Pharm 2 Exam 1
A client is currently taking pseudoephedrine to help manage the nasal congestion resulting from seasonal allergies. When the client reports being extremely restless and having difficulty getting to sleep at night, what assessment question will the nurse ask to best provide interventions to minimize those effects?
"How much coffee, tea, and soda do you drink daily?"
An adolescent client is prescribed a leukotriene receptor antagonist as a part of a medication regime to manage his/her asthma. Which statement made by the client requires additional education on this classification of medications?
"I need to take the medication when I start to have problems breathing."
The nurse is educating a client with a cough about the use of taking dextromethorphan for relief. What statement made by the client indicates teaching has been effective?
"I will take my medication and not eat or drink for 30 minutes."
A nurse is providing health education to a client recently diagnosed with asthma and prescribed albuterol and ipratropium. Which of the client's statements suggests a need for clarification by the nurse?
"I'll keep taking my medications until I'm not experiencing any more symptoms."
The parent of a 4-year-old client taking inhaled corticosteroids states she has not been routinely administering the medication because of concerns about the child not growing properly. What is the nurse's best response?
"Inhaled steroids will not affect the growth of your child."
The nurse is evaluating a client's understanding of the adverse reactions related to the use of theophylline. Which of the following statements by the client demonstrates an understanding of theophylline?
"It common to experience palpitations and flushing."
The nurse has provided teaching to a 15-year-old client who has been newly diagnosed with asthma. Which statemen by the client indicates understanding of the teaching the nurse has given on inhalers?
"Not all aerosol canisters should be shaken well before using."
The nurse is preparing teaching material about zafirlukast, a leukotriene receptor antagonist. Which information would the nurse emphasize with the client? Select all that apply.
"Report a headache to the health care provider." "Take the medication an hour before or 2 hours after meals."
A client being treated for cancer asks the nurse, "What does it mean that the medication is cytotoxic?" What should be the nurse's response?
"The medication is toxic to all living cells."
A client with leukemia is scheduled to begin treatment with a cytokine. What anticipatory guidance should the nurse provide?
"You'll likely feel flu-like after starting this medication."
When determining a client's personal best, the nurse would instruct the client to perform peak flow testing how many times?
3
A client is prescribed albuterol, 2 puffs every 6 hours. After teaching the client about the drug and its administration, the nurse determines that the teaching was successful when the client states that they will allow how much time between each puff?
3-5 minutes
A client has been admitted to a health care facility with asthma. The nurse is to administer theophylline to the client. To which clients can the nurse safely administer theophylline?
A 65-year-old male with asthma
The client has stopped taking an immunomodulator seven months ago. The nurse educates the client on which?
A anaphylactic reaction can occur up to one year.
The client is taking erlotinib as part of cancer treatment. Which client concern will the nurse assess as an indication that the medication is working?
Acne-like rash during therapy
The nurse is admitting a client who has multiple sclerosis and is on immunosuppresant therapy. The healthcare provider has written admission orders. Which order must the nurse clarify immediately?
Administer cancer vaccine
Mr. Ashum is prescribed an albuterol inhaler as part of his treatment regimen for asthma. What is the mechanism of action for this medication?
Albuterol causes relaxation of the bronchial smooth muscles.
A client, scheduled to receive one unit of packed red blood cells, has a history of an allergic reaction to a transfusion in the past. What class of medication will assist in preventing a reaction to the packed red blood cell transfusion?
Antihistamines
A client is prescribed a leukotriene receptor antagonist. The nurse should evaluate the effectiveness of the medication therapy based on the long term management of symptoms associated with which respiratory condition?
Asthma
An adult client has recently begun cancer treatment with methotrexate (MTX). When reviewing this client's laboratory work, the nurse should consequently prioritize assessment of what?
BUN and creatinine
The client on immunotherapy with cytokines has developed 3+ pitting edema in the lower extremities. The nurse anticipates this a result of what finding?
Capillary leak syndrome
The nurse is working on the pediatric oncology unit. Which immunotherapy will the nurse clarify if ordered for a pediatric client?
Checkpoint inhibitors
The client has been started on cytokine therapy. What effect(s) should the nurse anticipate this client will experience? Select all that apply.
Chills Fever Cough Headache
A client has been diagnosed with leukemia. Which alkylating agent is the only one that can be used for both acute and chronic leukemia?
Cyclophosphamide ifosfamide (alkalyting agent in a drugs to know)
The nurse is working on the oncology unit with a new client diagnosed with cancer. The client asks about the different drugs used in the treatment of cancer. What drug(s) should be included in the nurse's response? Select all that apply.
Cytokines Monoclonal antibodies Checkpoint inhibitors Vaccines Adoptive cell therapy NOT chimerics
A client comes to the clinic with what appears to be a cold. What group of upper respiratory drugs cause local vasoconstriction, which decreases blood flow and shrinks swollen membranes to improve air flow?
Decongestants
After teaching a group of students about antineoplastic antibiotics, the instructor determines that the teaching was successful when the students identify which drug as an example?
Doxorubicin
After teaching a group of students about antiasthmatic agents, the students demonstrate understanding of the information when they identify what as sympathomimetics? Select all that apply.
Epinephrine Terbutaline Formoterol
A nurse is teaching a client diagnosed with asthma about the disease. Which should the nurse instruct the client to avoid because it may cause bronchoconstriction?
Extremely cold temperatures
Procarbazine
Hodgkin's lymphoma
Adrenergics are a category of bronchodilators used in the treatment of asthma and COPD. A specific adverse effect contraindicates these medications for clients with cardiac tachyarrhythmias. In what conditions is cautious use recommended? (Select all that apply.)
