Pharm Exam 2
Teaching: Codeine
change position slowly
A nurse is assessing a client prior to administering atenolol. Which of the following findings should prompt the nurse to withhold the medication? A. Heart rate 46/min B. Oxygen saturation 95% C. Respiratory rate 18/min D. Blood pressure 160/94 mm Hg
A. Heart rate 46/min
Priority indication of Magnesium sulfate toxicity
Respiratory depression
Albuterol contraindication
Hypertension
Indications for Procainamide IV
Treat a-fib (these treat dysrhythmias)
Which antihypertensive medication has a side effect of cough?
Lisinopril (ending in -pril = ACE inhibitor)
To be monitored when taking -statins
Liver function
Best time to administer Furosemide
0800
Digoxin toxicity will occur at what serum blood level?
2.0 ng/mg and above
Digoxin toxicity: first sign
Anorexia
Expectorant to treat a cough: Expected action?
Stimulates secretions
Assessment data would be a priority for -statins
Jaundice
Contraindication of Propranolol
Asthma
Potential adverse effect of smoking cannabis
Exacerbation of asthma
Diphenhydramine side effect
Sedation
A nurse is assessing a client who is taking amiodarone to treat atrial fibrillation. Which of the following findings is a manifestation of a serious amiodarone complication?
dyspnea, cough, chest pain
A nurse is teaching a client who has a new prescription for captopril. Which of the following instructions should the nurse include in the teaching? A. Monitor for a cough. B. Hold medication for heart rate less than 60/min. C. Take this medication with food. D. Avoid grapefruit juice.
A. Monitor for a cough.
Potassium administration parameter
Cardiac monitoring
Verapamil by IV bolus to a client who is having cardiac dysrhythmias ...important side effect to monitor
Hypotension
A nurse is caring for a client who has heart failure and a prescription for digoxin. Which of the following statements by the client indicates an adverse effect of the medication? A. "I can walk a mile a day." B. "I've had a backache for several days." C. "I am urinating more frequently." D. "I feel nauseated and have no appetite."
"I feel nauseated and have no appetite."
A nurse is assessing a client who is receiving dopamine IV to treat left ventricular failure. Which of the following findings should indicate to the nurse that the medication is having a therapeutic effect? A. Systolic blood pressure is increased B. Cardiac output is reduced C. Apical heart rate is increased D. Urine output is reduced
A. Systolic blood pressure is increased
Why is Lidocaine administered post cardiac event?
prevents dysrthymias
A nurse is teaching about the use of space with the parent of a child who is prescribed an inhaled medication via metered dose inhaler. Which of the following information should the nurse include in the teaching?
"Using a spacer will allow more of the medication to reach your child's lungs."
A client who is taking digoxin would withhold the drug is his pulse rate were which of the following?
56 beats /minute
A nurse on a telemetry unit is caring for a client who has unstable angina and is reporting chest pain with a severity of 6 on a 0 to 10 scale. The nurse administers 1 sublingual nitroglycerin tablet. After 5 min, the client states that his chest pain is now a severity of 2. Which of the following actions should the nurse take? A. Administer another nitroglycerin tablet. B. Initiate a peripheral IV. C. Call the Rapid Response Team. D. Obtain an ECG.
A. Administer another nitroglycerin tablet.
A nurse is providing teaching to a client who has stable angina and a new prescription for transdermal nitroglycerin. Which of the following instructions should the nurse include? (Select all that apply.) A. Apply the patch to a hairless area and rotate sites. B. Apply a new patch each morning. C. Remove the patch for 10 to 12 hr daily. D. Apply the patch to dry skin and cover the area with plastic wrap. E. Apply a new patch at the onset of anginal pain.
A. Apply the patch to a hairless area and rotate sites. B. Apply a new patch each morning. C. Remove the patch for 10 to 12 hr daily.
Assessment prior to administration of Metoprolol
BP and HR
Manifestations of a serious Amiodarone complication?
Cough
What sign is most indicative of dehydration in a client taking diuretics?
