who have multiple sclerosis.

A nurse is caring for a client who has tuberculosis and will begin taking isoniazid. Which of the following actions should the nurse take? Determine the client's daily alcohol intake. Tell the client to expect red-orange urine. Reinforce teaching on a low-calorie diet. Instruct the client to have a yearly tuberculin skin test.

Determine the client's daily alcohol intake. Isoniazid can cause liver damage; therefore, it is important for the nurse to determine the client's daily alcohol intake because alcohol use increases this risk. The nurse should instruct the client to reduce or avoid all use of alcohol.

A nurse is performing the third check before administering hydromorphone to a client. After opening the unit-dose packet, the client tells the nurse he does not want to take the medication now. Which of the following actions should the nurse take? Complete an unusual occurrence report of the incident. Encourage the client to take the medication. Leave the medication at the client's bedside in case he changes his mind. Dispose of the medication with a second nurse as a witness.

Dispose of the medication with a second nurse as a witness. The nurse must have a witness when disposing of a controlled substance.

A nurse working in a provider's office administers an oral dose of ampicillin to a client and then monitors her for the next 30 min. Which of the following findings indicates the client is having an allergic reaction to the medication? (Select all that apply.) Elevated blood pressure Pruritus Flushing Wheezing Tinnitus

Elevated blood pressure is incorrect. Clients having an allergic reaction to ampicillin are more likely to have hypotension. Pruritus is correct. Clients having an allergic reaction to ampicillin can develop severe itching, resulting from the body's immune response to the medication as an antigen. Flushing is correct. Clients having an allergic reaction to ampicillin can develop flushing, resulting from the body's immune response to the medication as an antigen. Wheezing is correct. Clients having an allergic reaction to ampicillin can develop wheezing, resulting from the body's immune response to the medication as an antigen. Tinnitus is incorrect. Tinnitus indicates damage to the inner ear. Aminoglycosides, rather than penicillins, can cause ototoxicity.

A nurse is caring for a client who has a new prescription for risperidone fto treat schizophrenia. Which of the following laboratory tests should the nurse plan to review prior to administering the first dose? Fasting blood glucose level Serum albumin level CD4 T-cell count Platelet count

Fasting blood glucose level A client taking risperidone is at risk for developing diabetes due to the metabolic effects of the medication. A fasting blood glucose level should be measured as a baseline prior to administration of the first dose, again 12 weeks later, and then annually.

A nurse is monitoring a client who is receiving repaglinide for type 2 diabetes mellitus. Which of the following laboratory tests should the nurse plan to review to obtain information about the long-term therapeutic effect of this medication? Fasting blood glucose level 1-hr oral glucose tolerance test Urinary ketones Glycosylated HbA1c

Glycosylated HbA1c HbA1c measures the average of blood glucose levels over the past 2 to 3 months. Therefore, the nurse should review this laboratory test to obtain information about the long-term therapeutic effect of repaglinide.

A nurse in a provider's office is reinforcing teaching with a client who has a prescription for diphenoxylate/atropine. Which of the following instructions should the nurse include in the teaching? This medication can turn your stools black. High doses of this medication can cause drowsiness. Avoid drinking grapefruit juice while taking this medication. You might have urinary frequency after taking two or more doses.

High doses of this medication can cause drowsiness. Diphenoxylate is an opioid, which can cause drowsiness.

A nurse is assisting with an admission of a client who reports muscle aches and pains associated with his construction work. The provider suggests taking acetaminophen. The nurse should notify the provider about which of the following information obtained from the client? History of hepatitis B Cigarette smoker History of hypertension Allergy to sulfonamides

History of hepatitis B Acetaminophen can result in hepatotoxicity in clients who have a history of liver damage or failure.

A nurse is caring for a client who has a new prescription for eplerenone to treat hypertension. For which of the following adverse effects should the nurse monitor? Hematuria Hypernatremia Hyperkalemia Constipation

Hyperkalemia The client is at risk for increased potassium levels because eplerenone can cause potassium retention.

