pharm exam 4 lots of prepu
A 44-year-old warehouse worker experienced a painful lower back injury that has not responded to treatment with nonsteroidal anti-inflammatory drugs. Consequently, the man's care provider is considering the short-term use of cyclobenzaprine (Flexeril). Which of the following assessment questions would inform the clinician's decision to prescribe this drug?
"Are you taking antidepressant medications these days?"
A client prescribed corticosteroids following a liver transplant asks if it will be necessary to take this medication indefinitely. How should the nurse respond?
"Daily antirejection drug therapy will continue for as long as your transplanted liver is in place."
A client diagnosed with heart disease is prescribed an antiarrhythmic drug. Further teaching is needed when the client makes which statement?
"I know I must take my medication every day for my heartbeat to be fixed."
A nurse is caring for a client who is receiving a corticosteroid for arthritic pain. Which statement made by the client would raise concern about medication dosage revision?
"I recently lost my health care coverage and need to look for another job."
A nurse is teaching a client about musculoskeletal medication that has been prescribed. The client needs further teaching about the medication when making which statements?
"I take my medicine with three to four beers each evening."
The nurse just completed client education relative to chronic adrenocortical insufficiency and corticosteroid medication treatment. Which statement indicates the client requires further instruction?
"I will start this medication as soon as I am feeling ill or tired."
The nurse educates a client recently diagnosed with hypothyroidism about using the prescribed levothyroxine. The client has a history of diabetes. Which client statement establishes the need for further clarification?
"It does not matter which brand of the drug I take, they are all the same."
A female client with hyperthyroidism reports nervousness and "racing" heart one week after starting antithyroid medication. How should the nurse respond to the client's report?
"It may take three to four weeks for the effects of this medication to be seen."
The home health nurse provides client teaching to a client who is taking oral prednisolone. The nurse provides what instruction to the client?
"Take it first thing in the morning."
While the nurse is preparing the client for discharge, the client asks why the health care provider has prescribed prednisone every other day instead of daily. What would be the nurse's best response?
"Taking it every other day minimizes adverse effects."
A client who is experiencing lower back pain has been prescribed cyclobenzaprine. The nurse should provide what health education in order to ensure safe and effective treatment?
"This will likely make you drowsy, so don't take it before doing anything that would require alertness."
A client reports difficulty swallowing an antiarrhythmic capsule. What is the nurse's best response?
"You can try a different form of the medication."
The nurse administers a bolus of lidocaine to a client with a life-threatening ventricular arrythmia and follows it with a continuous infusion at what rate?
1 to 4 mg/min
Methimazole (Tapazole) 30 mg /day orally divided in 3 doses is prescribed for a client diagnosed with Graves' disease. The pharmacy has 5 mg tablets available. How many tablets should the nurse administer with each dose?
2
A client has been prescribed a daily dose of 7.5 mg of bromocriptine mesylate for dizziness. The available drug is in the form of 2.5-mg tablets. How many tablets will be administered to the client to meet the recommended course for 4 days?
12
The circulating nurse in the operating room is aware that a client receiving enflurane (Ethrane) for abdominal surgery may require which additional medication for adequate muscle relaxation?
Succinylcholine (Anectine)
A nurse is monitoring the drug level of a client receiving quinidine. Which serum drug level would the nurse immediately report to the primary health care provider?
6.2 mcg/mL
During the first year of somatropin treatment, children can increase their yearly growth rate to which amount?
8 to 10 cm/yr
Which client demonstrates the clearest indication for treatment with prednisone?
A 70-year-old man whose rheumatoid arthritis has not responded to OTC pain relievers
A nurse is preparing to administer flecainide. The nurse identifies this drug as being classified as which type of antiarrhythmic?
Class IC
What should the nurse assess to determine the hemodynamic effect of the client's arrhythmia?
Client's blood pressure and pulse rate
A client learning to self-administer desmopressin subcutaneously should be taught to administer the injection at which site?
Abdomen
After reviewing antiarrhythmic drugs, a group of nursing students demonstrate understanding of the drugs when they identify which as a class II antiarrhythmic? Select all that apply.
Acebutolol Propranolol
A group of students are reviewing the contraindications for glucocorticoid therapy. The students demonstrate understanding when they identify which condition?
Acute infection
The nurse is working in collaboration with a nurse anesthetist to assess a preoperative client. When addressing the client's risk for malignant hyperthermia as a result of neuromuscular junction blockers, what assessment should be prioritized?
Assessing for a family history of malignant hyperthermia
A client with spinal cord injury is experiencing muscle spasticity. Which agent would most likely be ordered?
