Pharm exam 2
The nurse is caring for a client on a norepinephrine infusion. Which findings indicate that the medication is effective? The client's intracranial pressure decreases to 15 mmHg. The client's temperature increases to 35.9 degrees Celsius. The client's heart rate decreases to 110 beats per minute. The client's blood pressure increases to 88/40 mmHg.
The client's blood pressure increases to 88/40 mmHg.
Which instruction will the nurse include in a teaching plan for a client taking a calcium channel blocker such as nifedipine? SATA Reduce calcium intake. Report peripheral edema. Expect temporary hair loss. Avoid drinking grapefruit juice. Change to a standing position slowly.
Report peripheral edema. Avoid drinking grapefruit juice. Change to a standing position slowly.
A 6-year-old with asthma is prescribed an inhaled corticosteroid. The nurse would conclude the parent understands teaching about the medication side effects when the mother makes which statement? "I'll watch for frequent urination." "I'll check for white patches in the mouth." "I'll be alert for short episodes of not breathing." "I'll monitor for an increased BG level."
"I'll check for white patches in the mouth."
Which response would the nurse provide to a client receiving digoxin who calls and complains of "yellow vision."? "This is related to your illness rather than your medication" "This medication may need to be discontinued. Come to the clinic this afternoon." "This is an expected side effect; you will become accustomed to it over time." "This side effect is only temporary. You should continue the medication."
"This medication may need to be discontinued. Come to the clinic this afternoon."
Which adverse effect would a nurse monitor for when caring for a client with hypertension who is prescribed metoprolol? Hirsutism Bradycardia Restlessness Angina
Bradycardia
Which common side effect does the nurse caution the client about when starting a new bile-acid sequestrant for hypercholesterolemia? Bleeding Diarrhea Leg pain Facial flushing
Diarrhea
A child is being treated with cardiac medications developed vomiting, bradycardia, anorexia, and dysrhythmias. The nurse understands which medication toxicity is responsible for these symptoms? Digoxin Nesiritide Dobutamine Spironolactone
Digoxin
Which foods will the nurse discuss when teaching a client who has a new prescription for warfarin? Dairy products High-fiber fruits Green leafy vegetables Whole-grain breads and cereals
Green leafy vegetables
Which medication side effect will the nurse assess for when caring for a client with a MI receiving IV nitroglycerin to relieve pain? Nausea Delirium Bradycardia Hypotension
Hypotension
Which technique using a metered-dose inhaler (MDI) by a client with COPD would cause a nurse to conclude additional teaching is needed? Places the tip of the inhaler just past the lips Holds the inspired breath for at least 3 seconds Activated the inhaler during inspiration Inhales rapidly with the lips sealed around the nebulizer opening
Inhales rapidly with the lips sealed around the nebulizer opening
The nurse is caring for a client receiving daily furosemide. The client's potassium levels are low, and the health care provider orders repletion with an oral potassium supplement. Which action is most important for the nurse to take? Auscultate the client's lung sounds in all fields Obtain hourly weights Place the client on a cardiac monitor Offer the client a banana with lunch
Place the client on a cardiac monitor
Which medication will the nurse be prepared to administer to a client admitted to the hospital with a diagnosis of DVT who is prescribed IV heparin sodium if the client experiences excessive bleeding? Vitamin K Oprelvekin Warfarin sodium Protamine sulfate
Protamine sulfate
The nurse administers albuterol to a child with asthma. Which common side effect would the nurse monitor for in the child? Flushing Dyspnea Tachycardia Hypotension
Tachycardia
While providing care for the client hospitalized for acute bronchitis and prescribed aminophylline, which clinical manifestation will the nurse attribute to the initiation of this drug therapy? SATA Bradycardia Bradypnea Tachycardia Dysrhythmia Dry mouth
Tachycardia Dysrhythmia
The registered nurse (RN) is aware of what primary benefit of the prescription of a drug classified as a glucocorticosteroid? Treats total body inflammation Weakens the overall immune system Relieves body irritation Prevents the spread of infection
Treats total body inflammation
Which adverse effect will the nurse instruct the client to anticipate when prescribed albuterol to relieve severe asthma? SATA Tremors Lethargy Palpitation Bronchoconstriction Decreased pulse rate
Tremors Palpitations
Which agent will be used if an antidote is needed for a client taking warfarin? Vitamin K Fibrinogen Prothrombin Protamine sulfate
Vitamin K
Which assessment findings would indicate a possible asthma exacerbation? SATA Fever Stridor Wheezing Tachycardia Hypotension
Wheezing Tachycardia
Which rationale supports the nurses instructions to a client with the healthcare provider before self-medicating with OTC decongestants? Can cause nasal dryness Can cause urinary retention May cause BP to decrease May reduce the need for glaucoma medication
Can cause urinary retention
The nurse is caring for a client who is taking enalapril for hypertension. Which client statement should the nurse report to the health care provider? "My heartburn has been bothering me more since I started taking this medication." "I have been trying to pay closer attention to the types of food that I eat." "I stopped taking my nasal decongestant when I started this medication." "I have developed a dry, hacking cough that I cannot get to go away."