A nurse is monitoring an older adult client who has been receiving long-term hydrochlorothiazide therapy for recurring episodes of heart failure. Which of the following findings should the nurse recognize as an adverse effect of this medication? Hypokalemia Hyperchloremia Hypernatremia Hypocalcemia

Hypokalemia Hydrochlorothiazide can cause hypokalemia from excessive potassium excretion.

A nurse is assisting with the care of a client who is in preterm labor and is receiving magnesium sulfate by continuous IV infusion. Which of the following findings indicats magnesium toxicity? Urinary output 60 mL/hr Hyporeflexia Respirations 14/min Tachycardia

Hyporeflexia Magnesium sulfate depresses neuromuscular activity, leading to muscle weakness and paralysis. Therefore, hyporeflexia can indicate magnesium toxicity.

A nurse is caring for a client who has a 10-year history of alcohol use disorder and is experiencing acute alcohol withdrawel. Which of the following is the priority intervention for this client? Suggest the client attend a support group. Administer naltrexone. Implement seizure precautions. Assist the client to identify triggers of alcohol use.

Implement seizure precautions. The greatest risk to the client at this time is injury from seizures and falls. Therefore, the nurse's priority is to implement seizure precautions to prevent injury if the client develops seizure.

A nurse is caring for a client who is taking bethanechol. For which of the following adverse effects should the nurse monitor? Decreased urination Increased GI motility Dry mouth Hypertension

Increased GI motility Bethanechol is a muscarinic agonist that increases GI motility, leading to abdominal cramps and diarrhea.

A nurse is reinforcing teaching with a client about the adverse effects of simvastatin. For which of the following adverse effects should the nurse instruct the client to monitor? Muscle pain Fine hand tremors Urinary retention Double vision

Muscle pain The nurse should instruct the client to notify the provider if muscle pain or tenderness develops, because this could indicate rhabdomyolysis.

A nurse is reinforcing discharge teaching with a client who has type 2 diabetes mellitus and a new prescription for metformin. The nurse should instruct the client to monitor for which of the following adverse effects? (Select all that apply.) Muscle pain Agitation Weight gain Constipation Metallic taste

Muscle pain is correct. A client who is taking metformin should monitor for muscle pain, which could indicate lactic acidosis. Agitation is correct. Agitation indicates a CNS adverse effect of the medication. Weight gain is incorrect. Metformin does not cause weight gain. Constipation is incorrect. Metformin can cause GI manifestations such as diarrhea, nausea, and vomiting. Metallic taste is correct. Metformin can cause GI manifestations such as a bitter or metallic taste.

A nurse is reinforcing teaching with a client who is to start therapy with gemfibrozil. Which of the following should the nurse instruct the client to watch for and report to the provider? ​Bruising Numbness in the feet ​Facial flushing Muscle weakness

Muscle weakness Myopathy is an adverse effect of gemfibrozil. The nurse should instruct the client to report any muscle weakness or muscle tenderness.

A nurse is reviewing the history of a client who is about to start taking cefotetan to treat a bacterial infection. Which of the following information from the client's medical record should the nurse report to the provider before the client begins receiving this medication? Hearing impairment Milk-protein allergy Tendon pain Penicillin allergy

Penicillin allergy Cefotetan is a cephalosporin, an antibiotic structurally similar to penicillins. It is possible that a client who has a severe allergy to penicillin could develop cross-reactivity and have an allergic reaction to cephalosporins.

A nurse is reinforcing teaching with a client who is to start therapy using a nitroglycerin transdermal patch. Which of the following instructions should the nurse include? Cover the patch with a dry dressing. Apply another patch if experiencing chest pain. Leave each patch in place for 24 hr. Place the patch on a different site for each application.

Place the patch on a different site for each application. The client should place the patch on a different site for each application to prevent skin irritation. Acute chest pain is not treated with a transdermal patch

A nurse is instilling timolol eyedrops for a client who has glaucoma. Which of the following actions is appropriate for the nurse to take after instilling the eyedrops? Press the nasolacrimal duct. Apply pressure to the upper eyelid. Ask the client to blink the eyes several times. Tell the client to keep the eyes open for at least 15 seconds.

Press the nasolacrimal duct. This action will prevent the medication from absorbing into systemic circulation.