Baclofen
A nurse understands that which skeletal muscle relaxants should not be administered to a client with skeletal muscle spasms caused by systemic lupus erythematosus?
Baclofen
Which medication would the nurse expect to administer if prescribed to achieve skeletal muscle relaxation?
Baclofen
A child is receiving growth hormone therapy. The nurse suspects possible thyroid dysfunction based on which assessment?
Cold intolerance
Which would be used to diagnose adrenal function?
Corticotropin
What would expected findings during an assessment of a client with hyperthyroidism include? (Select all that apply.)
Increased appetite Tachycardia Goiter
The client with hypothyroidism takes levothyroxine daily and has triiodothyronine (T3), thyroxine (T4), and thyroid-stimulating hormone (TSH) levels drawn in the laboratory to check appropriateness of prescribed dosage. What results would the nurse analyze as indicating the need for a higher dosage of medication?
Elevated TSH, reduced T3 and T4 levels
You are caring for a client with cerebral edema caused by trauma. Which of the following medications would you anticipate being administered?
Dexamethasone
The client is taking baclofen. What would be the most important safety instruction for the nurse to give to this client?
Discontinue the use of alcohol.
When planning care for a client prescribed a growth hormone antagonist, the nurse should monitor for which possible adverse effect? (Select all that apply.) c
Dizziness Glucose intolerance Nausea Headache
What is the most important teaching from the plan of care, to emphasize, when a client is prescribed a skeletal muscle relaxant?
Do not drive or operate machinery until individual drug effects are known.
A nurse administers carisoprodol to a client for the treatment of an acute musculoskeletal condition. The nurse would be alert for which adverse effect after administering the drug?
Drowsiness
The nurse should monitor a client for which effect of a drug interaction in a client taking thyroid hormones and a beta blocker?
Tachycardia
A nurse should recognize that a client taking antithyroid medication may be developing thyrotoxicosis if the client exhibits which of the following symptoms?
Extreme tachycardia
An older adult resident of a long-term care facility is experiencing muscle spasticity and has just been prescribed a centrally acting skeletal muscle relaxant. The client has comorbidities of early stage Alzheimer's disease and chronic obstructive pulmonary disease (COPD). What nursing action should the nurse prioritize for adding to the client's care plan?
Falls prevention measures
After teaching a group of students about mineralocorticoids, the instructor determines that the teaching was successful when they state which agent as an example?
Fludrocortisone
The nurse is preparing to administer a scheduled dose of levothyroxine to a client. What assessment should the nurse perform prior to giving the drug?
Heart rate
A newborn is diagnosed with hypothyroidism. What will the client likely develop if the condition is left untreated?
Intellectual disability
A nurse is caring for a client for whom the healthcare provider has ordered disopyramide. Before administering disopyramide, what is the nurse's priority action to maintain safety?
Lower the bed and raise the side rails.
A client, diagnosed with hypothyroidism, is currently taking an opioid for knee pain. This client is at increased risk for developing which adverse reaction?
Myxedema coma
A 32-year-old client who has been prescribed levothyroxine is being discharged. Which symptom should the nurse instruct this client to report to the health care provider?
Nervousness
A client is brought to the emergency department after taking an overdose of levothyroxine. When assessing this client, what adverse effects would the nurse expect to find?
Nervousness and tachycardia
A 47-year-old female client with is admitted to a medical unit for exacerbation of asthma. The client has a BMI of 22 and no other health problems. The client is being treated with steroid therapy. The client asks why she cannot just stay on the prednisone long term. What would be the best answer based on the long-term effects of prednisone therapy?
Prednisone can lead to osteoporosis.
The nursing class is studying family nursing. What hormone would the instructor tell the students plays a part in milk production?
Prolactin
Which antiarrhythmic drug is also used to treat a myocardial infarction?
Propranolol (Inderal)
After 48 hours of thyroid hormone replacement therapy, a client reports still having no appetite. Which is the nurse's best action?
Reassure the client that more time is needed to see results.
Which physiologic action increases a client's stress-related release of cortisol?
Release of epinephrine and norepinephrine
Your patient underwent abdominal surgery and has been prescribed morphine to control pain. Morphine, an opioid analgesic, is a central nervous system (CNS) depressant. Which of the following should be the priority assessment for your patient?
Respiratory rate and depth
A 32-year-old client has been admitted to the hospital for cardiac arrhythmias. When providing client education, the nurse should include that the heart has a specialized electrical system, with the pacemaker of the heart in what location?
Sinoatrial node
A client being treated with desmopressin exhibits confusion and drowsiness, and reports a headache. What is the nurse's best action?
Take the client's vital signs.
A client diagnosed with hypothyroidism is started on levothyroxine. What should the client be taught regarding medication administration in the home setting?
