Pharm ATI Practice

A nurse on the acute care unit is caring for a client who is receiving gentamycin IV. The nurse should report which of the following findings to the provider as an adverse effect of the medication?

Tinnitus *Aminoglycosides are ototoxic

A nurse is assessing a client who is postoperative following an outpatient endoscopy procedure using midazolam. The nurse should monitor for which of the following findings as an indication that the client is ready for discharge?

When their capnography level has returned to baseline indicating that gas exchange is adequate.

EKG indication of hypokalemia:

*U-waves

A nurse is providing discharge teaching about handling medication to a client who is to continue taking oral transmucosal fentayl raspberry-flavored lozenges on a stick. Which of the following information should the nurse include in the teaching?

-Effect within 10 - 15 minutes -Move product around the inside of the mouth for best absorption; actively sucking not chewing *Store unused and partially used sticks in a storage container

Which OTC medication should be discontinued with a new prescription for lithium?

Ibuprofen

Newborn Vaccinations: HepB & TDaP

Hepatitis B (@ Birth) TDaP (2m, 4m, 6m, 15-18m, 4-6y)

Potassium and digoxin:

Hypokalemia predisposes patient to digoxin toxicity

Administration of heparin:

SubQ Outside 2in radius of umbilicus Do not aspirate Apply firm pressure p but do not massage

What should clients taking captopril report a sore throat?

This can indicate neutropenia a serious A/E; can be reversed if identified early and medication is promptly discontinued.

A nurse is caring for a client who is taking acetazolamide for chronic open-angle glaucoma. For which of the following adverse effects should the nurse instruct the client to monitor and report?

*Tingling of the fingers -Diarrhea -Anorexia & Wt loss -polyuria

A nurse is teaching a client who is to start taking hydrocodone with acetaminophen tablets for pain. Which of the following information should the nurse include in the teaching?

-Take with food/milk for GI upset -Take effect within 20 minutes and last 4 to 6 hours -Can be crushed or chewed *Decreased respirations might occur r/t resp. depression

A nurse is teaching a client about the use of risedronate for the treatment of osteoporosis. The nurse should identify which of the following statements as an indication that the client understands the teaching?

-Take with full glass of water -30 minutes prior to eating in the morning -Avoid antacids, calcium, aluminum or magnesium *Sit upright for 30 minutes after

A nurse is providing teaching to a client who has a gastric ulcer and a new prescription for ranitidine. Which of the following instructions should the nurse include?

-with/without food -Must take full course -store at room temperature *Report yellowing of the skin r/t hepatotoxicity

Normal range for platelets:

150,000-400,000 /mm3 (*Anticoagulant therapy*)

What action should the nurse always take prior to administering a beta blocker?

Determine apical pulse! *Same for digoxin

A nurse is caring for a client who is receiving filgrastim. Which of the following findings should the nurse document to indicate the effectiveness of the therapy?

Increased neutrophil count (Stimulates bone marrow to produce neutrophils; for clients receiving chemotherapy to minimize the risk of infection)

A nurse is providing teaching to a client who has a prescription for ergotamine sublingual to tx migraine H/A:

take one tablet at the onset of a migraine

Appropriate serum digoxin level:

0.8 to 2 ng/mL

With with cardiac medication will you note facial flushing as a S/E:

Niacin

*A nurse is is caring for a client who is experiencing alcohol withdrawal. For which of the following client outcomes should the nurse administer chlordiazepoxide?

*Prevent delirium tremors

Teaching plan for a new prescription of simvastatin:

*Report muscle pain (rhabdomyolysis) *No grapefruit Take in evening (increased diurnal cholesterol) *Lifelong therapy

A nurse is teaching a client about cyclobenzaprine. Which of the following client statements should indicate to the nurse that the teaching is effective?

*Taper off medication before discontinuing it (to prevent abstinence syndrome or rebound insomnia) -dry mouth -treat muscle spasms -report urinary retention r/t anticholinergic effects

A nurse is assessing a client after administering a second dose of cefazolin IV. The nurse notes that the client has anxiety, hypotension and dyspnea. Which of the following medications should the nurse administer first?

Anaphylaxis! *Epinephrine to induce vasoconstriction and bronchodilation

Which medication(s) will interfere with the effectiveness of oral contraceptives?