A nurse is monitoring a client who has just returned to the unit following surgery. The client received an initial dose of morphine 5 mg IV bolus for pain relief. Which of the following adverse effects should the nurse report immediately to the provider? Emesis Sedation Respiratory rate 11/min Blood pressure 100/74 mm Hg

Respiratory rate 11/min ​When using the airway, breathing, circulation approach to client care, the priority finding is a respiratory rate of 11/min indicating respiratory depression.

A nurse is reinforcing teaching with a client who has a new prescription for spironolactone for hypertension. Which of the following instructions should the nurse include in the teaching? Increase foods high in zinc. Restrict foods high in potassium. Restrict foods high in vitamin K. Increase foods high in magnesium.

Restrict foods high in potassium. Spironolactone is a potassium-sparing diuretic, which can cause hyperkalemia. Therefore, the client should restrict foods that are high in potassium.

A nurse is caring for a client who has hypertension and a prescription for metoprolol. Which of the following conditions is a contraindication for this medication? Peripheral vascular disease Diabetes mellitus Second-degree AV block Renal failure

Second-degree AV block Metoprolol slows the conduction through the AV node. Therefore, it is contraindicated for clients who have an AV block that is greater than first degree.

A nurse is reinforcing teaching with a client who is prescribed captopril for hypertension. Which of the following side effects should the nurse instruct the client to report to the provider immediately? Photosensitivity Weight loss Sore throat Altered taste sensation

Sore throat The greatest risk to the client is infection related to neutropenia. Unexplained fever, sore throat, and fatigue can indicate an infection and should be immediately reported to the provider.

A nurse is monitoring a client who is receiving a transfusion of packed RBCs. The client's temperature increases to 39.1° C (102.4° F). Which of the following actions should the nurse take first? Obtain a urine specimen. Administer diphenhydramine. Stop the transfusion. Notify the charge nurse.

Stop the transfusion. An elevated temperature indicates that this client is at greatest risk for a blood transfusion reaction; therefore, the first action the nurse should take is to stop the transfusion.

A nurse is collecting data from a client who has been taking carbidopa/levodopa. Which of the following findings should indicate to the nurse that the medication is effective? the client is able to wash his face the client experiences fear seizures the client reports decreased heart burn the client is able to sleep through the night

The client is able to wash his face levodopa activates dopamine receptors, restoring nerve transmission carbidopa enhances these effects by inhibiting the breakdown of levodopa in the intestines

A nurse is caring for a client who has just received a prescription for tolbutamide to treat diabetes mellitus. The nurse should question the prescription if the client reports which of the following medication allergies? Amoxicillin-clavulanate Trimethoprim/sulfamethoxazole Azithromycin Cephalexin

Trimethoprim/sulfamethoxazole Clients who have a hypersensitivity to sulfonamide antibiotics might also be allergic to sulfonylureas such as tolbutamide. Therefore, the nurse should question the client's prescription for tolbutamide.

A nurse is monitoring a client who is receiving IV amphotericin B. Which of the following findings indicates an adverse reaction to this medication? Serum potassium level 5.6 mEq/dL Hematocrit 55% Polyuria Vertigo

Vertigo Ototoxicity is an adverse effect of amphotericin B. Manifestations of ototoxicity include vertigo, tinnitus, and hearing loss.

A nurse is caring for a client who is receiving methylprednisolone sodium succinate. Which of the following laboratory values should the nurse plan to monitor? SATA white blood cell count serum potassium creatine phosphokinase blood glucose amylase

WBC, Serum potassium, blood glucose WBC will decrease causing rise in chance for infection Potassium levels will drop causing hypokalemia along with fluid retention Blood glucose levels can rise

A nurse is reinforcing teaching with a female client who has a new prescription for isotretinoin. Which of the following instructions should the nurse include in the teaching? (Select all that apply.) You will need to have your triglyceride levels monitored. You can have nosebleeds while taking this medication. You may receive a 90-day supply of this medication from the pharmacy. You will need to have two negative pregnancy tests prior to starting the medication. You will need to take a vitamin A supplement twice daily.

