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Two months after taking nitrofurantoin for a bacterial infection, a client reports the onset of severe, watery diarrhea to the home care nurse. How should the nurse respond? A. Determine if the full course of the initial prescription of medication was taken. B. Explain that the diarrhea may be an adverse effect that requires further evaluation C. Offer instructions about the use of an over-the-counter antidiarrheal medication. D. advise that the infection has returned, and additional medication will be needed

B. Explain that the diarrhea may be an adverse effect that requires further evaluation

Rivastigmine, a cholinesterase inhibitor, is prescribed for a female patient with early-stage Alzheimer's Disease. The patient's daughter tells the nurse that she plans to start administering the drug when her mother's symptoms worsen, hoping to avoid nursing home placement. How should the nurse respond? A. Affirm the decision to use the medication when the symptoms start to worsen. B. Explain that the drug should be used early in the disease process. C. Assess the patient's current mental status before deciding to support the decision. D. Confirm that the daughter is aware of the progressive nature of the disease. H. w should the nurse respond?

B. Explain that the drug should be used early in the disease process.

A client with Parkinson's disease who is taking carbidopa/levodopa reports the urine appears to be darker in color. Which action should the nurse take? A. Measure the client's urinary output. B. Explain the color change is normal. C. Obtain a specimen for a urine culture. D. Encourage an increase in oral intake.

B. Explain the color change is normal

The nurse is planning to administer the antiulcer gastrointestinal (GI) agent sucralfate to a client with peptic ulcer disease. Which action should the nurse include in this client's plan of care? A. Administer sucralfate once a day, preferably at bedtime. B. Give sucralfate on an empty stomach. C. Monitor for electrolyte imbalance. D. Assess for secondary Candida infection.

B. Give sucralfate on an empty stomach.

The charge nurse places a fall precautions sign on the client's door. What side effects of morphine could contribute to this client's fall risk? Select all that apply. A. Seizures B. Nausea C. Orthostatic hypotension D. Sedation E. Euphoria F. Itching G. Urinary retention

B. Nausea C. Orthostatic hypotension D. Sedation

The nurse is teaching a client with type 1 diabetes mellitus (DM) about the onset, peak, and duration of a new prescription for glargine insulin. If the insulin is administered at 0800, when is the client most likely to experience hypoglycemia? A. Midmorning. B. No peak occurs. C. Midafternoon. D. Shortly after midnight.

B. No peak occurs

A client is receiving intravenous (IV) vancomycin and the nurse plans to draw blood for a peak and trough to determine the serum level of the medication. Which of the following collection times provide the best determination of these levels? A. Thirty minutes into the administration of the IV dose and 30 minutes before the next administration of the medication. B. One hour after completion of the IV dose and one hour before the next administration of the medication. C. Two hours after completion of the IV dose and two hours before the next administration of the medication. D. Immediately after completion of the IV dose and 30 minutes before the next administration of the medication.

B. One hour after completion of the IV dose and one hour before the next administration of the medication

- Admit to the surgical floor - Clear liquid diet, advance as tolerated - Continuous cardiorespiratory monitoring - Morphine 1 mg/hr intravenously - Alert surgeon to signs of bleeding or infection in the surgical site - Docusate sodium 240 mg orally every am - Naloxone 2 mg intravenously as needed for respiratory depression - Ibuprofen 600 mg orally every 6 hours What should the nurse do immediately? Select all that apply. A. Print an electrocardiogram strip B. Provide rescue breaths with a manual ventilation bag C. Give naloxone 2 mg intravenously D. Apply oxygen via nasal cannula E. Perform chest compressions F. Call for rapid response

B. Provide rescue breaths with a manual ventilation bag C. Give naloxone 2 mg intravenously F. Call for rapid response

The nurse admits a client with a diagnosis of stage 4 cancer. The client has a prescription to wear a subcutaneous morphine sulfate patch for pain. The client is short of breath and difficult to arouse. While performing a head to toe assessment, the nurse discovers four patches on the client's body. Which action should the nurse take first? A. Apply oxygen face mask. B. Remove the morphine patches. C. Administer a narcotic reversal drug. D. Monitor blood pressure.

B. Remove the morphine patches.

Before administering a newly prescribed dose of terbinafine HCL to a client with a fungal toenail infection, which assessment finding is most important for the nurse to address? A. Employed as a construction worker. B. Reported history of alcoholism. C. White blood cell count of 8,500/mm3 (8.5 x 10^9/L). D. Toenails appear thick and yellow

B. Reported history of alcoholism.

The nurse initiates an infusion of piperacillin-tazobactam for a client with a urinary tract infection. Five minutes into the infusion, the client reports not feeling well. Which client manifestation should the nurse identify as a reason to stop the infusion? A. Hypertension. B. Scratchy throat. C. Bradycardia. D. Pupillary constriction.

