PHARM ATI PROCTORED PRACTICE:

A nurse in an outpatient facility is assessing a client who is prescribed furosemide 40 mg daily. The client reports taking extra doses to promote weight loss. Which of the following findings should indicate to the nurse that the client is dehydrated? A) Urine specific gravity 1.035 B) Distended neck veins C) BUN 18 mg/dL D) Bounding radial pulse

A) Urine specific gravity 1.035

A nurse is reviewing a record of a client who is requesting a prescription for sildenafil citrate. Which of the following data in the client's record should the nurse identify as a contraindication to the use of this medication? A) Diabetes mellitus B) Current use of isosorbide to treat heart failure C) Eyeglasses for presbyopia D) Osteoarthritis

B) Current use of isosorbide to treat heart failure - NITROGLYCERIN & ISOSORBIDE ARE CONTRAINDICATIONS FOR SILDENAFIL

A nurse is caring for a client who is taking selegiline. The nurse should monitor the client for which of the following adverse effects of selegiline and notify the provider if it occurs? A) Bruising B) Drowsiness C) Coughing D) Constipation

B) Drowsiness - Can be a manifestation of serotonin syndrome (this is a antidepressant med for parkinson's)

A nurse is teaching a client who has primary adrenal insufficiency (Addison's disease) and a prescription for hydrocortisone. Which of the following statements should the nurse include in the teaching about this medication? A) "You may need to take a lower dosage when you are ill or experiencing stress" B) "Take this medication before going to bed because it will make you tired" C) "Carry a supply of pills and a single-use injectable preparation with you at all times" D) "You will need to stop this medication before routine procedures as a colonoscopy"

C) "Carry a supply of pills and a single-use injectable preparation with you at all times"

A nurse is providing discharge teaching about lithium toxicity to a client who has a new prescription for lithium. Which of the following statements by the client indicates an understanding of the teaching? A) "I should take naproxen if I have a headache because aspirin can cause lithium toxicity." B) "I can develop lithium toxicity if I eat foods with lots of sodium." C) "I can develop lithium toxicity if I experience vomiting and diarrhea." D) "I might need to take a daily diuretic along with my lithium to prevent lithium toxicity."

C) "I can develop lithium toxicity if I experience vomiting and diarrhea."

A nurse is preparing to administer medication to a client. The nurse should understand that which of the following abbreviations indicates the greatest frequency of medication administration? A) BID B) TID C) QID D) Q8H

C) QID - BID: x2 a day - TID: x3 a day - QID: x4 a day

A nurse in the provider's office is assessing a client who has been taking amoxicillin for 10 days and reports diarrhea and cramping. The nurse should recognize that these manifestations occur secondary to which of the following adverse effects? A) Development of gastric ulcers B) Development of milk intolerance C) Allergic reactions to the medication D) Alterations in gastrointestinal flora

D) Alterations in gastrointestinal flora

A nurse is reviewing the lab reports of a client who has been taking warfarin for atrial fibrillation. Which of the following results should the nurse report to the provider immediately? A) PT 18 seconds B) Platelet count 160,000 C) Hct 43% D) INR 5.5

D) INR 5.5

A nurse assessing a client who is receiving a continuous morphine IV infusion and finds the client's respiratory rate has decreased from 20/min to 12/min. Which of the following actions should the nurse take? A) Flush the IV line with saline B) Administer flumazenil C) Lower the head of the bed D) Slow the rate of infusion

D) Slow the rate of infusion

A nurse suspects that a client is having an allergic reaction to a medication. Which of the following factors should the nurse identify as increasing the likelihood of an allergic reaction to the medication? A) This is the client's initial dose of the current prescription B) The client received a large dosage C) The route of administration was oral D) The client has had previous exposure to the medication

D) The client has had previous exposure to the medication

A nurse is caring for a client who takes Ginkgo biloba daily at home. Which of the following effects should the nurse expect from the use of this herbal supplement? A) Decreased platelet aggregation B) Prevention of migraine headaches C) Increased risk of deep-vein thrombosis D) Lowered cholesterol and triglyceride levels

A) Decreased platelet aggregation

A nurse is caring for a client who has a new prescription for levothyroxine to treat hypothyroidism. Which of the following findings should the nurse identify as an indication that the client requires intervention? A) Heart rate 106/min B) Dry skin C) Oral temperature 98.2F D) Lethargy