Decreased body weight
Severe adverse reactions associated with Theophylline
Seizures and arrhythmias
A nurse is teaching a client about taking an expectorant to treat a cough. The nurse should explain that this type of medication has which of the following actions?
Stimulates secretions
The charge nurse on the unit walks by one of the new nurse's rooms. What would require the charge nurse to stop and intervene immediately?
The charge nurse sees the nurse administering potassium chloride as intravenous push
You are visiting an 80-year-old patient in her home. She is receiving 0.125 of oral digoxin (Lanoxin) daily. She also takes hydrochlorothiazide 50 mg B.I.D. She complains of blurred vision and nausea. You observe she is confused and disoriented at times. Which of the following might be the problem?
The patient may have digitalis toxicity
A nurse is providing instructions to a client who has a new prescription for sublingual nitroglycerin (Nitrostat) to treat angina pectoris. Which of the following instructions should the nurse include? A. "Place the tablet under your tongue, and then take a small sip of water." B. "The medication can take up to 15 minutes to take effect." C. "Avoid taking the medication prior to exercising." D. "Stop taking the medication and notify your provider if you develop a headache."
A. "Place the tablet under your tongue, and then take a small sip of water."
A nurse is teaching a client who has a new prescription for colesevelam to lower his low-density lipoprotein level. Which of the following instructions should the nurse include? A. "Take this medication 4 hr after other medications." B. "Reduce fluid intake." C. "Take this medication on an empty stomach." D. "Chew tablets before swallowing."
A. "Take this medication 4 hr after other medications."
A nurse is teaching a client who has hypertension and a new prescription for atenolol. Which of the following findings should the nurse include as adverse effects of this medication? A. Bradycardia B. Tremor C. Cough D. Constipation
A. Bradycardia
A client who is receiving magnesium sulfate has a urine output of 20 mL/hr. Which of the following medications should the nurse expect to administer? A. Calcium gluconate B. Flumazenil C. Naloxone D. Protamine
A. Calcium gluconate
A nurse is providing teaching to a client who has hypertension and a new prescription for captopril. Which of the following instructions should the nurse provide? A. Do not use salt substitutes while taking this medication. B. Take the medication with food. C. Count your pulse rate before taking the medication. D. Expect to gain weight while taking this medication.
A. Do not use salt substitutes while taking this medication.
A nurse on an oncology unit is preparing to administer doxorubicin to a client who has breast cancer. Prior to beginning the infusion, the nurse verifies the client's current cumulative lifetime dose of the medication. For which of the following reasons is this verification necessary? A. An excess amount of doxorubicin can lead to myelosuppression B. Exceeding the lifetime cumulative dose limit of doxorubicin might cause extravasation. C. An excess amount of doxorubicin can lead to cardiomyopathy. D. Exceeding the lifetime cumulative dose limit of doxorubicin might produce red tinged urine and sweat.
An excess amount of doxorubicin can lead to cardiomyopathy.
A nurse in the emergency department is caring for a client who took 3 nitroglycerin tablets sublingually for chest pain. The client reports relief from the chest pain but now he is experiencing a headache. Which of the following statements should the nurse make? A. "A headache is an indication of an allergy to the medication." B. "A headache is an expected adverse effect of the medication." C. "A headache indicates tolerance to the medication." D. "A headache is likely due to the anxiety about the chest pain."
B. "A headache is an expected adverse effect of the medication."
A nurse is providing teaching to a client who has a new prescription for transdermal nitroglycerin paste. Which of the following statements by the client indicates the need for further teaching? A. "I should measure the dosage on the supplied paper." B. "I should leave the patch in place until it is time for the next dose." C. "I should get up slowly when I stand." D. "I might have a headache when I first start taking this medication."
