Pharm assessment A
A nurse is caring for a client who is receiving 0.9% sodium chloride 1,000 mL to infuse over 8 hr. The drop factor on the manual IV tubing is 15 gtt/mL. The nurse should ensure that the manual infusion is set to deliver how many gtt/min? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)
31 gtt/min
At 0800 hr a nurse initiates a 1,000 mL intravenous (IV) infusion on a client, which is running at 125 mL/hr. It is now 1300 hr. How much fluid is left in the IV bag?
375 mL
A nurse is preparing to administer a PRN medication to a group of clients. Which of the following clients should the nurse administer medication to first?
A client who is attending postoperative physical therapy and requests pain medication.
A nurse is reinforcing teaching with a client who has seizures and a new prescription for valproic acid. The nurse should instruct the client to report which of the following adverse effects of valproic acid immediately to the provider?
Abdominal Pain
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?
Administering 25 mL of the syrup
A nurse is contributing to the plan of care for a client who has schizophrenia and a new prescription for clozapine. The nurse should include in the plan to monitor the client for which of the following adverse effects of this medication?
Agranulocytosis
A nurse is caring for a client who has a prescription for an IM injection of penicillin G benzathine. The client asks why the injection must be given IM instead of through the IV line. Which of the following responses should the nurse make?
An IM injection allows more precise control of the medication level in your blood
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?
Avoid prolonged exposure to sunlight
A client cames to an urgent care 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, along with an elevated heart rate and blood pressure level. The nurse should suspect intoxication with which of the following substances?
Cocaine Intended effects: Rush of euphoria and pleasure, increased energy Severe effects: tachycardia and hypertension
A nurse is collecting data from a client who has Parkinson's disease and is taking levodopa/carbidopa. The nurse should identify which of the following findings as an adverse effect of this medication?
Dark urine
A nurse is caring for a client who has hyperthyroidism and has been taking methimazole. Which of the following laboratory findings should indicate to the nurse that the medication has had a therapeutic effect?
Decreased T4
A nurse is caring for a client who has multiple sclerosis and has a new prescription for baclofen. Which of the following findings indicates to the nurse that the medication is having a therapeutic effect?
Decreased muscle spasticity
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.
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. The nurse should instruct the client that which of the following over-the-counter mediations is contraindicated while taking oxycodone?
Diphenhydramine
A nurse is reinforcing teaching with a client who has a new prescription for etanercept to treat rheumatoid arthritis. Which of the following instructions about self-administering this medication should the nurse include?
Discard any solutions that are cloudy
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 notify the provider that the combination of these medications will place the client at risk for which of the following adverse effects?
Dysphagia
A nurse is collecting data from the parent of a toddler who is about to receive the varicella immunization. The nurse should identify that an anaphylactic reaction to which of the following substances is a contraindication for receiving this immunization?
Gelatin
A nurse is reinforcing teaching with the parent of a preschooler who otitis media. The child has had a low-grade fever and irritability for 2 days. Which of the following instructions should the nurse include in the teaching?
Give acetaminophen as needed for discomfort and fever
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?
Glycosylated HbA1c
A nurse is reinforcing teaching about benzodiazepine withdrawal with an older adult client who discontinued taking lorazepam after taking it for 3 months. Which of the following instructions should the nurse include?
Have someone assist you with ADLs
A nurse is reviewing the laboratory results of a client who takes insulin for the management of diabetes mellitus. Which of the following findings should indicate to the nurse the medication is effective?
HbA1c 3%
A nurse is caring for a client who has chronic kidney disease and has been receiving epoetin alfa for 2 weeks. Which of the following findings should indicate to the nurse that the client's medication is having the desired therapeutic effect?
Hemoglobin rises 0.5 g/dL
A nurse is collecting data from a client who is asking about taking celecoxib for treatment of joint pain. The nurse should identify that which of the following findings is a contraindication to receiving celecoxib?
History of myocardial infarction Celecoxib is a last-choice medication for chronic pain due to the increased risks of myocardial infarction (MI) and stroke due to secondary suppression of vasodilation.
