Pharm ATI

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. The client should discard any vials or prefilled syringes that contain solutions that are discolored, cloudy, or have sediment in them.

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 The nurse should identify that a hypersensitivity reaction to either gelatin or neomycin is a contraindication for receiving the varicella vaccine because it contains both of these substances.

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 increases the risk of myocardial infarction caused by increased vasoconstriction and unimpeded platelet aggregation. It is contraindicated for a client who has a history of myocardial infarction or heart disease.

A nurse is reinforcing teaching with a client who has a new prescription for colchicine to man age gouty arthritis. Which of the following manifestations should the nurse include as an adverse effect of this medication.

Abdominal pain Abdominal pain indicates cellular damage to the gastrointestinal tract. The nurse should notify the provider, and the client should discontinue the medication immediately.

A nurse is reinforcing teaching with a client who has seizures and a new prescription for vampiric acid (generalized seizure medication). The nurse should instruct the client to report which of the following adverse effects of vampiric acid to the provider immediately?

Abdominal pain. The greatest risk to the client is hepatotoxicity and pancreatitis, which can cause abdominal pain. Therefore, the client should notify the provider immediately if experiencing a decrease in appetite, nausea, abdominal pain, or yellowing of the skin.

A nurse is contributing to the pan of care for a client who has schizophrenia and a new prescription of clozapine. The nurse should include in the plan to monitor the client for which of the following adverse effects of this medication.

Agranulocytosis The nurse should monitor the client's WBC count and notify the provider for a value below the expected reference range of 5,000 to 10,000/mm3

A nurse is collecting data from a client who is receiving digoxin (heart failure medication and atrial fibrulation) for treatment of heart failure. The nurse should identify which of the following findings as adverse effects of this medication?

Blurred Vision Nausea Dysrhythmia The nurse should identify visual changes such as blurred vision, halos, and yellow or green tinged vision to adverse effects of digoxin. The nurse should identify that nausea and vomiting are adverse effects of digoxin. The nurse should identify that dysrhythmias are an adverse effect of digoxin.

A nurse is reinforcing teaching with a newly licensed nurse about using metoprolol to treat hypotension. Which of the following conditions should the nurse include as a contraindication for this medication?

Bradycardia Metoprolol is beta blocker that slows the conduction through the AV node. Therefore, it is contraindicated for clients who have bradycardia, or a heart rate that is consistently less than 60/min

A client comes 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 clients pupils are dialated, along with elevated heart rate and blood pressure level. The nurse should suspect intoxication with which of the following substances?

Cocaine The client who has cocaine toxicity typically has tachycardia, elevated blood pressure, dilated pupils, and displays delusions. The client's behavior and physiological data indicate cocaine intoxication.

A nurse is collecting data form 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 The nurse should identify that levodopa/carbidopa can cause darkening of the client's sweat, urine, and saliva.

A nurse is caring for a client who has multiple sclerosis and 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. The nurse should identify that baclofen is an antispasmodic that decreases muscle spasticity in a client who has multiple sclerosis.

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. The nurse should instruct the client to reduce or avoid all use of alcohol because isoniazid can cause liver damage; therefore, it is important for the nurse to determine the client's daily alcohol intake.

A nurse is reinforcing teaching with a client who has a new prescription for theophylline. The nurse should instruct the client that which of the following is an expected outcome of this medication?

Dilates bronchioles Theophyilline is a bronchodilator, which affects smooth muscle relaxation and leads to open airways.

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 medications is contraindicated while taking oxycodone?

Diphenhydramine Both diphenhydramine, an antihistamine, and oxycodone, an opioid analgesic, can cause CNS depression. Therefore, when a client uses two medications together, the client us at increased risk for sedation, respiratory depression, and injury.

A nurse is reinforcing teaching with a client who is using phenylephrine nasal spray three times daily and report rebound congestion. Which of the following instructions should the nurse include to reduce the effects of rebound congestion?

Discontinue use in the left nostril, then in the right nostril. Discontinuing the medication one nostril at a time can overcome rebound congestion.

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 error?

Furosemide 10.0 mg PO daily The nurse should avoid using zero following a whole number. The prescription can result in a medication error because the nurse can mistake the dosage as 100 mg instead of 10 mg because the decimal point is not always recognized.

A nurse is reinforcing teaching with a parent of a preschooler who has 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. The nurse should instruct the parent to administer analgesics, such as acetaminophen or ibuprofen, to decrease discomfort and fever related to otitis media.

A nurse is monitoring a client who has type 2 diabetes mellitus and is receiving repaglinide. Which of the following laboratory test should the nurse plan to review to obtain information about the long term therapeutic effect of this medication.

Glycoslated HbA1c The clients HbA1c value measures the average blood glucose levels over the past 2 to 3 months. Therefore, the nurse should review this laboratory test to obtain information about the long term therapeutic effect of repaglinide.

A nurse is caring for a client who has chronic kidney disease and has been receiving epoetin for 2 weeks. Which of the following findings should indication to the nurse that the client's medication is having the desired therapeutic effect.

Hemoglobin rises 0.5 g/dl Initial therapeutic effect, such as hemoglobin rising 0.5 g/dl can occur within the first 2 weeks of therapy. The client's hemoglobin should reach target levels of 10 to 11 g/dl in 2 to 3 months.

