pharm 4

1. Magnesium hydroxide alleviates constipation by which action?

- Causes water absorption into the colon

1. The nurse recognizes that metoclopramide (Reglan) is useful in treating postoperative nausea and vomiting because of what action

- It promotes motility in the small intestine

1. Which complication does the nurse expect in a patient who is using calcium antacids for a prolonged period?

- Kidney stone

1. A patient has been taking aluminum hydroxide to treat gastric hyperacidity for a few days. The patient reports being constipated. Which drug will the provider order in addition to aluminum hydroxide?

- Magnesium hydroxide

1. For a client with chronic renal failure, the nurse MOST likely will question a prescription for which type of antacid?

- Magnesium-containing antacids (can cause hypermagnesemia in clients with chronic renal failure)

1. Which nursing intervention helps prevent complications in a patient who is scheduled for a tonsillectomy and has been prescribed metoclopramide?

- Monitoring the patient's blood pressure

1. A patient who is receiving an aminoglycoside (gentamicin) has a urinalysis result with all of these findings. Which finding should a nurse associate most clearly with an adverse effect of gentamicin?

- Protein

1. Before discharge, the nurse is reviewing a client's prescribed medication regimen for tuberculosis (TB). The client asks the nurse why pyridoxine (vitamin B6) has been prescribed while continuing to take isoniazid (Nydrazid) to treat TB. What is the nurse's best response?

- Pyridoxine will help prevent numbness, and tingling that can occur secondary to the isoniazid.

1. The nurse is teaching a patient who is starting antitubercular therapy with rifampin. Which adverse effects would the nurse expect to see?

- Reddish brown urine

1. During antitubercular therapy with isoniazid, the patient received another prescription for pyridoxine. Which statement by the nruse best explains the rationale for this second medication?

- This vitamin helps to prevent neurologic adverse effects

1. The nurse knows that there is an increased risk of ototoxicity in a patient receiving an aminoglycoside if which level is high?

- Trough

1. The nurse is caring for a patient who has nausea and vomiting who has been prescribed promethazine. Which is the most appropriate assessment before administering this medication

- Vital signs

1. to avoid fecal impaction, psyllium should be administered with at least how many ounces of fluid?

8

1. the nurse is planning care for a client prescribed once daily IV gentamicin therapy. When should the nurse schedule a trough drug level to be drawn?

a. 12 hours after completing the antibiotic infusion (trough serum drug levels should be drawn at least 8-12 hours after the medication is infused)

1. the nurse will question the use of a fluoroquinolone antibiotic in a client already prescribed which medication?

a. Amiodarone (cordarone) (dangerous cardiac dysrhythmias are more likely to occur when quinolones are taken by clients receiving antidysrhyhmic drugs)

1. For a client receiving an IV infusion of gentamicin, the nurse would monitor which lab values?

a. BUN and creatinine

1. the nurse should assess a client for nephrotoxicity and ototoxicity when administering which antimicrobial?

a. Gentamicin (aminoglycoside)

1. Which is a complication of vancomycin IV infusions?

a. Red man syndrome (hypotension accompanied by flushing or itching of the head, face, neck, and upper trunk area)

1. a patient with a history of renal problems is asking for advice about which antacid he should use. The nurse will make which recommendation?

- Aluminum-based antacids are the best choice for you

1. Before administering promethazine to a patient who has nausea and vomiting, the nurse examines the patient's skin turgor before administering the drug. Why does the nurse perform this assessment?

- Assess for s/s of dehydration

1. During treatment with zidovudine, the nurse needs to monitor for which potential adverse effect

- Bone marrow suppression

1. How does sucralfate achieve a therapeutic effect?

- By forming a protective barrier over the gastric mucosa

1. The nurse would teach a client prescribed simethicone to avoid which substance?

- Carbonated beverages (used to decrease gas and belching, both of which can be aggravated or caused by ingesting carbonated beverages)

1. Bacterial resistance to antibiotics can occur with which situations?

- Clients stop taking an antibiotic when they feel better - Antibiotics that are prescribed to treat a viral infection

1. When the nurse is teaching about anti-gout drugs, which statement by the nurse is correct?

- Colchicine is best taken on an empty stomach

1. The nurse will monitor a client taking an aluminum-containing antacid, for which adverse effect?

- Constipation (aluminum and calcium cause constipation; magnesium causes diarrhea, and sodium causes sodium and fluid retention)

1. The nurse knows colchicine (Colcrys) exerts its therapeutic effect by what action?

- Decreases mobility of leukocytes

1. A patient has been instructed to use an OTC form of the bulk-forming laxative to prevent constipation. The nurse will advise the patient of the potential adverse effects, including

- Fluid and electrolyte disturbbances - Gas formation

1. When administering sucralfate, which action by the nurse is most correct?

- Give the drug on an empty stomach

1. A patient who is taking oral tetracycline complains of heartburn and request an antacid. Which action by the nurse is correct?