B. Scratchy throat.

A client with hepatic encephalopathy is receiving lactulose. Which assessment provides the nurse with the best information to evaluate the client's therapeutic response to the drug? A. Stool color and character. B. Serum electrolytes and ammonia. C. Serum hepatic enzymes. D. Fingerstick glucose.

B. Serum electrolytes and ammonia.

A patient with type 1 diabetes mellitus has been prescribed a glucagon emergency kit for home use. When should the nurse instruct the patient and family that glucagon needs to be administered? A. Before meals to prevent hyperglycemia. B. When signs of severe hypoglycemia occur. C. When unable to eat during sick days. D. At the onset of signs of diabetic ketoacidosis.

B. When signs of severe hypoglycemia occur.

On admission, the healthcare provider describes a broad spectrum of antibiotic, ticarcillin for a client with a gram-negative infection. Before administering the first dose, it is most important for the nurse to implement which prescription? A. Monitor for signs of sodium and fluid retention. B. Wound and blood specimen for culture and sensitivity. C. Irrigation and tropical antibiotic application to wound area. D. Complete the blood count and serum electrolytes.

B. Wound and blood specimen for culture and sensitivity

An older adult with iron deficiency anemia is being discharged with a prescription for ferrous sulfate enteric-coated tablets. To promote best absorption of the medication, which information should the nurse include in the discharge instructions? A Bedtime is the best time to take the tablet. B Crush the tablets and mix with pudding. C Wait 2 hours after meals to take the tablet. D Take the tablet with a daily multivitamin.

C

A client with chemotherapy induced nausea receives a prescription for metoclopramide.Which adverse effect is most important for the nurse to report? A Nausea. B Diarrhea. C Involuntary movements. D Unusual irritability.

C Involuntary movements.

The nurse is planning care for a client with major depression who is receiving a new prescription for duloxetine. Which information is most important for the nurse to obtain? A Family history of mental illness B Weight change in the last month. C Liver function laboratory results. D Recent use of other antidepressants.

C Liver function laboratory results.

The client is in the provider's office for a physical. He states that he has been monitoring his blood pressure, but it is continuing to go up. The physician has given the client a prescription for captopril. Choose the most likely options for the information missing from the statement(s) by selecting from the lists of options provided. Captopril is a ____________ that works by _________________. A non-steroidal anti-inflammatory drug B angiotensin II receptor blocker C angiotensin-converting enzyme inhibitor D aldosterone antagonist

C angiotensin-converting enzyme inhibitor

A client in the surgical recovery area asks the nurse to bring the largest possible dose of pain medication available. Which action should the nurse implement first? A. Determine when the last dose was administered. B. Review the history for past use of recreational drugs. C. Ask the client to rate the current level of pain using a pain scale. D. Encourage the client to use diversional thoughts to manage pain.

C. Ask the client to rate the current level of pain using a pain scale.

An elderly client with heart failure comet to the emergency room because of nausea, vomiting, and anorexia. Based on the client's signs and symptoms, which data from the medical history has the most significance when planning this client's care? A. A coronary artery bypass procedure was performed in 1995. B. Suffered with depression following death of spouse in 1999. C. Digoxin and furosemide daily since 1996. D. A Colonoscopy was performed for routine screening six months ago.

C. Digoxin and furosemide daily since 1996

A client has a new prescription for zolpidem, a hypnotic. The client tells the home health nurse that he plans to take a dose of the medication during the day because he is exhausted and needs to take a short afternoon nap prior to an evening activity in his home. Which action should the nurse take? A. Explain that the client needs to allow for sleep time of at least two hours. B. Advise the client to take the medication with the noon meal. C. Encourage the client to wait until bedtime to take the medication. D. Remind the client to drink plenty of fluids when taking the medication.

C. Encourage the client to wait until bedtime to take the medication.

When caring for a client with diabetes insipidus who is receiving antidiuretic hormone intranasally, which serum lab test is most important for the nurse to monitor? A. Platelets B. Glucose C. Osmolality D. Calcium

C. Osmolality

A client with bulimia and depression who is taking phenelzine 90 mg daily is admitted to an acute care hospital for uncontrolled hypertension. Which dietary choices should the nurse instruct the client to avoid? A. Beef tips with gravy. B. Deep-fried shrimp. C. Pepperoni pizza. D. Pan-seared catfish.

C. Pepperoni pizza.

The nurse is planning care for a client with major depression who is receiving a new prescription for duloxetine. Which information is most important for the nurse to obtain? A. Weight change in the last month. B. Liver function laboratory results. C. Recent use of other antidepressants. D. Family history of mental illness.

C. Recent use of other antidepressants.

The nurse is preparing a discharge teaching plan for a client who is taking ciprofloxacin hydrochloride tablets, which were prescribed because of a suspected anthrax exposure. Which instruction(s) should be included in the teaching plan? (Select all that apply.) A. Crush and mix the tablets with pudding if you have trouble swallowing the tablets. B. Use non-steroidal anti-inflammatory drugs (NSAID) to relieve mild joint aches and pains caused by the medication. C. Report any tendon pain or swelling to the healthcare provider immediately. D. Increase fluid intake while taking the medication.