You will need to have your triglyceride levels monitored is correct. This medication can elevate triglyceride levels, so the client needs to have levels tested prior to treatment and periodically thereafter. You can have nosebleeds while taking this medication is correct. Due to the drying effects of this medication, nosebleeds are very common. You may receive a 90-day supply of this medication from the pharmacy is incorrect. This medication may only be dispensed in a 30-day supply. You will need to have two negative pregnancy tests prior to starting the medication is correct. Due to the potential for severe birth defects, assurance that the client is not pregnant is essential. You will need to take a vitamin A supplement twice daily is incorrect. Vitamin A enhances the risk of isotretinoin toxicity. The client should avoid supplements.

A nurse is planning to reinforce teaching regarding newborn immunizations to a client who is 24 hr postpartum. Which of the following teachings should the nurse plan to include? "Your baby will receive the first hepatitis B vaccine before discharge." "Your baby will receive the rotavirus vaccine if your blood titer is low." "Your baby will receive the first influenza virus vaccine at the 4-week checkup." "Your baby will receive the varicella vaccine if you have a history of chicken pox."

Your baby will receive the first hepatitis B vaccine before discharge." The newborn should receive the first hepatitis B vaccine at birth, with the next two doses at least 2 months apart.

a nurse is reinforcing teaching with a client who has a new prescription for colchicine to treat gouty arthritis. Which of the following manifestations should the nurse include as an adverse effect of this medication? abdominal pain wheezing excessive urination tinnitus

abdominal pain this indicates cellular damage o the GI tract

a nurse is collecting data from a client who is taking eventide to treat DM. For which of the following findings should the nurse withhold the eventide dose and notify the provider immediately? loss of appetite abdominal pain muscle weakness heartburn

abdominal pain the greatest risk to clients is pancreatitis

a nurse is caring for a client who is having an acute asthma attack. Which of the following medications should the nurse administer first? beclomethasone albuterol cromolyn prednisone

albuterol this is a short acting beta-2 agonist with a rapid onset. the others are for maintenance therapy

a nurse is reinforcing teaching with a client who has helicobacter pylori and a new prescription for tetracycline. Which of the following instructions should the nurse include in the teaching? expect urine to turn orange take the medication with 240mL (8oz) of milk watch for excessive bleeding when brushing teeth avoid prolonged exposure to sunlight

avoid prolonged exposure to sunlight

a client comes into an ambulatory clinic and announces with great enthusiasm "I am an expert at all things medical as they apply to me, and I require zolpidem!" the client's pupils are dilated and his HR and BP are elevated. the nurse should suspect intoxication with which of the following? alcohol cocaine barbiturates heroin

cocaine clients with cocaine intoxication typically have elevated BP, tachycardia, dilated pupils and display delusions. heroin-slurred speech, drowsiness, constricted pupils, decreased BP barbiturates-same as heroin plus impaired judgment and irritability alcohol- same as barbiturates minus constricted pupils

a nurse is preparing to administer a liquid medication and a tablet to a client who is receiving enteral feedings through a NG tube Which of the following actions should the nurse take? mix the liquid medication with the tube feeding crush the tablet to mix with the liquid medication crush the tablet to mix with 30mL of warm water mix the liquid with 20mL of cold water

crush the tablet and mix with 30ml warm water

a nurse is reinforcing teaching with a client who has a new prescription for theophylline. The nurse should instruct the client that which of the following is an expected outcome of this medication? dilates bronchioles reduces inflammation loosens secretions blocks leukotrienes

dilates bronchioles

a nurse is reinforcing teaching with a client following placement of a cast for a fractured ankle. The client is to take oxycodone for pain management. When reviewing the client's OTC medications, which of the following should the nurse tell the client to avoid while taking the oxycodone? docusate sodium ranitidine diphenhydramine ibuprofen

diphenhydramine causes CNS depression

a nurse is teaching a client who has a new prescription for ciprofloxacin. which of the following instructions should the nurse include in the teaching? drink 8 full glasses of water per day increase exposure to sunlight take the medication with an antacid take this medication with 1 cup of milk

drink 8 full glasses of water per day prevents crystalluria and dehydration avoid milk calcium inhibits medication absorption

a nurse is reviewing the medial administration record of a client who has a history of Stevens-Johnson syndrome when taking Septra. Which of the following medications should the nurse withhold to prevent and allergic reaction? prednisone furosemide lansoprazole digoxin

furosemide septra and furosemide are chemically related

A nurse is collecting data from a client who is scheduled to receive the varicella vaccine. The nurse should withhold the vaccination if the client tells her he is allergic to which of the following substances? eggs gelatin yeast latex

gelatin substances that can cause an anaphylactic reaction with vaccinations: eggs-influenza yeast-HPV and Hepatitis B latex-vaccinations packaged in a syringe or vial coating latex. some forms of HPV come this way