- Give the tetracycline, but delay the antacid for 1-2 hours

1. A nurse monitors a patient who is receiving an aminoglycoside (gentamicin) for symptoms of vestibular damage. Which finding should the nurse expect the patient to have first?

- Headache

1. The nurse is about to give a dose of vancomycin (Vancocin), but before doing so checks the patient's lab work and finds that the trough vancomycin level is 24 mcg/mL. What will the nurse do next?

- Hold the drug and notify the physician

1. The nurse is caring for a patient who has cancer and exhibits symptoms of nausea and vomiting. The patient has been prescribed radiation therapy and metoclopramide. What is the most appropriate nursing action in this situation?

- Instruct the patient to avoid taking anticholinergics and opiates

1. A patient who is receiving vancomycin (Vancocin) IV for a methicillin-resistant Staphylococcus aureus (MRSA) infection asks a nurse, "Why can't I take this medicine in a pill?" Which response should the nurse make?

- It is more effective by IV, because the pill for will stay in the digestive tract

1. A patient develops flushing, rash, and pruritus during an IV infusion of vancomycin (Vancocin). Which action should a nurse take?

- Reduce the infusion rate

1. Related to its mechanism of action, what is an additive effect of lactulose?

- Reducing ammonia levels

1. A client is prescribed OTC laxative magnesium hydroxide. Which condition in the client's history would alert the nurse to discuss this medication with the client and the HCP?

- Renal insufficiency

1. A patient is receiving vancomycin (Vancocin). The nurse identifies what as the most common toxic effect of vancomycin therapy?

- Renal toxicity

1. Which nursing diagnosis is appropriate for a client prescribed colchicine (Colcrys)

- Risk for fluid volume deficit related to nausea, vomiting, and diarrhea

1. When planning to administer metoclopramide (Reglan), the nurse is aware that this drug must be given in regards to which fluid or food consideration?

- Take 30 minutes before meals and at bedtime

1. When reviewing the medication orders for a patient who is taking penicillin, the nurse notes that the patient is also taking the oral anticoagulant warfarin (Coumadin). What possible effect may occur as the result of an interaction between these drugs?

- The penicillin will cause an enhanced anticoagulant effect of the warfarin

1. A patient who has been hospitalized for 2 weeks has developed a pressure ulcer that contains multidrug-resistant Staphylococcus aureus (MRSA). Which drug would the nurse expect to be chosen for his therapy?

- Vancomycin

1. A patient who has a vancomycin-resistant enterococci (VRE) infection is receiving linezolid (Zyvox). Which laboratory result indicates that the patient is having an adverse effect?

- WBC count of 1200 units/L

1. The primary health care provider prescribes metoclopramide (Reglan) to a patient for the treatment of nausea and vomiting. What will the nurse advise the patient when administering this drug?

- You should avoid long-term use (causes tardive dyskinesia, an involuntary neurologic movement)

1. The patient begins antitubercular therapy with rifampin and also takes oral contraceptives. Which statement by the nurse is most accurate regarding potential drug interactions?

- You will need to switch to another form of birth control while you are taking rifampin

1. when reviewing the various types of antinausea medications, the nurse recognizes that prokinetic drugs are also used for

- delayed gastric emptying

The nurse assesses a hospitalized patient who has nausea and vomiting who has been prescribed promethazine (Phenergan). What side effect might the nurse expect in this patient?

Increased risk of low blood pressure (adverse effect of orthostatic hypotension)

1. the client's culture has grown gram-positive cocci, and the HCP prescribes two different antibiotics, one of which is gentamicin. To treat this type of infection, which type of antibiotic is typically prescribed together with gentamicin?

Penicillin

The nurse is reviewing the medication administration record of a patient who is taking isoniazid (INH). Which drug or drug class has a significant drug interaction with isoniazid?

Phenytoin (Dilantin)