C. Report any tendon pain or swelling to the healthcare provider immediately. D. Increase fluid intake while taking the medication.

A patient with hepatic encephalopathy is receiving lactulose. Which assessment provides the nurse with the best information to evaluate the patient's therapeutic response to the drug? A. Stool color and character. B. Fingerstick glucose. C. Serum electrolytes and ammonia. D. Serum hepatic enzymes.

C. Serum electrolytes and ammonia.

A female client starts a new prescription, oxybutynin, for symptoms of an overactive bladder. The client tells the nurse that she is training to run in a marathon. Which instruction should the nurse emphasize? A. Avoid crowds to help prevent acquiring infections. B. Wear protective padding to protect from bruising if a fall occurs. C. Take measures to avoid dehydration and over-heating. D. Keep skin and eyes covered to protect from sun injury

C. Take measures to avoid dehydration and over-heating.

A client with anemia secondary to chronic kidney disease started a prescription for epoetin alfa two months ago. Which client finding best indicates that the medication is effective? A. Reports on increased energy levels and decreased fatigue. B. Takes concurrent iron therapy without adverse effects. C. The hemoglobin level increased to 12 grams/dL (120mmol/L). D. Food diary shows increased consumption of iron rich foods.

C. The hemoglobin level increased to 12 grams/dL (120mmol/L).

An older adult with iron deficiency anemia is being discharged with a prescription for ferrous sulfate enteric-coated tablets. To promote best absorption of the medication, which information should the nurse include in the discharge instructions? A. Take the tablet with a daily multivitamin. B. Bedtime is the best time to take the tablet. C. Wait 2 hours after meals to take the tablet. D. Crush the tablets and mix with pudding

C. Wait 2 hours after meals to take the tablet.

A client with heart failure (HF) develops hyperaldosteronism and spironolactone is prescribed. Which instruction should the nurse include in this client's plan of care? A Monitor skin for excessive bruising. B Replace salt with a salt substitute. C Cover your skin before going outside. D Limit intake of high-potassium foods.

D Limit intake of high-potassium foods.

The nurse is providing instructions about a client's new medications. How should the nurse explain the purpose of probenecid, a uricosuric drug? A Prevents the formation of kidney stones. B Increases the strength of the urine stream. C Decreases pain and burning during urination D Promotes excretion of uric acid in the urine.

D Promotes excretion of uric acid in the urine.

A client receives a new prescription for levothyroxine. Which statement made by client indicates to the nurse the education was effective? A Consume foods that are high in iodine. B Avoid the use of iron supplements. C Administer levothyroxine at bed time. D Take medication on an empty stomach.

D Take medication on an empty stomach.

A client who received a renal transplant three months ago is readmitted to the acute care unit with signs of graft rejection. While taking the client's history, the nurse determines that the client has been self-administering St. John's Wort, an herbal preparation, on the advice of a friend. Which information is most significant about this finding? A Ingestion of Wort can reduce the client's intake of sodium. B Adding the herb decrease the need for corticosteroids. C The client probably used this herb to treat depression. D Wort can decrease plasma concentrations of cyclosporine.

D Wort can decrease plasma concentrations of cyclosporine.

After taking orlistat for one week, a female client tells the home health nurse that she is experiencing increasingly frequent oily stools and flatus. Which action should the nurse take? A. Instruct the client to increase her intake of saturated fats over the next week. B. Advise the client to stop taking the drug and contact her healthcare provider. C. Obtain a stool specimen to evaluate for occult blood and fat content. D. Ask the client to describe her dietary intake history for the last several days.

D. Ask the client to describe her dietary intake history for the last several days.

A client in the surgical recovery area asks the nurse to bring the largest possible dose of pain medication available. Which action should the nurse implement first? A. Determine when the last dose was administered. B. Encourage the client to use diversional thoughts to manage pain. C. Review the history for a past use of recreational drugs. D. Ask the client to rate the current level of pain using a pain scale.

D. Ask the client to rate the current level of pain using a pain scale.

A client with multiple sclerosis starts a new prescription, baclofen, to control muscle spasticity. Three days later, the client calls the clinic nurse and reports feeling fatigued and dizzy. Which instruction should the nurse provide? A. Increase intake of fluids and high protein foods. B. Stop taking the medication immediately. C. Obtain transportation to the emergency department. D. Avoid hazardous activities until symptoms subside.

D. Avoid hazardous activities until symptoms subside.

A client with atrial fibrillation receives a new prescription for dabigatran. Which instruction should the nurse include in this client's teaching plan? A. Eliminate spinach and other green vegetables in the diet. B. Continue obtaining scheduled laboratory bleeding tests. C. Keep an antidote available in the event of hemorrhage. D. Avoid use of nonsteroidal anti-inflammatory drugs (NSAIDs).