A nurse is reinforcing teaching with a client who is taking metformin for treatment of type 2 diabetes mellitus. The nurse should indicate in the teaching that the medication decreases which of the following physiological factors ? cellular sensitivity to insulin insulin released from the pancreas glucose production in the liver transport of glucose to the muscles

glucose production in the liver metformin improves insulin sensitivity and decreases production of glucose in the liver

a client is visiting her provider to follow up on routine lab work related to warfarin therapy for mitral valve replacement The client's INR is 5.0. Which of the following questions should the nurse ask based on the INR result? "have you been taking a vitamin K supplement" "have you skipped a dose of your medication" "did you have your PTT levels drawn alt week" "have you noticed any bruising"

have you noticed any bruising 5.0 is above the expected range and puts the clients at risk for bleeding

a nurse is caring for a client who has a history of psychosis and is taking chlorpromazine. which of the following actions should the nurse take to counteract the adverse effects of this medication? suggest more frequent use of antiperspirant help the client apply sunblock before going outside give the client a list of OTC antidiarrheals recommend the client take med on a empty stomach

help the client apply sunscreen before going outside this medication increases the skin's sensitivity to UV light

a nurse is caring for a client who has chronic renal failure and has been receiving epoetin alfa for 2 weeks. Which of the following indicated to the nurse that the medication is having the desired therapeutic effect? albumin is within expected reference range urine output increases to 60mL/hr hemoglobin rises by 0.5g/dL BUN level is within expected reference range

hemoglobin rises by 0.5g/dL initial effects occur within the first two weeks of therapy. target levels, 10-12g/dL, reached in 2-3 months

a nurse is collecting data from a client who is asking about taking celecoxib for treatment of joint pain. The nurse should recognize which of the following is a contraindication to receiving celecoxib? hyperglycemia allergy to PCN history of MI PUD

history of MI Celecoxib increases the risk of MI because of increased vasoconstriction and unimpeded platelet aggregation.

a nurse is reviewing a client's medication administration record and discovers that an additional dose of captors has been administered in error to the client. The nurse should monitor the client for which of the following adverse reactions? bradycardia facial flushing hypotension tinnitus

hypotension an additional dose can cause a decrease in blood pressure . It can also cause an increased heart rate at the same time with skin itching, not facial flushing

a nurse is caring for a client who has schizophrenia and is to start therapy with risperidone. For which of the following should the nurse monitor to determine whether the treatment is effective? improved social interactions decreased obsessive-compulsive thoughts decreased hand tremors improved urinary control

improved social interactions risperidone is an atypical antipsychotic that can minimize the manifestations of speech deficiency and dull affect

A nurse is reinforcing teaching with a client who has rheumatoid arthritis and a new prescription for methotrexate. Which of the following information should the nurse include in the teaching? avoid grapefruit juice increase salt intake avoid aged cheese increase fluid intake

increase fluid intake extra fluids helps reduce renal damage and increases drug excretion

a nurse id caring for a client who is taking phenylephrine. the nurse should plan to monitor the client for which of the following adverse effects? increased drowsiness increased heart rate decreased blood pressure decreased WBC

increased heart rate CNS stimulant that can cause cardiac arrhythmia, tachycardia, insomnia, HTN

a nurse is collecting data from a client who states he has been taking ibuprofen for joint pain. After reviewing the client's MAR, which of the following medications should the nurse discuss with the provider? omeprazole atorvastatin lisinopril metformin

lisinopril concurrent use use of an NSAID with an ACE inhibitor can decrease the hypertensive effects of the ACE inhibitor