Carbamazepine (accelerated inactivation r/t action on hepatic medication-metabolizing enzymes)

A nurse is caring for a client who has cancer and is taking morphine and docusate sodium. The nurse should instruct the client that taking the docusate sodium daily can minimize which of the following adverse effects of morphine?

Constipation (docusate sodium is a stool softener)

A nurse is is caring for a client who is experiencing alcohol withdrawal. For which of the following client outcomes should the nurse administer propranolol?

Decrease or lessen cravings

Which medication can interact with calcium gluconate?

Digoxin

Antidote for benzodiazepines (i.e. diazepam) OD:

Flumazenil

A nurse is providing teaching to a client taking bupropion as an aid to quit smoking. Which of the following findings should the nurse identify as an adverse effect of the medication?

Insomnia (it is a stimulant antidepressant)

A nurse is is caring for a client who is experiencing alcohol withdrawal. For which of the following client outcomes should the nurse administer clonidine or atenolol?

Minimize autonomic components such as diaphoresis

A nurse is preparing to administer PO sodium polystyrene sulfonate to a client who has hyperkalemia. What action should the nurse plan to take?

Monitor for constipation, can lead to fecal impaction

What is one of the contraindications of taking ciprofloxacin?

Tendonitis (*tendon rupture)

A nurse is providing teaching to a patient with MS and a new prescription for methylprednisone. What should the nurse include?

*BG monitored during tx (glucocorticoids increase BG) *Avoid contact w/people with known infections (immunosuppressant) Take with food/milk to decrease GI upset Increase dietary intake of potassium-rich foods (K depleting, hypokalemia) *Avoid grapefruit (increases the effect of med)

A nurse administers a dose of metformin to a client instead of the prescribed dose of metoclopramide. Which of the following actions should the nurse take first?

*Check the client's blood glucose r/t risk of hypoglycemia (metformin is an oral anti-diabetic)

S/E teaching plan for oxybutynin, for urinary incontinence:

*Dry mouth increased intraocular pressure: report eye pain, halos and *Blurred vision, and *Dry eyes Cardiovascular S/E: prolonged QT, palpitations, HTN and tachycardia

A nurse is administering donepezil to a client who has Alzheimer's Disease. Which of the following findings should the nurse report to the provider immediately?

*Dyspnea

A nurse is assessing a client who has schizo and is takin Haloperidol. The nurse should report what finding(s) to the provider as a manifestation of Neuroleptic Malignant Syndrome (NMS)?

*Extreme fever -Resp. distress -diaphoresis -tachycardia -altered BP -incontinence -muscle rigidity

A nurse is assessing a client who has myasthenia gravis and is taking neostigmine. Which of the following findings should indicate to the nurse that the client is experiencing an adverse effect?

Miosis (=pupillary constriction; common S/E of this med due to excessive muscarinic stimulation that causes difficulty with visual accomodation)

A nurse is assessing a client who is taking propylthiouracil for the treatment of Grave's disease. Which of the following findings should the nurse identify as an indication that the medication has been effective?

*Increase in ability to focus Graves disease s/sx: =hyperthyroidism -psychological (inability to focus, restlessness, insomnia, manic-behavior) -GI (increased appetite, wt loss, hypermotility) propylthiouracil is a thyroid hormone antagonist (hyperthyroidism/ thyroid strom) A/E includes myelosupression and a decrease in WBC count

A nurse is providing teaching to a client who has peptic ulcer disease and is to start a new prescription of sucralfate. Which of the following actions of sucralfate should the nurse include in the teaching?

.pylori)Forms a protective barrier over ulcers -from pepsin and gastric acid (H2 receptor agonists decrease stomach acid secretion) (Antacids neutralize the acids in the stomach and prevent formation of pepsin) (Combination Abx tx is required to eradicate H. pylori)

A nurse in an ED is caring for a patient with myasthenia gravis in cholinergic crisis. Which med should the nurse plan to administer?

Atropine (anticholinergic to reverse cholinergic toxicity caused by excessive amount of choinesterase inhibitor)

A nurse is planning care for a client receiving continuous IV mannitol. The nurse should monitor for what A/E?

Increased intraocular pressure r/t the osmotic gradient created between the intraocular fluid and plasma

A nurse is assessing a client 1 hour after administering morphine for pain. The nurse should identify which of the following findings as the best indication that the morphine has been effective?

The client rates pain as 3 on a scale from 0 to 10.