A) Heart rate 106/min

A nurse is preparing to administer a sublingual nitroglycerin tablet to a client who is reporting chest pain. For which of the following adverse effects should the nurse monitor after giving this medication? A) Hypotension B) Myalgia C) Diarrhea D) Ototoxicity

A) Hypotension

A nurse is caring for a client who has a prescription for an oral contraceptive to prevent pregnancy. The nurse should identify that which of the following actions is the purpose of this medication? A) Inhibition of ovulation B) Thinning of the endometrial lining C) Inhibition of luteinizing hormone D) Thinning of cervical mucous

A) Inhibition of ovulation

A nurse is teaching a client who has type 1 diabetes mellitus about a new subcutaneous insulin infusion pump. Which of the following pieces of information should the nurse include in the teaching? A) Plan to use a type of short-duration insulin in the infusion pump B) Replace the infusion pump set very 4 days C) Turn off the infusion pump for at least 3 hours each day D) Move the infusion pump catheter 1.27 cm away from the old site

A) Plan to use a type of short-duration insulin in the infusion pump

A nurse is caring for a client with diabetic ketoacidosis who has a prescription for an intravenous insulin therapy. The nurse should document that which of the following types of insulin was administered intravenously to treat ketoacidosis? A) Regular insulin B) Insulin lispro C) Insulin aspart D) Insulin glargine

A) Regular insulin

A nurse is teaching a client who has a new prescription for phenytoin. The nurse should inform the client that which of the following adverse effects can occur with the abrupt withdrawal of phenytoin? A) Status epilepticus B) Bleeding gums C) Disorientation D) Severe nausea

A) Status epilepticus

A nurse is providing teaching about sodium phosphate to a client who has a new prescription for sodium phosphate. The client is scheduled for a colonoscopy and is currently taking furosemide for hypertension. Which of the following statements should indicate to the nurse that the teaching has been effective? A) "I can take my water pill as prescribed" B) "I can experience an imbalance in my electrolytes from this medication" C) "I should drink 8 ounces of bowel cleanser every 10 minutes until I drink a total of 4 liters" D) "I can experience rebound constipation after using this medication"

B) "I can experience an imbalance in my electrolytes from this medication"

A nurse is teaching a client about the proper placement of a nitroglycerin patch. Which of the following statements by the client indicates an understanding of the teaching? A) "I'll apply the patch over areas of my body with little fatty tissue" B) "I can place the patch on any area of my body without hair" C) "I'll put the patch on the same site as the previous patch" D) "I have to apply the patch directly over my heart"

B) "I can place the patch on any area of my body without hair"

A nurse is caring for a client who is experiencing acute alcohol withdrawal. The nurse should expect to administer which of the following medications? A) Disulfiram B) Chlordiazepoxide C) Methadone D) Varenicline

B) Chlordiazepoxide

A nurse is caring for a client who is taking glucocorticoids. The nurse should monitor the client for which of the following adverse effects of the medication? A) Weight loss B) Peptic ulcer C) Hyperkalemia D) Diplopia

B) Peptic ulcer - Check client's stool for occult blood

A nurse is caring for a client who has asthma and is prescribed a short-acting beta2-agonist. Which of the following should the nurse identify as the expected outcome of this education? A) Reduces the frequency of attacks B) Reverses bronchospasm C) Prevents inflammation D) Decreases chronic manifestations

B) Reverses bronchospasm

A nurse is caring for a client who is experiencing acute pain and is receiving morphine. Which of the following findings should indicate to the nurse the need to withhold the client's next dose of morphine? A) The client reports the inability to void B) The client's respiratory rate is 10/min C) The client has hypoactive bowel sounds D) The client has vomited once in the last 4 hours

B) The client's respiratory rate is 10/min

A nurse providing teaching to a client with a new diagnosis of heart failure who has a prescription for furosemide. Which of the following statements should the nurse include in the teaching? A) "You can take ibuprofen for headaches while taking this medication" B) "You may experience increased swelling in your lower extremities while taking this medication" C) "You should eat foods that are high in potassium while taking this medication" D) "You should take this medication at bedtime"

C) "You should eat foods that are high in potassium while taking this medication"

A nurse is caring for a client and realizes after administering the 0900 medications that she administered digoxin 0.25 mg PO to the client instead of digoxin 0.125 mg PO. Which of the following actions should the nurse take? A) Notify the provider B) Contact the nursing supervisor C) Assess the client's apical pulse D) Complete an incident report

C) Assess the client's apical pulse

A nurse is caring for a client who has a prescription for clopidogrel. The nurse should monitor the client for which of the following adverse effects? A) Insomnia B) Hypotension C) Bleeding D) Constipation

C) Bleeding - Look out for coffee-ground emesis, black tarry stools, ecchymosis (discoloration of skin), or any indication of bleeding.