"I have developed a dry, hacking cough that I cannot get to go away."
What statement presented by the client prescribed albuterol for asthma will the nurse identify as an unexpected clinical manifestation of this drug? "I seem to have blurred vision anytime that I administer this drug to myself." "I have noticed that my heart feels like it is racing away after I take this drug." "Whenever I take this drug I notice that I just cannot fall asleep at night." "My hands get a little shaky after I take this drug, even if I take it just once."
"I seem to have blurred vision anytime that I administer this drug to myself."
Which is the priority information for the nurse to obtain from a client presenting to the emergency department with substernal chest pain of 8/10, diaphoresis, and a room air oxygen of 90%? A thorough medication history Insurance coverage information Social history, including alcohol use Use of supplemental oxygen in the home
A thorough medication history
Which antihypertensive medication class would the nurse identify as the likely cause of the cough in a client taking multiple medications for hypertension who develops a persistent hacking cough? Thiazide diuretics ACE inhibitors Calcium channel blockers Direct renin inhibitors
ACE inhibitor
A client had a heart catheterization with a stent earlier today. The healthcare provider prescribed abciximab for the client? Why was this medication prescribed for this client? Abciximab is a glycoprotein receptor inhibitor and stops platelet aggregation inhibiting the binding of fibrinogen. It was prescribed to help keep the client's stent open. Abciximab is a new oral anticoagulant that lowers the risk of bleeding. It was prescribed to help keep the client's stent open. Abciximab is an antiplatelet. It prevents platelet aggregation and prevents clots. It was prescribed to keep the client's stent open. Abciximab is a clot buster. It was prescribed to keep the client's stent open.
Abciximab is a glycoprotein receptor inhibitor and stops platelet aggregation inhibiting the binding of fibrinogen. It was prescribed to help keep the client's stent open.
Which measure would the nurse take when administering enoxaparin subcutaneously? Push over 2 minutes Administer in the abdomen Massage the site after administration Remove air pocket from prepackaged syringe before administration
Administer in the abdomen
The nurse is caring for a client who has been prescribed a diuretic to manage hypertension. The nurse should caution the client about use of which type of over-the-counter medication? SATA Cold medications Nasal decongestants Ibuprofen Antacids Acetaminophen
All
Which of the client's medications should the nurse suspect of new onset tinnitus? Digoxin 0.25 mg, one tab daily Aspirin 325 mg, two tabs every 4 hrs Captopril 25 mg, one tab 3x daily Diphenhydramine 25 mg, one tab every 4-8 hrs prn
Aspirin 325 mg, two tabs every 4 hrs
Which effect would the nurse anticipate after captopril is prescribed for a client? Increased urine output Decreased anxiety Improved sleep Decreased blood pressure
Decreased blood pressure
Which best indicates effective nitroglycerin therapy in a client admitted with a myocardial infarction awaiting transport to the cath lab? Increased troponin levels Increased blood pressure Decreased chest pain Decreased headache
Decreased chest pain
Which response indicated that a beta blocker prescribed for persistent ventricular tachycardia is working effectively? Decreased anxiety Reduced chest pain Decreased heart rate Increased blood pressure
Decreased heart rate
Which intervention would the nurse implement for a client admitted for an exacerbation for asthma? Determine the clients emotional state. Give prescribed medications to promote bronchiolar dilation. Provide education about the effect of a family history. Encourage the client to use an incentive spirometer routinely.
Give prescribed medications to promote bronchiolar dilation.