D. Avoid use of nonsteroidal anti-inflammatory drugs (NSAIDs).

The nurse is administering sevelamer during lunch to a client with chronic kidney disease (CKD). The client asks the nurse to bring the medication later. The nurse should describe which action of sevelamer as an explanation for taking it with meals? A. Promotes stomach emptying and prevents gastric reflux. B. Buffers hydrochloric acid and prevents gastric erosion. C. Prevents indigestion associated with ingestion of spicy foods. D. Binds with phosphorus in foods and prevents absorption.

D. Binds with phosphorus in foods and prevents absorption.

A client with a cold is taking the antitussive medication benzonatate. Which assessment information indicates to the nurse that the medication is effective? A. Expectorating bronchial secretions. B. Reports reduced nasal discharge. C. Able to sleep through the night. D. Denies having coughing spells.

D. Denies having coughing spells.

A patient with open-angle glaucoma asks the nurse about the duration of use for the prescribed eye drops. What is the nurse's accurate response? A. For long-term control of pain and swelling. 0% B. Until a smaller angle can be restored. 0% C. Until the excess pressure is reduced. 0% D. For long-term control of normal eye pressure.

D. For long-term control of normal eye pressure.

The nurse is caring for a client who is taking diclofenac, a nonsteroidal anti-inflammatory (NSAID) drug for rheumatoid arthritis. During a clinic visit, the client appears pale and reports increasing fatigue. Which of the client's serum laboratory values is most important for the nurse to review? A. Glucose. B. Total protein. C. Sodium. D. Hemoglobin.

D. Hemoglobin.

Prior to administering oral doses of calcitriol and calcium carbonate to a client with hypoparathyroidism, the nurse notes that the total level of calcium is 14 mg/dL (3.5 mmol/L). Which action should the nurse implement? A. Administer both prescribed medications as scheduled. B. Hold the calcitriol but administer the calcium carbonate as scheduled. C. Hold the calcium carbonate but administer the calcitriol as scheduled. D. Hold both medications until contacting the healthcare provider.

D. Hold both medications until contacting the healthcare provider.

A client with chemotherapy-induced nausea receives a prescription for metoclopramide. Which adverse effect is most important for the nurse to report? A. Diarrhea. B. Unusual irritability. C. Nausea. D. Involuntary movements.

D. Involuntary movements.

A client with heart failure (HF) develops hyperaldosteronism and spironolactone is prescribed. Which instruction should the nurse include in this client's plan of care? A. Replace salt with a salt substitute. B. Monitor skin for excessive bruising. C. Cover your skin before going outside. D. Limit intake of high-potassium foods.

D. Limit intake of high-potassium foods.

A client who is taking albendazole reports experiencing fatigue, nausea, and dark urine. The nurse observes a yellowing of the client's skin and sclera. Which lab results should the nurse review? A. Renal function panel. B. Thyroid function test. C. Basic metabolic panel D. Liver function test.

D. Liver function test.

A client taking atorvastatin becomes an increased serum creatine phosphokinase (CK) level. The nurse should assess the client for the onset of which problem? A. Nausea and vomiting. B. Excessive bruising. C. Peripheral edema. D. Muscle tenderness

D. Muscle tenderness

A client with myasthenia gravis receives a new prescription for pyridostigmine. Which information should the nurse obtain prior to administering the medication? A. Trouble sleeping B. Difficulty with urination C. Unexplained weight loss D. Recent oral intake

D. Recent oral intake

A client with open-angle glaucoma is using pilocarpine ophthalmic solution, a miotic agent. Which action should the nurse at the eye clinic include in evaluating the effectiveness of the medication? A. Use Snellen chart to assess visual acuity. B. Check amount of drainage from each eye. C. Palpate eyelids for decreased swelling. D. Review eye pressure measurements.

D. Review eye pressure measurements.

A client who is taking an oral contraceptive receives a new prescription for erythromycin. Which instruction should the nurse provide to the client? A. Stop the oral contraceptive immediately. B. Avoid prolonged exposure to direct sunlight. C. Take the medications at least 12 hours apart. D. Use an additional form of contraception

D. Use an additional form of contraception.

Report Wrong Answer Which assessment data indicated to the nurse that a client is having an anaphylactic reaction to a medication? A. Urticaria and pruritis. B. Insomnia and irritability. C. Tinnitus and diplopia. D. Wheezing and dyspnea

D. Wheezing and dyspnea

The nurse prepares to administer a scheduled dose of labetalol by mouth to a client with hypertension. The client's vital signs are temperature 99° F (37.2° C), heart rate 48 beats/minute, respirations 16 breaths/minute, and blood pressure (B/P) 150/90 mm Hg. Which action should the nurse take? A. Assess for orthostatic hypotension before administering the dose. B. Administer the dose and monitor the client's BP regularly. C. Apply a telemetry monitor before administering the dose. D. Withhold the scheduled dose and notify the health care provider.