A nurse is collecting data from the parent of an 11 year old child who has previously received all the immunizations in accordance with the CDC Recommended Immunization Schedule. Which of the following immunizations should the nurse plan to administer to this child at this age?
Human papilloma virus (HPV) Administer three doses over a 6-month period for males and females 11-12 years of age (minimum age of 9 years).
A nurse is caring for a client who has a new prescription for experenone to treat hypertension. The nurse should monitor for which of the following adverse effects of this medication.
Hyperkalemia
A nurse is assisting with the care of a client who has a methicillin-resistant Staphylococcus aureus (MRSA) infection and is receiving vancomycin via IV infusion. Which of the following changes in the client's condition should the nurse identify as the priority finding to report to the provider?
Hypotension Nausea Back Pain Chills
A nurse is reinforcing teaching with a client who has HIV and a new prescription for zidovudine. Which of the following clients statements should indicate to the nurse an understanding of the teaching?
I will be sure to have my blood tested for anemia
A nurse is reinforcing teaching with a client who has a prescription for alendronate. Which of the following client responses indicates to the nurse an understanding of the teaching?
I will take the medication with 8 ounces of water
A nurse is reinforcing teaching with a client who has a new prescription for propranolol. Which of the following information should the nurse include in the teaching?
If your pulse rate is less than 50 beats per minute, notify your provider.
A nurse is collecting data from a client who is taking ferrous sulfate orally. Which of the following findings reported by the client should indicate to the nurse that the medication is having a therapeutic effect?
Increased tolerance to exercise
A nurse is caring for a client who has a history of psychosis and is taking chlorpromazine. Which of the following action should the nurse take to counteract the adverse effects of this medication?
Inform the client to apply sunblock before going outside.
A nurse is caring for a client who has a prescription for a hydromorphone 2 mg immediate release tablet by mouth. The nurse administers a 4 mg immediate release tablet by mistake. Which of the following actions should the nurse take first?
Obtain the client's vital signs and level of consciousness.
A nurse is collecting data from a client who is postoperative and taking morphine for pain. Which of the following findings is the priority for the nurse to report to the provider?
Oxygen saturation 87%
A nurse is reviewing medication prescriptions for a group of clients. The nurse should recognize that which of the following prescriptions can result in a medication administration error?
Penicillin G benxathine 1.2 million units IM daily
A nurse is reviewing the history of a client who is to start taking cefotetan to treat a bacterial infection. Which of the following information from the client's medical record should the nurse report tot he provider before the client begins receiving this medication?
Penicillin allergy
A nurse is instilling timolol eyedrops for a client who has glaucoma. Which of the following actions should the nurse take after instilling the eyedrops?
Press the nasolacrimal duct
A nurse is collecting data from a female client who has been taking propylthiouracil (PTU) for 2 months to treat Graves' disease. Which of the following findings should the nurse recognize as an indication that the medication is effective?
Pulse 82/min
A nurse is reinforcing teaching with client who has hypertension and a new prescription for spironolactone. Which of the following instructions should the nurse include in teaching?
Restrict foods high in potassium
A nurse is reinforcing teaching about comfort measures with the parent of a 10-year old child who has a viral infection. The nurse should plan to tell the parents that aspirin is contraindicated because of the risk for which of the following conditions?
Reye's syndrome
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?
Stop the transfusion
A nurse is reinforcing teaching with a client who has a new prescription for omeprazole oral capsule. Which of the following instructions should the nurse include?
Swallow the medication whole.
The nurse is planning to administer metoprolol to a client who has heart failure and a heart rate of 48/ min. Which of the following actions should the nurse take?
Withhold the client's medication.
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?
You should report any thoughts of harming yourself You will need to have two negative pregnancy test prior to strain the medication.
A nurse is planning to reinforce teaching regarding newborn immunizations with a client who is 24 hr postpartum. Which of the following information should the nurse plan to include?
Your baby will receive the first hepatitis B vaccine before discharge.