The nurse identifies which anticoagulant medications as safe to administer during pregnancy for treatment of thrombophlebitis? SATA Heparin Warfarin Enoxaparin Clopidogrel Acetylsalicylic acid
Heparin Enoxaparin
Which medication would the nurse anticipate being prescribed by the primary health care provider to treat who is being treated for pruritus but complains of sedation? Loratadine Hydroxyzine Diphenhydramine Triamcinolone acetonide
Loratadine
The nurse is caring for a client with uncontrolled hypertension who develops atrial fibrillation with rapid ventricular response. The nurse anticipates that the health care provider will order which medication? Lisinopril Metoprolol Digoxin Apixaban
Metoprolol
The nurse is caring for a client with a new prescription for amlodipine. Which information is most important for the nurse to include in the medication teaching plan? Take medication on an as-needed basis Keep a food journal to document meals Use electric shavers rather than razors Move slowly when changing positions
Move slowly when changing positions
Which response indicated that sublingual nitroglycerin prescribed for a client with unstable angina is effective? Capacity for activity improves as a response to increased collateral circulation. Pulse rate increases because the cardiac output has been stimulated. Pain subsides as a result of arteriole and venous dilation. Sublingual area tingles because sensory nerves are being triggered.
Pain subsides as a result of arteriole and venous dilation.
Which action would the nurse perform when administering fluticasone propionate to a client with asthma? Assessing heart rate and rhythm Monitoring liver function blood tests Rinsing the oral cavity with water after use Obtaining blood glucose levels before meals
Rinsing the oral cavity with water after use
Which teaching is accurate when instructing a client about sublingual nitroglycerin if chest pain is experienced at home? SATA Stop what you are doing and sit down. First call 911, then take pills as instructed. Take the pill with a full glass of water. Simultaneously place three pills under the tongue. Store the pills in the dark colored, original container.
Stop what you are doing and sit down. Store the pills in the dark colored, original container.
Recognizing that the client prescribed theophylline for the treatment of bronchitis is at risk for toxicity, which clinical manifestation will alert the nurse to this occurrence? SATA Loss of appetite Drowsiness Restlessness Onset of seizures Insomnia
Loss of appetite Restlessness Onset of seizures Insomnia
The nurse is caring for a client with an abnormal heart rhythm. The nurse anticipates that the provider will order which type of medication? Negative chronotropic medication Positive chronotropic medication Positive inotropic medication Negative dromotropic medication
Negative dromotropic medication
After change of shift report, which client would the nurse assess first? A client with possible lung cancer who is scheduled for bronchoscopy. A client with left pleural effusion who is scheduled for a thoracentesis. A client with hospital acquired pneumonia and decreased breath sounds. A client with an acute asthma exacerbation and 85% oxygen saturation.
A client with an acute asthma exacerbation and 85% oxygen saturation.
The nurse is caring for multiple clients. Which client would benefit the most from receiving a negative inotropic medication? A client with asthma A client with high cholesterol A client with angina A client with chronic kidney disease
A client with angina
Which medication is often contraindicated when taking warfarin? Atenolol Ferrous sulfate Chlorpromazine Acetylsalicylic acid
Acetylsalicylic acid
Prior to the administration of a second dose of aminophylline to the client admitted to the hospital for acute bronchitis, what priority assessment will the nurse implement? Assess the client's sleep pattern Assess the client's appetite Assess the client's heart rate Assess the client's blood pressure
Assess the client's heart rate
Which medication would a nurse conclude is the cause of a decreased heart rate in a client receiving cardiac glycoside, a diuretic, an ACE inhibitor, and a vasodilator? Diuretic Vasodilator ACE inhibitor Cardiac glycoside
Cardiac glycoside
Which information will the nurse include when teaching a client with hypertension about metoprolol? Do not abruptly discontinue the medication Consume alcoholic beverages in moderation Report a heart rate of less than 70 bpm Increase the medication dosage if chest pain occurs
Do not abruptly discontinue the medication
Which adverse effect of warfarin will the nurse identify as a reason for a client with a partial occlusion of the left common carotid artery to seek medical consultation? SATA Hematuria Hemoptysis Delayed clotting from minor cuts Bleeding from gums when brushing teeth Vomiting coffee-ground emesis
Hematuria Hemoptysis Vomiting coffee-ground emesis
The nurse administers a scheduled dose of propranolol to a client. Which findings would indicate that the medication has been effective when the nurse reassesses the client an hour later? Initial blood pressure 162/94 mm/Hg, repeat blood pressure 128/70 mm/Hg Initial heart rate 54 bpm and irregular, repeat heart rate 88 bpm and regular Initial blood pressure 88/42 mm/Hg, repeat blood pressure 118/60 mm/Hg Initial hourly urine output 20 mL, repeat hourly urine output 52 mL
Initial blood pressure 162/94 mm/Hg, repeat blood pressure 128/70 mm/Hg
When the nurse is evaluating a client with an acute asthma attack who has just received a nebulized bronchodilator treatment, which finding requires the MOST rapid nursing action? Continued high-pitched expiratory wheezes Use of pursed-lip breathing during expiration Labored breathing and absent breath sounds Hyperresonance to percussion of posterior chest
Labored breathing and absent breath sounds
The nurse is caring for a client with a heart rate of 48 beats per minute who is exhibiting mental status changes. The client receives a dose of atropine. The nurse is aware that the primary goal of this medication is to accomplish which action? Increase the client's systolic blood pressure to greater than 100 mm of Hg. Restore the client's heart rhythm to normal sinus rhythm. Eliminate progression of manifestations associated with symptomatic bradycardia. Remove aberrant electrical pathways causing abnormal heart rhythms.