D. Withhold the scheduled dose and notify the health care provider

A client with psychosis who is receiving an antipsychotic medication is continually rubbing the back of the neck. Which nursing intervention is best for the nurse to implement? A. Provide the client a heating pad to place on the neck. B. Obtain a prescription for physical therapy services. C. Give a PRN prescription for benztropine. D. Obtain an extra pillow for the client to use at night.

Give a PRN prescription for benztropine.

History and Physical The client is a 42-year-old female who had a right above-the-knee amputation for osteomyelitis. The client has a drain in place and a surgical dressing that will need to be changed by the surgeon on post-op day 1. The nurse is discussing the client's pain management with a student nurse. Choose the most likely options for the information missing from the statement(s) by selecting from the lists of options provided. Morphine is a(n) ______(a)_____ and it activates ______(b)________ receptors and is used to relieve _________(c)_________. Choices a: a. Agonist-antagonist opiod b. Andogenous opiod c. Pure opioid antagonist d. Local anesthetic Choice B: a. Mu b. Kappa c. Delta d. NMDA e. GABA Choice C: a. Mild pain b. Moderate pain c. Severe pain d. Neuropathic pain e. Inflammatory pain

Morphine is a(n) **pure opioid antagonist** and it activates **mu** receptors and is used to relieve **severe pain**.

over her entire body with hives developing. She complains of feeling hot and nauseous. Cool cloths were applied to her face and extremities. She is restless in bed. IVF of NS is running. Orders: 1140 - Diphenhydramine 25 mg IV now - Methylprednisolone 100 mg IV now The nurse is implementing the plan of care. For each body system, select to specify the potential nursing intervention that would be appropriate for the care of the client. Each body system may support more than one potential nursing intervention. Each category must have at least one response option selected.

Respiratory-----------------correct choice is A Cardiovascular---------------correct choice is A,B, C Immunological----------------correct choice is A and D

History and Physical Nurses' Notes The client is a 26-year-old female with acute appendicitis. She has a 12-year history of type 1 diabetes and no other significant medical history. The appendectomy was completed without issue, and the client will be admitted to the surgical floor to recover. The nurse is preparing the client for discharge and discussing home medications. What home medications may affect the amount of insulin needed by the client? Select all that apply. St. John's Wort Corticosteroids Fluconazole Ibuprofen Oral contraceptives

St. John's Wort Corticosteroids Fluconazole Oral contraceptives

A client receives a new prescription for levothyroxine. Which statement made by the client indicates to the nurse that the education was effective? A. Take medication on an empty stomach. B. Consume foods that are high in iodine. C. Administer levothyroxine at bedtime. D. Avoid the use of iron supplements.

Take medication on an empty stomach.

What should the nurse double-check with a second nurse? Select all that apply. The insulin vial for color and clarity The history and physical with the diabetes diagnosis listed C The dose of insulin drawn up in the syringe The sliding scale insulin lispro order E The expiration date on the insulin vial The site for the insulin administration G The insulin concentration H The type of insulin to be administered The site for the insulin administration The insulin concentration The type of insulin to be administered

The insulin vial for color and clarity The sliding scale insulin lispro order E The expiration date on the insulin vial The insulin concentration

The nurse initiates an infusion of piperacillin-tazobactam for a client with a urinary tract infection. Five minutes into the infusion, the client reports not feeling well. Which client manifestation should the nurse identify as a reason to stop the infusion? A Scratchy throat. B Pupillary constriction. C Hypertension. D Bradycardia.

A

The nurse is administering the muscle relaxant baclofen by mouth (PO) to a client diagnosed with multiple sclerosis. Which intervention should the nurse implement? A Advise the client to move slowly and cautiously when rising and walking. B Monitor intake and output every 8 hours. C Ensure the client knows to stop baclofen before using other antispasmodics. D Evaluate muscle strength every 4 hours.

A Advise the client to move slowly and cautiously when rising and walking.

A client in the surgical recovery area asks the nurse to bring the largest possible dose of pain medication available. Which action should the nurse implement first? Wrong A Ask the client to rate the current level of pain using a pain scale. B Encourage the client to use diversional thoughts to manage pain. C Review the history for a past use of recreational drugs. D Determine when the last dose was administered.

A Ask the client to rate the current level of pain using a pain scale.

The nurse is caring for a client who has been taking ibuprofen. Which finding is most important for the nurse report to the healthcare provider? A Hematemesis. B Nausea. C Insomnia. D Dizziness.

A Hematemesis.

A male client with a history of heart failure (HF) complains of heartburn when he lies down after dinner. The home health nurse should encourage the client to talk to the healthcare provider about using which over-the-counter medication to relieve this problem? A Low sodium antacid. B Diphenhydramine. C Low dose aspirin. D Acetaminophen.