Take the medication on an empty stomach.
During a general health assessment, a client indicates taking thyroid medication to increase weight loss. What statement should be the basis of the nurse's response?
Taking excessive or unnecessary thyroid medication may produce serious or life-threatening manifestations of toxicity.
Baclofen is a prototype drug for the centrally acting skeletal muscle relaxants. What adverse effects do these drugs have? (Mark all that apply.)
Weakness Hypotension Dizziness
After teaching a group of nursing students about drugs used to treat osteoporosis, the instructor determines that the teaching was successful when the group identifies which drug as an example of a bisphosphonate?
Zoledronic acid
A female client has been taking prednisone for her asthma for 1 month. The nurse will teach her to gradually decrease her dose of prednisone to avoid:
adrenal insufficiency.
Which assessments should be made prior to beginning growth hormone antagonist therapy in order to identify any medication-related adverse effects? Select all that apply.
affect blood pressure pulse orientation
A diagnosis of precocious puberty primarily considers what client-focused factor? Select all that apply.
age race gender secondary sexual characteristics
The nurse anticipates an order for a glucocorticoid when caring for a client with what condition?
arthritis
The nurse is reviewing the medication regimen of a newly admitted client. The client currently takes dofetilide 250 mcg PO b.i.d. This client's health history likely includes:
atrial fibrillation.
A client with muscle spasticity has been prescribed baclofen. In order to promote the safe use of this medication, the nurse should encourage the client to:
avoid drinking alcohol for the duration of treatment.
After administering somatropin to an 11-year-old client with growth failure, what outcome would indicate that the drug should be stopped?
closure of the epiphyses in long bones
A stable client with atrial flutter is symptomatic from the arrhythmia. The health care provider administers dofetilide IV in an attempt to:
convert the arrhythmia to a sinus rhythm.
Which hormone stimulates the adrenal cortex to produce and secrete adrenocortical hormones?
corticotropin
The nurse teaches the client receiving propranolol at home for management of a ventricular arrhythmia to monitor what parameter?
daily blood pressure
A nurse is caring for a client with adrenocortical deficiency. The health care provider has prescribed a fludrocortisone drug to the client. Which adverse reaction should the nurse monitor for in the client?
edema
A nurse is caring for a 70-year-old client who is taking desmopressin (DDAVP). The client has a history of cardiovascular disease. The nurse will prioritize the assessment of:
electrolyte levels.
What is the most common cause of subclinical hyperthyroidism?
excess thyroid hormone therapy
While the nurse is talking with a client, the client informs the nurse that the client has been under treatment for weight loss management. The client indicates taking antithyroid medication to increase weight loss. Included in client education about antithyroid medication is that taking:
excessive or unnecessary antithyroid medication may produce serious or life-threatening manifestations of toxicity.
A client has been prescribed a growth hormone antagonist. The nurse should educate the client to the importance of which regularly scheduled diagnostic lab test? Select all that apply.
glucose tolerance growth hormone levels
A 32-year-old female client is taking tizanidine (Zanaflex) for spasticity related to her multiple sclerosis. The nurse will inform the client and her husband that the adverse effect that poses the greatest safety risk to the client is:
hypotension.
The nurse is administering lidocaine to a client with ventricular tachycardia. The nurse will need to observe for adverse effects, including
hypotension.
Nursing care for the postoperative client requiring long-term glucocorticoid therapy will be directed at overcoming what adverse effect of the drug?
impaired wound healing
A client is on daily doses of prednisone. To minimize adrenal suppression, the nurse's instructions for administration should include to take the medication:
in the morning.
When caring for a client receiving long-term therapy with corticosteroids, the nurse would plan care incorporating interventions aimed at preventing what?
infection
A nurse taking a medical history on a client prescribed a corticosteroid medication should focus on which condition?
infections
A 70-year-old woman with a history of atrial fibrillation takes digoxin and verapamil to control her health problem. Verapamil achieves a therapeutic effect by:
inhibiting the movement of calcium ions across the cardiac muscle cell membrane.
When providing care for a client who has been admitted with clinical hypothyroidism, the nurse should implement what intervention to address common characteristics of the disorder? Select all that apply.
monitor for constipation implement falls risk precautions maintain a warm room temperature
The nurse should teach clients who are taking thyroid hormones to take the medication:
on an empty stomach.