B. "I should leave the patch in place until it is time for the next dose."
A nurse is reviewing the medical record of a client who has hypertension and a new prescription for metoprolol. Which of the following findings should the nurse investigate further? A. Diet-controlled Type 2 diabetes mellitus B. A history of left-sided heart failure client to watch for signs of increasing left-sided heart failure, such as shortness of breath and weight gain indicating fluid retention, and report these findings to the provider. C. A concurrent prescription for tadalafil D. Recently treated bilateral pneumonia
B. A history of left-sided heart failure
A nurse is providing discharge teaching to a client who has a new prescription for verapamil for angina. Which of the following instructions should the nurse include? A. "Limit your fluid intake to meal times." B. "Do not take this medication on an empty stomach." C. "Increase your daily intake of dietary fiber." D. "You can expect swelling of the ankles while taking this medication."
C. "Increase your daily intake of dietary fiber."
A nurse is caring for a client who has atrial fibrillation and receives digoxin daily. Before administering this medication, which of the following actions should the nurse take? A. Offer the client a light snack. B. Measure the client's blood pressure. C. Measure the client's apical pulse. D. Weigh the client.
C. Measure the client's apical pulse.
A nurse is caring for a client who has atrial fibrillation and receives digoxin daily. Before administering this medication, which of the following actions should the nurse take? A. Offer the client a light snack. B. Measure the client's blood pressure. C. Measure the client's apical pulse. D. Weigh the client.
C. Measure the client's apical pulse.
A nurse is caring for a client who has a new prescription for propranolol. The nurse should monitor the client for which of the following adverse reactions to this medication? A. Ototoxicity B. Tachycardia C. Postural hypotension D. Hypokalemia
C. Postural hypotension
A nurse is providing instruction to a new nurse about caring for clients who are receiving diuretic therapy to treat heart failure. The nurse should explain that which of the following medications puts clients at risk for both hyperkalemia and hyponatremia? A. Furosemide B. Hydrochlorothiazide C. Metolazone D. Spironolactone
D. Spironolactone
5.A nurse is providing teaching to a client who has stable angina and a new prescription for nitroglycerin oral, sustained-release capsules. Which of the following instructions should the nurse include? A. Take 1 capsule at the onset of anginal pain. B. Stop taking the medication if side effects are troublesome. C. Take the medication with meals. D. Swallow the capsules whole.
D. Swallow the capsules whole.
Hypertensive crisis: which diuretic do you administer?
Furosemide (can be admin rapidly)
When combined with Furosemide, it is likely to increase the risk of hearing loss
Gentamicin
The client is receiving a simvistatin drug. Which assessment data would be a priority for the nurse to report to the physician?
Jaundice
A nurse is caring for a client who has thrombophlebitis and is receiving heparin by continuous IV infusion. The client asks the nurse how long it will take for the heparin to dissolve the clot. Which of the following responses should the nurse give? A. "It usually takes heparin at least 2 to 3 days to reach a therapeutic blood level." B. "A pharmacist is the person to answer that question." C. "Heparin does not dissolve clots. It stops new clots from forming." D. "The oral medication you will take after this IV will dissolve the clot."
"Heparin does not dissolve clots. It stops new clots from forming."
A nurse is caring for a client who has heart failure and a prescription for digoxin. Which of the following statements by the client indicates an adverse effect of the medication?
"I feel nauseated and have no appetite"
The client calls the nurse and frantically states "I think something is wrong! My stools are black and they have never been this color before!" The client recently started taking ferrous sulfate. What is the best response by the nurse?
"This is an expected side effect of the ferrous sulfate, it is okay."
Side effect of Hydrochlorothiazide
Hypokalemia
A nurse in a provider's clinic is assessing a client who takes sublingual nitroglycerin for stable angina. The client reports getting a headache each time he takes the medication. Which of the following statements should the nurse make? A. "Take only one dose of nitroglycerin to reduce the risk of getting a headache." B. "There's nothing that can be done to relieve the headaches that nitroglycerin causes." C. "Try taking a mild analgesic to relieve the headache." D. "We will ask the provider to prescribe a different medication for you."
C. "Try taking a mild analgesic to relieve the headache."
The physician tells you that a patient is hypokalemic. He has been taking a thiazide medication for treatment of his high blood pressure. You will instruct him to increase his dietary intake of which of the following? Select all that apply.
