PHARM adaptive quizzing

The healthcare provider prescribes nitroglycerin ointment for a client who was admitted for chest pain and a myocardial infarction (MI). Which statement, if made by the client, would indicate understanding of the side effects of nitroglycerin ointment?

"I may experience a headache."

A nurse is teaching a client about ampicillin that has been prescribed for a severe infection. Which statement indicates to the nurse that the client needs further teaching?

"It is okay for me to stop taking this medication after I improve."

A client with type 2 diabetes is taking one glyburide tablet daily. The client asks whether an extra pill should be taken before exercise. What is the nurse's best reply?

"Do not take an extra pill because you may become hypoglycemic when exercising."

An older client develops hypokalemia, and an intravenous infusion containing 40 mEq of potassium is instituted. The client tells the nurse that the IV stings a little. What is the nurse's best reply?

"You are receiving a large dose of potassium, and unfortunately it often causes a stinging sensation."

A client who is receiving atenolol for hypertension frequently reports feeling dizzy. What effect of atenolol should the nurse consider may be responsible this response?

Blocking the adrenergic response

Which drug does a nurse anticipate may be prescribed to produce diuresis and inhibit formation of aqueous humor for a client with glaucoma?

Acetazolamide

A client with Hodgkin disease is to receive antineoplastic vincristine as part of a therapy protocol. The client asks how this medication works. What mechanism of action does the nurse consider when responding to the client's question?

Arresting mitosis in metaphase

A nurse prepares to administer intravenous (IV) albumin to a client with ascites. What effect does the nurse anticipate?

As extravascular fluid decreases, the hematocrit will decrease.

A client is admitted to the emergency department with crushing chest pain. A diagnosis of acute coronary syndrome is suspected. The nurse expects that the client's initial treatment will include which medication?

Aspirin

A client is admitted to the hospital with a diagnosis of heart failure and acute pulmonary edema. The healthcare provider prescribes furosemide 40 mg intravenous (IV) stat to be repeated in 1 hour. What nursing action will best evaluate the effectiveness of the furosemide in managing the client's condition?

Auscultate breath sounds

A client admitted for uncontrolled hypertension and chest pain was prescribed a low-sodium diet and started on furosemide. The nurse should instruct the client to include which foods in the diet?

Bananas

A client with an intractable infection is receiving vancomycin. Which laboratory blood test result should the nurse report?

Blood urea nitrogen (BUN): 30 mg/dL (10.2 mmol/L)

A nurse assesses a client's intravenous site. What clinical finding, unique to infiltration, leads the nurse to conclude that the intravenous (IV) site has infiltrated, rather than become inflamed?

Coolness

A nurse inspects a two-day-old intravenous (IV) site and identifies erythema, warmth, and mild edema. The client reports tenderness when the area is palpated. What should the nurse do first?

Discontinue the infusion

A client with left ventricular heart failure is taking digoxin 0.25 mg daily. What changes does the nurse expect to find if this medication is therapeutically effective? Select all that apply.

Diuresis Decreased edema Decreased pulse rate

What effect of povidone-iodine does a nurse consider when using it on the client's skin before obtaining a specimen for a blood culture?

Eliminates surface bacteria that may contaminate the culture

What should the nurse monitor when a client is receiving a platelet aggregation inhibitor such as clopidogrel?

Epistaxis

A client is prescribed epoetin injections. To ensure the client's safety, which lab value should the nurse assess before administration?

Hemoglobin

A healthcare provider prescribes tissue plasminogen activator (t-PA) to be administered intravenously over 1 hour for a client experiencing a myocardial infarction. What is the nurse's priority assessment that is specific to this medication's effect?

Intravenous insertion site

When reviewing a drug to be administered, the nurse identifies that the package insert indicates that the Z-track injection technique should be used. Under what circumstance does the nurse expect that this technique will be necessary?

Medication is irritating to subcutaneous tissue and skin.

A client reports fatigue and dyspnea and appears pale. The nurse questions the client about medications currently being taken. In light of the symptoms, which medication causes the nurse to be most concerned?