Restore the client's heart rhythm to normal sinus rhythm.
The nurse is caring for a client with a critically high digoxin level that is experiencing significant changes in cardiac rhythm. The health care provider orders digoxin immune Fab. Which changes best indicate that this medication is working effectively? The client's blood sugar decreases to 140 mg/dL. The client reports clearer vision and fewer palpitations. The client's systolic blood pressure increases from 84 to 110 mmHg. The client's serum sodium level increases from 132 to 135 mEq/L.
The client reports clearer vision and fewer palpitations.
The nurse is caring for multiple clients who are each scheduled to receive a dose of propranolol. For which client should the nurse withhold the medication and contact the health care provider? The client with atrial fibrillation who reports chest discomfort The client with hypertension who reports dizziness The client with portal hypertension who reports nausea The client with asthma who reports increased wheezing
The client with asthma who reports increased wheezing
Which common early indication of acute digoxin toxicity would a nurse teach a client to be alert for? Urticaria Photophobia Vomiting Respiratory distress
Vomiting
An adolescent prescribed loratadine 10 mg daily for hay fever is concerned the medication will cause drowsiness during the school day. Which action would the nurse take? Explain this medication rarely causes drowsiness Advise to take half a tablet in the morning before school Suggest skipping the next day's dose if hay fever is better Recommend contacting the allergist for a prescription containing a stimulant
Explain this medication rarely causes drowsiness
Which information about a client who has heart failure would the nurse communicate to the health care provider before administration of the prescribed digoxin? Apical pulse rate 96 bpm Bilateral foot and ankle pitting edema Crackles heard at the base of both lungs Potassium level of 2.3 mEq/L
Potassium level of 2.3 mEq/L
Which instruction regarding the use of fluticasone nasal spray is appropriate for client teaching? SATA Use the medication on a regular basis, not PRN. Clear the nasal passages before using the medication. Discontinue the use of the medication if nasal infection develops. Remember that driving may be dangerous because of the medications sedative effect. Begin taking the medication 2 weeks before pollen season starts, and use it throughout the season.
Use the medication on a regular basis, not PRN. Clear the nasal passages before using the medication. Discontinue the use of the medication if nasal infection develops.
The nurse is caring for a client who is receiving losartan. Which statement indicates that the client correctly understands the nurse's teaching about this medication? "I should make sure to eat extra bananas and potatoes." "I should avoid public gatherings or situations with large crowds." "I should limit activities and allow extra time in the day for rest." "I will make sure to change positions slowly and carefully."
"I will make sure to change positions slowly and carefully."
The parent expresses frustration to the nurse that the montelukast just isn't working though she has been giving it to her child nightly for the past 3 nights. The nurse correctly educates the mother with which correct statement? "It may not be the correct medication for your child's asthma symptoms" "It takes 1-2 weeks to see a therapeutic response from the medication." "I will notify the provider, he may need a higher dosage of medication." "Stop giving the medication if it is not working for your child."
"It takes 1-2 weeks to see a therapeutic response from the medication."
The nurse is caring for a client with cardiogenic shock. The health care provider orders that the client be placed on a dobutamine drip. The nurse understands that the goal of this medication is to produce which outcome? Resolution of atrial fibrillation Increased cardiac output Return to normal sinus rhythm Decreased heart rate and blood pressure
Increased cardiac output
Why would the nurse advise the client who takes furosemide and digoxin for heart failure to drink a glass of orange juice every day? Maintaining potassium levels Preventing increased sodium levels Limiting the medications' synergistic effects Correcting the associated dehydration
Maintaining potassium levels