A Low sodium antacid.

A client is receiving intravenous (IV) vancomycin and the nurse plans to draw blood for a peak and trough to determine the serum level of the drug. Which collection times provide the best determination of these levels? A Two hours after completion of the IV dose and two hours before the next administration of the medication. B One hour after completion of the IV dose and one hour before the next administration of the medication. C Thirty minutes into the administration of the IV dose and 30 minutes before the next administration of the medication. D Immediately after completion of the IV dose and 30 minutes before the next administration of the medication.

A Two hours after completion of the IV dose and two hours before the next administration of the medication.

For each statement, click to indicate whether the statements by the student nurse indicate understanding or no understanding of naloxone. A. "You can give naloxone intravenously, intramuscularly, or subcutaneously." B. "Naloxone works best on pure agonist opioids." C. "If the first dose does not work, you can give as many doses as needed to reverse respiratory depression." D. "Naloxone will not affect the client's level of pain." E. "When given IV, naloxone starts working immediately and can last several hours.

A. "You can give naloxone intravenously, intramuscularly, or subcutaneously." B. "Naloxone works best on pure agonist opioids

The nurse administers naloxone to a patient with opioid-induced respiratory depression. An hour later, the nurse finds the patient has a respiratory rate of 4 breaths/minute, oxygen saturation of 75%, and is unresponsive. What action should the nurse take? A. Administer a second dose of naloxone. B. Prepare to assist with chest tube insertion. C. Determine Glasgow Coma Scale score. D. Initiate cardiopulmonary resuscitation

A. Administer a second dose of naloxone.

A client with bipolar disorder admitted with severe depression and suicidal ideation receives a prescription for lithium carbonate. Which instruction should the nurse provide to the client? A. Eliminate use of nonsteroidal anti-inflammatory drugs (NSAIDs). B. Monitor blood glucose levels daily. C. Notify healthcare provider prior to dental procedures. D. Avoid consuming all foods that contain iodine.

A. Eliminate use of nonsteroidal anti-inflammatory drugs (NSAIDs).

History and Physical The client is a 42-year-old female who had a right above-the-knee amputation for osteomyelitis. The client has a drain in place and a surgical dressing that will need to be changed by the surgeon on post-op day 1.What other medications would the nurse expect the surgeon to prescribe along with morphine? Select all that apply. A. Ibuprofen B. Propofol C. Methadone D. Senna E. Docusate sodium F. Naloxone

A. Ibuprofen D. Senna E. Docusate sodium

The nurse administers risedronate to a client with osteoporosis at 0700. The client asks for a glass of milk to drink with the medication. What action should the nurse take? A. Instruct the client that it is necessary to take nothing but water with the medication. B. Withhold the medication until the client's breakfast tray is available on the unit. C. Consult with a pharmacist about scheduling the dose one hour after the client eats. D. Assign an unlicensed assistive personnel (UAP) to bring the client a glass of low-fat milk.

A. Instruct the client that it is necessary to take nothing but water with the medication.

The nurse administers risedronate to a client with osteoporosis at 0700. The client asks for a glass of milk to drink with the medication. Which action should the nurse take? A. Instruct the client that it is necessary to take nothing but water with the medication. B. Assign an unlicensed assistive personnel (UAP) to bring the client a glass of low fat milk. C. Consult with a pharmacist about scheduling the dose one hour after the client eats. D. Withhold the medication until the client's breakfast tray is available on the unit.

A. Instruct the client that it is necessary to take nothing but water with the medication.

Which nursing action has the highest priority when administering a dose of codeine with acetaminophen to a client? A. Instruct the client to request assistance when ambulating to the bathroom. B. Administer a stool softener/laxative at the same time as the analgesic. C. Advise the client that the medication should start to work in about 30 minutes. D. Tell the client to notify the nurse if the pain is not relieved.

A. Instruct the client to request assistance when ambulating to the bathroom.

A client taking atorvastatin develops an increased serum creatine phosphokinase (CK) level. The nurse should assess the client for the onset of which problem? A. Muscle tenderness. B. Nausea and vomiting. C. Excessive bruising. D. Peripheral edema.

A. Muscle tenderness.

Prior to administering the evening dose of carbamazepine, the nurse notes that the client's morning carbamazepine level was 84 mcg/L (35.6 mmol/L). Which action should the nurse take? A. Notify the healthcare provider of the carbamazepine level. B. Administer the carbamazepine as prescribed. C. Assess the client for side effects of carbamazepine. D. Withhold this dose of the carbamazepine.

A. Notify the healthcare provider of the carbamazepine level.

When administering medications to a group of patients, which patient should the nurse closely monitor for the development of acute kidney injury (AKI)? A. Patient on Vancomycin. B. Patient on Sucralfate. C. Patient on Lorazepam. D. Patient on Digoxin.