Green leafy vegetables Bananas and citrus fruit Low-fat products
A nurse is preparing to administer verapamil by IV bolus to a client who is having cardiac dysrhythmias. For which of the following adverse effects should the nurse monitor when giving this medication? A. Hyperthermia B. Hypotension C. Ototoxicity D. Muscle pain
Hypotension
What is a priority nursing intervention for a client who has just begun antihypertensive treatment with Losartan?
Take the clients blood pressure
Therapeutic effect of IV Dopamine
increased urinary output
A nurse in a coronary care unit is admitting a client who has had CPR following a cardiac arrest. The client is receiving lidocaine IV at 2 mg/min. When the client asks the nurse why he is receiving that medication, the nurse should explain that it has which of the following actions? A. Prevents dysrhythmias B. Slows intestinal motility C. Dissolves blood clots D. Relieves pain
A. Prevents dysrhythmias
A nurse is providing teaching for a client who has hypertension and a prescription change from metoprolol to metoprolol/hydrochlorothiazide. Which of the following statements by the client indicates an understanding of the teaching? A. "Now I will not have to diet to lose weight." B. "With the new medication, I should experience fewer side effects." C. "I will not have to do anything different because it is the same medication." on of the diuretic in the combination drug. D. "The extra letters after the name of medication means it is a stronger dose."
B. "With the new medication, I should experience fewer side effects."
A nurse is teaching a client who has a new prescription for simvastatin. Which of the following instructions should the nurse include? A. "You should expect brown-colored urine." B. "You should avoid grapefruit juice." C. "You should monitor for ringing in the ears." D. "You should take the medication in the morning."
B. "You should avoid grapefruit juice."
A nurse is teaching a client who has a new prescription for transdermal nitroglycerin to treat angina pectoris. Which of the following instructions should the nurse include in the teaching? A. Apply a new transdermal patch once a week. B. Apply the transdermal patch in the morning. C. Apply the transdermal patch in the same location as the previous patch. D. Apply a new transdermal patch when chest pain is experienced.
B. Apply the transdermal patch in the morning.
A nurse is providing discharge teaching for a client who has pulmonary edema and is about to start taking furosemide. Which of the following instructions should the nurse include? A. Take aspirin if headaches develop. B. Eat foods that contain plenty of potassium. C. Expect some swelling in the hands and feet. D. Take the medication at bedtime.
B. Eat foods that contain plenty of potassium.
.A nurse is preparing to administer verapamil by IV bolus to a client who is having cardiac dysrhythmias. For which of the following adverse effects should the nurse monitor when giving this medication? A. Hyperthermia B. Hypotension C. Ototoxicity D. Muscle pain
B. Hypotension
A nurse is assessing a client who is receiving a continuous IV infusion of dopamine. Which of the following findings should the nurse recognize as a therapeutic effect? A. Increased pulse B. Increased urine output C. Decreased blood pressure D. Decreased dysrhythmias
B. Increased urine output
A nurse at a provider's office receives a phone call from a client who reports nausea and unrelieved chest pain after taking a nitroglycerin tablet 5 min ago. Which of the following is an appropriate response by the nurse? A. Tell the client to take an antacid. B. Instruct the client to call 911. C. Tell the client to take another nitroglycerin tablet in 15 min. D. Advise the client to come to office.
B. Instruct the client to call 911.
A nurse is teaching with a group of nurses about the administration of nitroglycerin. Which of the following routes of administration provides the most rapid onset for the client? A. Transdermal patch B. Sublingual C. Suspended-release D. Topical ointment
B. Sublingual
A nurse is caring for a client who has congestive heart failure and is taking digoxin daily. The client refused breakfast and is complaining of nausea and weakness. Which of the following actions should the nurse take first? A. Check the client's vitals B. Request a dietitian consult C. Suggest that the client rests before eating the meal D. Request an order for an antiemetic
Check the client's vital signs
A nurse is caring for four clients. After administering morning medications, she realizes that the nifedipine prescribed for one client was inadvertently administered to another client. Which of the following actions should the nurse take first? A. Notify the client's provider. B. Check the client's vital signs. C. Fill out an occurrence form. D. Administer the medication to the correct client.