A nurse is reinforcing teaching with a client who has bipolar disorder and a new prescription for lithium. Which of the following instructions should the nurse include in the teaching? take medication on empty stomach monitor for signs of hyperthyroidism watch for signs of urinary retention maintain a consistent sodium intake

maintain sodium intake decreased serum sodium levels cause lithium levels to increase which can lead to toxicity

a nurse is collecting data from a client who has heart failure and has been taking digoxin and hydrochlorothiazide. which of the fallowing findings is a manifestation of an adverse effect of these medications? hyperactive reflexes muscle weakness hypoglycemia thrombophlebitis

muscle weakness HCTZ can result in excessive potassium excretion by the kidneys, leading to hypokalemia. Hypokalemia can lead to fatal dysrhythmias in clients taking digoxin.

a nurse is collecting data from a client who has a prescription of tobramycin. Which of the following findings should the nurse immediately report to the provider? report of nausea fever oliguria repot of headache

oliguria indicates that the client is at risk for nephrotoxicity

a nurse is reinforcing teaching with a client who is receiving enalapril 20mg PO daily. The nurse should instruct the client to monitor for which of the following adverse affects of this medication? facial flushing blurred vision muscle tremors dry cough

persistent dry or nonproductive cough is an adverse effect of this medication. caused by the accumulation of bradykinin from the medication

a nurse is monitoring a client who is to start therapy with spironolactone. Which of the following lab results should the nurse report to the provider? Sodium 140mEq/L Potassium 5.3mEq/L Chloride 99mEq/L Magnesium 1.9mEq/L

potassium 5.3mEq/L This finding is above the expected range

a nurse is caring for a client who is receiving vancomycin. The nurse should monitor the client for and report which of the following changes in condition? abdominal pain red neck insomnia blurred vision

red neck red neck syndrome includes: flushing , pruritus, hypotension, and tachycardia

a nurse is caring for a client who is prescribed disulfiram and consumed alcohol 12 hours ago. Which of the following adverse reactions is the priority finding to report to the provider? hyperemesis severe headache palpitation respiratory depression

respiratory depression this can indicate the client is experiencing acetaldehyde syndrome

a nurse is collecting data from a client who has a new prescription for levodopa/carbidopa. For which of the following should the nurse monitor and document as the priority finding? dark urine diaphoresis anorexia syncope

syncope the greatest risk to this client would be injury from falling

a nurse is collecting data from a client who is receiving theophylline for treatment of bronchial asthma. The nurse should recognize that which of the following findings indicate theophylline toxicity? SATA tachycardia nausea urinary retention drowsiness headache

tachycardia, nausea, headache urinary FREQUENCY and INSOMNIA are manifestations of adverse effects, not toxicity

a nurse is reinforcing teaching about immunizations with a client who is pregnant. which of the following vaccine should the nurse include in the teaching as safe to receive during pregnancy? herpes zoster tetanus and diphtheria varicella measles, mumps, and rubella

tetanus and diphtheria Tdap is safe during pregnancy, the others are contraindicated

a nurse is caring for a client who has a new prescription for sumatriptan. the nurse notes that the client takes fluoxetine. the nurse should question the provide because the combination put the client at risk for which of the following adverse effects? tremors renal calculi dysphagia hearing loss

tremors concurrent use of these medications can cause excessive simulation of serotonin receptors placing the client at risk for serotonin syndrome.

a client has been taking digoxin fro 1 month The nurse should recognize which of the following as a manifestation of digoxin toxicity? pulse rate of 100/min blood pressure 140/90mm Hg wheezing vomiting

vomiting

a nurse is preparing to instill an antibiotic ear drop for a client who has otitis external. Which of the following actions should the nurse take? chill the medication before instilling it use a cotton swab to remove ant debris before instilling drops pack the auditory canal with a cotton ball after instilling drops wiggle the earlobe after instilling the drops

wiggle the earlobe after instilling the ear drops this helps move the drops down the client's external auditory canal cold drops can cause dizziness

a nurse is reinforcing teaching with a client who is to start chemotherapy with metronidazole for a UTI. which of the following should the nurse include in the teaching? "your urine may become reddish brown" "store the medication in the refrigerator" "your physician will monitor hemoglobin levels" "discontinue the mediation when the symptoms are gone"

your urine will become reddish brown