A. Patient on Vancomycin

To prevent deep vein thromboses following knee replacement surgery, an adult male client is receiving daily subcutaneous enoxaparin. Which laboratory result requires immediate action by the nurse? Reference Range: Hematocrit [42% to 52% (0.42 to 0.52 volume fraction)] Platelets [150,000 to 400,000/mm² (150 to 400 × 10^9/L)] Creatinine [0.5 to 1.1 mg/dL (44 to 97 μmol/L)] Blood Urea Nitrogen (BUN) [10 to 20 mg/dL (3.6 to 7.1 mmol/L)] A. Platelet count of 100,000/mm³ (100 x 10^9/L). B. Hematocrit 45% (0.45 volume fraction). C. Blood urea nitrogen (BUN) 20 mg/dL (7.1 mmol/L). D. Serum creatinine 1.0 mg/dL (88.4 μmol/L)

A. Platelet count of 100,000/mm³ (100 x 10^9/L).

The health care provider prescribes the antibiotic tetracycline HCl for an adult client who arrived at an outpatient clinic. Which instruction should the nurse include in the teaching plan for this client? A. Protect the skin from sunlight while taking the drug. B. Take with orange juice to enhance GI absorption. C. Return to the clinic weekly to obtain serum drug levels. D. Take with milk or antacids to prevent gastrointestinal (GI) irritation.

A. Protect the skin from sunlight while taking the drug.

The nurse is preparing a discharge teaching plan for a client who is taking ciprofloxacin hydrochloride tablets which were prescribed because of a suspected anthrax exposure. Which instructions should be included in the teaching plan? (Select all that apply.) A. Report any tendon pain or swelling to the healthcare provider immediately. B. Use NSAIDS to relieve mid joint aches and pains caused by the medication. C. Crush and mix the tablets with pudding if you have trouble swallowing the tablets. D. Limit exposure to sunlight and avoid tanning beds.

A. Report any tendon pain or swelling to the healthcare provider immediately. D. Limit exposure to sunlight and avoid tanning beds.

The nurse initiates an infusion of piperacillin-tazobactam for a client with a urinary tract infection. Five minutes into the infusion, the client reports not feeling well. Which client manifestation should the nurse identify as a reason to stop the infusion? A. Scratchy throat. B. Pupillary constriction. C. Bradycardia. D. Hypertension.

A. Scratchy throat

A client receives a new prescription for somatropin. Which information provided by the client indicates a need for further education by the nurse? A. Store unused vials at room temperature. B. Rotate injection sites to minimize discomfort. C. Discard the medication if the solution is cloudy. D. Administer the medication subcutaneously.

A. Store unused vials at room temperature.

History and Physical The client is a 42-year-old female who had a right above-the-knee amputation for osteomyelitis. The client has a drain in place and a surgical dressing that will need to be changed by the surgeon on post-op day 1. What actions should the nurse take to ensure safety during morphine administration? Select all that apply. A. Take an initial respiratory rate B. Perform a 12-lead electrocardiogram C. Suction the client to clear the airway D. Have a manual resuscitation bag at the bedside E. Ask the client about other medications she takes F. Restrain the client with soft restraints

A. Take an initial respiratory rate D. Have a manual resuscitation bag at the bedside E. Ask the client about other medications she takes

The nurse is planning to discharge teaching for a client with diabetes mellitus who has a new prescription for insulin glargine. Which action should the nurse include in the discharge teaching? A. Teach the client self-injection skills for daily subcutaneous administration. B. Demonstrate how to select dose based on before meal blood sugar readings. C. Explain to the family how to inject this medication for severe hypoglycemia. D. Provide information on increasing medication dosage if ketoacidosis occurs

A. Teach the client self-injection skills for daily subcutaneous administration.

The nurse is administering muscle relaxant baclofen by mouth (PO) to a client diagnosed with multiple sclerosis. Which intervention is the most important for the nurse to implement? A. Advise the client to move slowly and cautiously when rising and walking. B. Evaluate muscle strength every 4 hours. C. Monitor intake and output every 8 hours. D. Ensure the client knows to stop baclofen before using other antispasmodics.

Advise the client to move slowly and cautiously when rising and walking.

After taking orlistat for one week, a female client tells the home health nurse that she is experiencing increasingly frequent oily stools and flatus. Which action should the nurse take? A Instruct the client to increase her intake of saturated fats over the next week. B Ask the client to describe her dietary intake history for the last several days. C Advise the client to stop taking the drug and contact her healthcare provider. D Obtain a stool specimen to evaluate for occult blood and fat content.

B

A female client who is a vegetarian has a new prescription for warfarin. The client states she eats leafy green vegetables every day. How should the nurse respond? A Suggest that the client replace the leafy vegetables with a protein source such as nuts or beans. B Advise the client that the healthcare provider needs to be made aware of her current diet. C Commend the client for her healthy lifestyle and encourage her to continue her current diet habits. D Confirm that her diet choices will help the medication be more effective in preventing blood clots.