A nurse is caring for a client who has diabetes insipidus. Which of the following lab values should the nurse identify as reflecting a contraindication to receiving vasopressin to treat this disorder? A) Sodium 152 B) Potassium 6.0 C) Creatinine clearance 50 ml/min D) Aspartate aminotransferase 52

C) Creatinine clearance 50 ml/min

A nurse is preparing to administer Digoxin to a client. Which of the following findings should the nurse identify as a contraindication to the client receiving this medication? A) Blood pressure 180/70 mmHg B) Oxygen saturation rate 94% C) Heart rate 51/min D) Respiratory rate 21/min

C) Heart rate 51/min - (Heart rate less than 60/min = this medication should be withheld)

A nurse is reviewing lab values for a client who reports fatigue and cold intolerance. The client has an increased thyroid-stimulating hormone level and a decreased T3 and T4 level. The nurse should anticipate a prescription for which of the following medications? A) Methimazole B) Somatropin C) Levothyroxine D) Propylthiouracil

C) Levothyroxine

A nurse is reviewing the medication administration record of a client who is receiving opioid medication for pain. Which of the following prescriptions should the nurse clarify with the provider? A) Metoprolol B) Ondansetron C) Lorazepam D) Naloxone

C) Lorazepam - SHOULD NOT BE GIVEN WITH AN OPIOID

A nurse is teaching a newly licensed nurse about contraindications to ceftriaxone. A severe allergy to which of the following medications is a contraindication to ceftriaxone? A) Gentamicin B) Clindamycin C) Piperacillin D) Sulfamethoxazole-trimethoprim

C) Piperacillin - (This is a penicillin)

A nurse is caring for a client who is 39 weeks of gestation who has gestational hypertension. The client has a new prescription for misoprostol for cervical ripening and induction of labor. Which of the following findings in the client's medical history should the nurse identify as increasing the client's risk of complications due to the use of this medication? A) Positive bacterial vaginosis culture B) History of failure to progress C) Previous cesarean delivery D) Positive serum Rh sensitization

C) Previous cesarean delivery

A nurse is preparing a discharge teaching plan for a client who is scheduled to begin long-term oral prednisone for asthma. Which of the following instructions should the nurse include in the plan? A) Stop taking medication if rash occurs B) Take medication on an empty stomach to enhance absorption C) Schedule the medication on alternate days to decrease adverse effects D) Treat shortness of breath with an extra dose of the medication

C) Schedule the medication on alternate days to decrease adverse effects - Some of the effects of long-term glucocorticoid therapy can be avoided by using alternate-day therapy

A nurse is assessing a client who has hypothyroidism and takes levothyroxine. Which of the following findings indicates the client is experiencing levothyroxine overdose? A) Bradycardia B) Cold intolerance C) Tremor D) Hypothermia

C) Tremor

A nurse is caring for a client who takes Warfarin 2.5 mg PO daily and has an INR of 6.2. The nurse should anticipate a prescription from a provider for which of the following medications? A) Protamine sulfate B) Fondaparinux C) Vitamin K D) Bivalirudin

C) Vitamin K

A nurse is providing teaching to a client who has a new prescription for hydrochlorothiazide 50 mg PO daily to treat hypertension. Which of the following instructions should the nurse include in the teaching? A) "Take hydrochlorothiazide as needed for edema" B) "Check your weight once a week" C) "Take hydrochlorothiazide on an empty stomach" D) "Take hydrochlorothiazide in the morning"

D) "Take hydrochlorothiazide in the morning" - Do this to allow the client to allow for diuresis during the day and to prevent nocturia

A nurse is teaching a client who is taking levothyroxine for hypothyroidism about a new prescription for a calcium supplement. Which of the following pieces of information should the nurse include in the teaching? A) The calcium supplement will enhance the effect of the levothyroxine B) The calcium supplement will accelerate the metabolism of the levothyroxine C) Take the medications together at 1700 for the greatest effect D) Take the calcium supplement 4 hr after taking the levothyroxine

D) Take the calcium supplement 4 hr after taking the levothyroxine