Methyldopa

A healthcare provider prescribes doxorubicin for a client with acute myelogenous leukemia. Which specific interventions should the nurse implement? Select all that apply.

Monitor for jaundice Increase fluids by mouth Provide frequent oral care Assess vital signs routinely

In the postanesthesia care unit a client received intrathecal morphine intraoperatively to control pain. Considering the administration of this medication, what should the nurse include as part of the client's initial 24-hour postoperative care?

Monitoring of respiratory rate hourly

A client hospitalized for uncontrolled hypertension and chest pain was started on a daily diuretic 2 days ago upon admission, with prescriptions for a daily basic metabolic panel. The client's potassium level this morning is 2.7 mEq/L (2.7 mmol/L). Which action should the nurse take next?

Notify the healthcare provider that the potassium level is below normal

A healthcare provider prescribes two units of blood for a client who is bleeding. Which nursing interventions are necessary before the blood transfusion is administered? Select all that apply.

Obtain the clients vitals Determine typing and crossmatching of blood. Use a Y-type infusion set to initiate 0.9% normal saline.

A client with a partial occlusion of the left common carotid artery is to be discharged while still receiving warfarin. Which clinical adverse effect should the nurse identify as a reason for the client to seek medical consultation? Select all that apply.

Presence of blood in urine (hematuria). Vomiting coffee-ground emesis.

Enoxaparin 40 mg subcutaneously daily is prescribed for a client who had abdominal surgery. The nurse explains that the medication is given for what purpose?

Provide prophylaxis against postoperative thrombus formation

A client using fentanyl transdermal patches for pain management in late-stage cancer dies. What should the hospice nurse who is caring for this client do about the patch?

Remove and dispose of the patch in an appropriate receptacle.

What should the nurse include in a teaching plan for a client taking calcium channel blockers such as nifedipine? Select all that apply.

Report peripheral edema. Avoid drinking grapefruit juice. Change to a standing position slowly.

The nurse prepares to give a prescribed capsule of hydroxyzine to a client. The client begins to vomit, so the nurse holds the oral medication. The nurse has not opened the medication package. What does proper and safe disposal of the capsule of hydroxyzine require the nurse to do?

Return the capsule to the pharmacy

A client takes isosorbide dinitrate daily. The client states, "I would like to start taking sildenafil for erectile dysfunction." The nurse explains that taking both of these medications concurrently may result in which complication?

Severe hypotension

a nurse is providing discharge medication teaching to a client who will be taking furosemide and digoxin after discharge from the hospital. What information is most important for the nurse to include in the teaching plan?

Signs and symptoms of digoxin toxicity

Which medication requires the nurse to monitor the client for signs of hyperkalemia?

Spironolactone

What should the nurse keep in mind when administering a benzodiazepine to a client?

The medication can cause rebound insomnia if it is discontinued abruptly.

A client is prescribed albuterol to relieve severe asthma. What adverse effect will the nurse instruct the client to anticipate? Select all that apply.

Tremors Palpitations

A client is taking lithium sodium. The nurse should notify the healthcare provider for which laboratory value?

White blood cell (WBC) count of 15,000 mm 3 (15 X 10 9/L)

After thoracic surgery for removal of a cancerous lesion in the lung, the client is drowsy, complains of pain when awakened, and then falls asleep. The client has a prescription for morphine sulfate via IV every 3 hours as needed for pain. The client's preoperative blood pressure was 128/76 mm Hg. Postoperative assessments reveal that the client's blood pressure ranges between 90/60 and 100/70 mm Hg. What is the nurse's best initial action?

Withhold morphine until the blood pressure stabilizes.

A client is receiving hydrochlorothiazide. What should the nurse monitor to best determine the effectiveness of the client's hydrochlorothiazide therapy?

blood pressure

A client with anorexia nervosa is admitted to the critical care unit following a period of prolonged starvation. What signs or symptoms indicate to the nurse that the client may have hypokalemia? Select all that apply.

muscle weakness cardiac dysrhythmias

A client with chronic liver disease reports, "My gums have been bleeding spontaneously." The nurse identifies small hemorrhagic lesions on the client's face. The nurse concludes that the client needs which additional supplement?

vitamin K