B Advise the client that the healthcare provider needs to be made aware of her current diet.

Prior to administering oral doses of calcitriol and calcium carbonate to a client with hypoparathyroidism, the nurse notes that the client's total calcium level is 14 mg/dL (3.5 mmol/L). Which action should the nurse implement? Reference Range: Total Calcium [Reference Range: Adult 9 to 10.5 mg\/dL or 2.25 to 2.62 mmol\/L] A Administer both prescribed medications as scheduled. B Hold both medications until contacting the healthcare provider. C Hold the calcium carbonate, but administer the calcitriol as scheduled. D Hold the, calcitriol but administer the calcium carbonate as scheduled.

B Hold both medications until contacting the healthcare provider.

The healthcare provider prescribes the antibiotic tetracycline HCI for an adult client that arrived at an outpatient clinic. Which instruction should the nurse include in the teaching plan for this client? A Take with orange juice to enhance Gl absorption. B Protect the skin from sunlight while taking the drug. C Return to the clinic weekly to obtain serum drug levels. D Take with milk or antacids to prevent gastrointestinal (GI) irritation.

B Protect the skin from sunlight while taking the drug.

A client with anemia secondary to chronic kidney disease (CKD) started a prescription for epoetin alfa two months ago. Which client finding best indicates that the medication is effective? Reference Range Hemoglobin (Hgb) [Reference Range: Male: 14 to 18 g/dL (8.7 to 11.2 mmol/L)] A Hemoglobin level increased to 12 g/dL (7.45 mmol/L). B Reports of increased energy levels and decreased fatigue. C Food diary shows increased consumption of iron-rich foods. D Takes concurrent iron therapy without adverse effects.

B Reports of increased energy levels and decreased fatigue.

The nurse is administering sodium polystyrene sulfonate to a client in acute kidney injury (AKI). Which laboratory finding indicates that the medication has been effective? Glucose [Reference Range: 74 to 106 mg/dL (4.1 to 5.9 mmol/L)] Hemoglobin (Hgb) [Reference Range:12-16 g/dL (120-160 g/L)] Potassium (K+) [Reference Range: 3.5 to 5.0 mEq/L (3.5 to 5.0 mmol/L)] Ammonia [Reference Range: Adult: 10 to 80 Mcg/dL (6 to 47 Mcmol/dL)] A Serum ammonia level of 30 Mcg/dL (17.62 Mcmol /dL). B Serum potassium level of 3.8 mEq/L (3.8 mmol/L). C Serum glucose level of 120 mg/dL (6.7 mmol/L). D Hemoglobin level of 13.5 g/dL (135 g/L).

B Serum potassium level of 3.8 mEq/L (3.8 mmol/L).

The nurse prepares to administer a scheduled dose of labetalol by mouth to a client with hypertension. The client's vital signs are temperature 99° F (37.2° C), heart rate 48 beats/minute, respirations 16 breaths/minute, and blood pressure (B/P) 150/90 mm Hg. Which action should the nurse take? A Administer the dose and monitor the client's BP regularly. B Withhold the scheduled dose and notify the healthcare provider. C Apply a telemetry monitor before administering the dose. D Assess for orthostatic hypotension before administering the dose.

B Withhold the scheduled dose and notify the healthcare provider.

A client who is taking an oral dose of a tetracycline reports gastrointestinal (GI) upset. Which snack should the nurse instruct the client to take with the tetracycline? A. Cheese and crackers. B. Toasted wheat bread and jelly. C. Fruit-flavored yogurt. D. Cold cereal with skim milk.

B. Toasted wheat bread and jelly.

A female client with mild depression reports to the nurse recently starting St. John's wort. Which information provided by the client requires further instruction? A. Hard candy can be used for a dry mouth. B. Another form of contraception is not needed. C. Insomnia may occur while taking the medication. D. Sensitivity to the sun can develop

B. Another form of contraception is not needed.

After taking orlistat for one week, a female client tells the home health nurse that she is experiencing increasingly frequent faty stools and flatus. Which action should the nurse take? A. Advise the client to stop taking the drug and contact the healthcare provider. B. Ask the client to describe her dietary intake history for the last several days. C. Instruct the to increase her intake of saturated fats over the next week. D. Obtain a stool to evaluate occult blood and fat content. E. Obtain a stool to evaluate occult blood and fat content.

B. Ask the client to describe her dietary intake history for the last several days.

A client with a seizure disorder is seen at the clinic for a follow-up visit and a prescription renewal for phenytoin. Which assessment finding warrants immediate intervention by the nurse? A. Blood pressure 100/78 mm Hg. B. Double vision. C. Puffy, bleeding gums. D. Chronic insomnia.

B. Double vision.