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 changes in the clients conditions should the nurse identify as the priority finding to report the provider?

Hypotension When using the urgent vs non urgent approach to client care, the nurse determines that the priority finding to report to the provider is hypotension. If the client's vancomycin infusion is too rapid, it can cause red man syndrome, which is a group of adverse effects that includes tachycardia, hypotension, flushing, and urticaria.

A nurse is reinforcing teaching with a client who has HIV and a new prescription for zidovudine, Which of the following client statements should indicate

I will be sure to have my blood tested for anemia. Zidovudine can cause severe anemia and neutropenia. The client should have blood tests performed before treatment begins and have continued monitoring during the course of treatment.

A nurse is reinforcing teaching with a client who has a prescription for alendronate (Fosamax, prevents bone loss). Which of the following client responses indicates to the nurse an understanding of the teaching?

I will take this medication with 8 ounces of water. The client should take alendronate on an empty stomach with 240 ml (8oz) of water to ensure it does not lodge in the esophagus, which can result in esophageal ulcerations.

A nurse is caring for a client who is taking phenylephrine. The nurse should plan to monitor the client for which of the following manifestations as an adverse effect of this medication?

Increased heart rate Due to cardiac effects phenylephrine can cause tachycardia and other cardiac dysrhythmias.

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 The client who takes ferrous sulfate, which is used to treat iron-deficiency anemia, can have fatigue and shortness of breath due to a low hemoglobin level. An increased tolerance to exercise is an indication the ferrous sulfate is having a therapeutic effect. Increased tolerance to exercise occurs when the hemoglobin level increases allowing more oxygen to be carried to the vital organs and tissues.

A nurse is reinforcing teaching with a client who has bipolar disorder and a new prescription for lithium. Which of the following instructions should the nurse include in the teaching?

Maintain constant sodium intake. The client should maintain a consistent sodium intake while taking lithium. Decreased serum sodium levels cause lithium excretion to decline, which can lead to toxicity.

A nurse is reinforcing teaching with a client about the adverse effects of simvastatin. For which of the following adverse effects should the nurse instruct the client to notify the provider?

Muscel pain The nurse should instruct the client to notify the provider if muscle pain or tenderness develops because this can indicate the client is developing rhabdomyolysis.

A nurse is collecting data from a client who postoperative and taking morphine for pain. Which of the following is priority for the nurse to report to the provider?

Oxygen saturation 87% When using the airway, breathing, and circulation approach to client care, the nurse determines that the priority findings is an oxygen saturation 87%, which is a manifestation of respiration depression and should be reported to the provider.

A nurse is reinforcing teaching with a client who is to start therapy using nitroglycerin transdermal patch. Which of the following instructions should the nurse include?

Place the patch on a different site for each application. The client should place the patch on a different site for each application to prevent skin irritation.

A nurse is installing timolol eyedrops for a client who has glaucoma. Which of the following actions should the nurse take after installing eyedrops?

Press the nasolacrimal duct The nurse should press the client's nasolacrimal duct after instilling the eye drops to prevent the medication from absorbing into systemic circulation.

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 Tachycardia is a manifestation of hyperthyroidism. The nurse should identify that a pulse of 82/min is within the expected range of 60 to 100/min, indicating that the medication is effective.

A nurse is reinforcing teaching with a client who has hypertension and a new prescription for spironolactone. Which of the following instructions should the nurse include in the teaching?

Restrict foods high in potassium. The nurse should instruct the client that spironolactone is a potassium sparring diuretic, which can cause hyperkalemia. Therefore, the client should restrict foods that are high in potassium and salt substitutes that contain 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 play not tell the parent that aspirin is contraindicated because of the risk for which of the following conditions?

Reye's syndrome Aspirin is contraindicated for children and adolescents who have a viral illness because it increases the risk for the development of Reye;s syndrome.

A nurse is monitoring a client who is receiving a transfusion of packed RBCs. The clients temperature increases to 39.1º C (102.4º F). Which of the following actions should the nurse take?

Stop the transfusion. The greatest rip of this client is injury from a transfusion reaction that can cause acute intravascular hemolysis or anaphylaxis. Therefore, the first action the nurse should take is to stop the transfusion.

A nurse is reinforcing teaching with a client who has a new prescription for omeprazole oral capsules. Which of the following instructions should the nurse include?

Swallow the medication whole The nurse should instruct the client to swallow the capsules or tablets whole and not chew or crush them. Omeprazole, a proton pump inhibitor, blocks the secretion of gastric acid. It is available in delayed-release capsules and over the counter in delated release tablets, as well a suspensions and powders.

A nurse is caring for a client who has a new prescription for sumatriptan (Antimigraine drug that stimulates cerebral arteries causing vasoconstriction). 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?

Tremors Concurrent use of sumatriptan and fluoxetine can lead to excessive stimulation of serotonin receptors, placing the client at risk for serotonin syndrome. The client can experience tremors, confusion, and hallucinations.

A nurse is planning to reinforce teaching about 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. The newborn should receive the first hepatitis B vaccine brith, with the next dose at age 1 to 2 months.

A nurse 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 if the following responses should the nurse make?

Your medication can't be given IV because it is not water soluble. The nurse should inform the client this type of penicillin has poor water solubility and is never administered intravenously.