Hypertension Seizure disorders Diabetes mellitus
A client's chemotherapy regimen has been deemed successful, but the client is experiencing debilitating nausea and vomiting. These adverse effects should signal the nurse to the possibility of what nursing diagnosis?
Imbalanced nutrition: less than body requirements
The nurse is planning care for a client who is scheduled to begin treatment with an immune-modulating drug for cancer. The nurse should include what potential nursing diagnoses? Select all that apply.
Impaired comfort Diarrhea Altered skin integrity
A client with asthma is administered zileuton along with theophylline. The nurse should be especially alert for which of the following?
Increased serum theophylline
The triage nurse in the emergency department has a 42-year-old client with asthma present for treatment. The client's respiratory rate is 40 breaths per minute. Based on this objective data, what is the correct nursing diagnosis for this client?
Ineffective breathing pattern
The nurse is providing education to a client with asthma on the therapeutic action of inhaled corticosteroid agents. How will the nurse describe the action?
Inhaled corticosteroid agents reduce airway inflammation.
The client is quietly reading during immune modulation therapy. The nurse asks the client if there is anything the client needs. The client states, "I am beginning to lose my hair. I knew I would at some point." Which immune modulators are known to cause alopecia? Select all that apply.
Interferons Hedgehog pathway inhibitors Kinase inhibitors
When teaching a client about their prescribed asthma therapy, the nurse understands that which medications may increase the risk of asthma-related death?
Long-acting beta-2 agonists
A 36-year-old client is prescribed inhaled corticosteroid (ICS) for daily use. Which adverse effects should the nurse closely monitor for in this client?
Oropharyngeal Candida albicans infection
A client with breast cancer being treated with tamoxifen is also taking the oral anticoagulant coumadin for chronic atrial fibrillation. What is important to monitor in this client?
Prothrombin time
A client reports anxiety, restlessness, nausea, and vomiting after using a nasal decongestant. Which drug should the nurse consider as the cause for these side effects?
Pseudoephedrine
The client calls the physician's office and is experiencing shortness of breath and the bronchodilators have not been working. The client also states being very frustrated and has missed work the past two days. The nurse identifies that the client is in which zone of her asthma action plan?
Red
A client, experiencing respiratory distress related bronchi constriction, will benefit from what therapeutic action provided by anticholinergic medication therapy?
Relaxation of smooth muscle
What can the oncology nurse do to minimize the exposure risk to chemotherapeutic agents?
Review institutional policies and procedures related to chemotherapy
The nurse is reviewing the history of a client who has been identified as a candidate for an adrenergic bronchodilator. What condition will the nurse identify as a reason for cautious administration of the drug?
Seizure disorder
A 42-year-old female with breast cancer has had a radical mastectomy. She will have radiation therapy and then begin chemotherapy. Drug therapy will consist of a combination of doxorubicin, cyclophosphamide, and paclitaxel. What will the nurse include in the teaching plan concerning the drug therapy?
Take special care when shaving or brushing her teeth.
The nurse is providing care for an adult client who has lymphoma and who has recently begun immunotherapy. What nursing action best addresses the expected adverse effects?
Teach the client to wear sunscreen and avoid direct sunlight
Why are inhaled steroids used to treat asthma and COPD?
They act locally to decrease release of inflammatory mediators
Expectorants elicit their effect by which mechanism?
Thinning respiratory secretions
The client is being treated for non-Hodgkin lymphoma with monoclonal antibody. Labwork during treatment reveals hyperkalemia, hypocalcemia, hyperuricemia, and hyperphosphatemia. What does the nurse believe has happened to this client?
Tumor lysis syndrome
A female client is prescribed methotrexate for meningeal leukemia. What health education should the nurse prioritize?
Use reliable forms of barrier contraception.
A client is being assessed by the home care nurse for the appropriate use of a metered-dose inhaler. Instructions concerning which intervention will assist a client in the proper use of the device?
Using a spacer
When evaluating an asthmatic client's knowledge of self-care, the nurse recognizes that additional instructions are needed when the client makes which of the following statements?
When I am short of breath, I will increase the use of my fluticasone."
Which client is most likely to benefit from the administration of a nasal steroid?
a client who has chronic allergic rhinitis (hay fever)
Malignant cells seem to be more susceptible than normal cells to the effects of which class of antineoplastic drugs?
alkylating agents
A client has been admitted to the emergency department (ED) in status asthmaticus. The ED nurse should anticipate administering which medication?
beta2 agonists in high doses
A client is in the clinic to have blood drawn to assess theophylline levels. The client appears to be responding well to the medication and is not experiencing any adverse effects. What serum level will the nurse expect the client to have?
between 10 and 20 mcg/mL (55.51 and 111.01 µmol/L)
An older adult client presents with sneezing, a nonproductive cough, and reports nasal congestion that began 5 days ago. What common, viral respiratory infection is the client likely experiencing?
common cold
What medication should be prescribed to minimize the risk associated with a blood transfusion for a client with a history of a previous transfusion reaction?
diphenhydramine
The nurse is providing education to the parents of a child who has been newly diagnosed with asthma. During teaching, the nurse should explain that asthma attacks occur when mast cells release substances that cause what reaction?
inflammation.
The nurse is caring for a client who has been diagnosed with chronic obstructive pulmonary disease (COPD). The plan of care will focus on which client problem?
lack of patent airway
A client is diagnosed with acute sinusitis. To promote sinus drainage, what medication will the nurse anticipate being prescribed for this client?
topical decongestants
The dosages of the chemotherapy agents that will be administered are based primarily on what client variable?
weight