Check the client's vital signs.
A nurse is providing teaching to a client who has angina pectoris and a new prescription for nitroglycerin sublingual tablets. Which of the following statements by the client indicates an understanding of the teaching? A. "I'll dial 911 if I still have pain after taking 3 nitroglycerin tablets 5 minutes apart." B. "I'll dial 911 if I still have pain after taking 4 nitroglycerin tablets over a 20-minute period." C. "I'll dial 911 when I have pain and then take the nitroglycerin tablets." D. "I'll dial 911 if 1 nitroglycerin tablet does not relieve my pain, and then take up to 2 more tablets 5 minutes apart while waiting."
D. "I'll dial 911 if 1 nitroglycerin tablet does not relieve my pain, and then take up to 2 more tablets 5 minutes apart while waiting."
A nurse is teaching a client who has angina about nitroglycerin sublingual tablets. Which of the following statements should the nurse include in the teaching? A. "Place one tablet under your tongue every 5 minutes for 30 minutes to relieve chest pain." B. "Nitroglycerin decreases chest pain by dissolving blood clots that are occluding the arteries." C. "You can store the bottle of tablets in your bathroom medicine cabinet." D. "Nitroglycerin dilates cardiac blood vessels to deliver more oxygen to the heart."
D. "Nitroglycerin dilates cardiac blood vessels to deliver more oxygen to the heart."
A nurse is providing discharge teaching to a client who has a new prescription for verapamil for angina. Which of the following instructions should the nurse include? A. "Limit your fluid intake to meal times." B. "Do not take this medication on an empty stomach." C. "Increase your daily intake of dietary fiber." D. "You can expect swelling of the ankles while taking this medication."
C. "Increase your daily intake of dietary fiber."
A nurse is preparing to administer verapamil by intravenous bolus to a client who is having cardiac dysrhythmias. For which of the following adverse effects should the nurse monitor when giving this medication?
Hypotension
Why do we administer Mannitol slowly?
prevent fluid overload
A nurse on a medical unit is planning care for an older adult client who takes several medications. Which of the following prescribed medications places the client at risk for orthostatic hypotension? (Select all that apply.) A. Furosemide B. Telmisartan C. Duloxetine D. Clopidogrel E. Atorvastatin
A. Furosemide B. Telmisartan C. Duloxetine
A nurse is assessing an older adult client who is receiving digoxin. The nurse should recognize that which of the following findings is a manifestation of digoxin toxicity? A. Anorexia B. Ataxia C. Photosensitivity D. Jaundice
Anorexia
A nurse is teaching a client who has angina pectoris about starting therapy with SL nitroglycerin tablets. The nurse should include which of the following instructions regarding how to take the medication? A. "Take this medication after each meal and at bedtime." B. "Take one tablet every 15 min during an acute attack." C. "Take one tablet at the first indication of chest pain." D. "Take this medication with 8 ounces of water."
C. "Take one tablet at the first indication of chest pain."
A nurse is preparing to administer digoxin to a client who has heart failure. Which of the following actions is appropriate? A. Withholding the medication if the heart rate is above 100/min B. Instructing the client to eat foods that are low in potassium C. Measuring apical pulse rate for 30 seconds before administration D. Evaluating the client for nausea, vomiting, and anorexia
D. Evaluating the client for nausea, vomiting, and anorexia
A nurse is providing teaching to a client who has hypertension and a new prescription for verapamil. Which of the following beverages should the nurse tell the client to avoid while taking this medication? A. Milk B. Orange juice C. Coffee D. Grapefruit juice
D. Grapefruit juice
A nurse is caring for a client who is taking lisinopril. Which of the following outcomes indicates a therapeutic effect of the medication? A. Decreased blood pressure B. Increase of HDL cholesterol C. Prevention of bipolar manic episodes D. Improved sexual function
Decreased blood pressure