A hospital client's current medication administration record specifies oral administration of propylthiouracil (PTU) every 8 hours. What sign or symptom may have originally prompted the care provider to prescribe this drug?
persistent tachycardia
A client being treated with oral prednisone is also prescribed furosemide. The nurse should prioritize assessment of what laboratory value?
potassium
The client is 8 weeks pregnant and requires an antithyroid medication. The nurse identifies what drug as the drug of choice for this client?
propylthiouracil
A 92-year-old male client is being sent home on disopyramide for a ventricular arrhythmia. The client asks why he must continue to take this drug. The nurse's best response would be that a ventricular arrhythmia may:
result in death.
Which hormones are responsible for the growth of the body during childhood, especially the growth of muscles and bones?
somatotropin
What is the main purpose of the hormones secreted by the hypothalamus?
stimulating or inhibiting release of hormones from the pituitary
A 72-year-old woman is on long-term glucocorticoid therapy. It will be most important for the nurse to instruct the client to:
take measures to minimize the risk of falls.
Symptoms such as severe tachycardia, fever, dehydration, heart failure, and coma are consistent with what thyroid-associated health condition?
thyroid storm
An older adult client is diagnosed with hypothyroidism, and before therapy starts, the nurse conducts a preadministration assessment. Which symptoms should be thoroughly evaluated and documented in the preadministration assessment and periodically throughout therapy by the nurse?
unsteady gait
In some cases, low-dose amiodarone may be used to prevent recurrence of what cardiac disorder?
Atrial fibrillation
Gonadotropins are classified in which pregnancy category?
category X -abdominal pain and ascites
A nurse is caring for a client who has been diagnosed with hypothyroidism. Levothyroxine (Synthroid) has been prescribed. Before the drug therapy is started, the nurse will assess for:
history of taking anticoagulant drugs.
A breast-feeding woman is prescribed a Class 3 antiarrhythmic. What information should the nurse provide to the client regarding the safety of the breast-feeding while taking this medication?
Breast-feeding must be discontinued and other forms of feeding should be introduced.
A client has been admitted to the unit for treatment of a multiple sclerosis exacerbation. The admission order indicates that the client is taking baclofen. Which outcome would the nurse expect to be associated with use of this medication?
Decreased muscle spasms
The nurse notes that a client's current medications include both diltiazem for a arrhythmia and nitroglycerin. The nurse should recognize the need to closely monitor the which client assessment datum?
blood pressure
When describing the drugs classified as class IV antiarrhythmics, the nurse would identify these as:
calcium channel blockers.
Certain bisphosphonates can be utilized in the treatment of which of the following conditions? (Choose one)
Paget's disease
A client is receiving a thyroid hormone to treat hypothyroidism. Which would indicate to the nurse that the client needs a reduced dosage of the drug?
Tachycardia
A head injury has resulted in the hospitalization of a client. Nursing assessments confirm that the client is producing substantial amounts of dilute urine and is consuming large amounts of liquids. Considering the history and assessment findings support the possibility of what metabolic disorder?
Diabetes insipidus (DI)
A nurse is preparing an ordered dose of sodium iodide 131I. The nurse should proceed knowing that this drug will help to resolve hyperthyroidism by what means?
destroying thyroid tissue
A nurse is preparing medication information for the spouse of a client diagnosed with cerebral edema. Which medication should the nurse include in this information?
dexamethasone
What drug type is most likely to cause respiratory depression and myxedema coma in clients with thyroid disorders?
opioid analgesics
A client with muscular dystrophy has recently begun taking dantrolene for the treatment of muscle spasms. When assessing for adverse effects, what assessment questions should the nurse include? Select all that apply.
"Do you find that the medication gives you an upset stomach?" "Are you getting any sudden or frequent urges to urinate?" "Have you experienced any new or unusual aches and pains since starting the medication?"
What question is important for the nurse to ask a client who is scheduled to receive a first dose of radioactive iodine for hyperthyroidism?
"Do you have any trouble swallowing?"
Which statement indicates a client understands the management of care after a thyroidectomy?
"I will have to take thyroid hormones for the rest of my life."
A 43-year-old woman was diagnosed with multiple sclerosis 2 years ago and has experienced a recent exacerbation of her symptoms, including muscle spasticity. Consequently, she has been prescribed Dantrolene (Dantrium). In light of this new addition to her drug regimen, what teaching point should the woman's nurse provide?
"You might find that this drug exacerbates some of your muscle weakness while it relieves your spasticity."
An adult client is preparing to begin corticosteroid treatment for rheumatoid arthritis. When teaching this client about the appropriate use of corticosteroids, the nurse should include what teaching point?
"You will likely gain some weight after you start taking this drug."
Laboratory testing reveals that a client is in a severely hyperthyroid state, and propylthiouracil has been prescribed. When providing health education related to this drug, the nurse should stress what information to the client?
"You'll need to take these pills every 8 hours."
The nurse is caring for a pediatric client who has been diagnosed with paroxysmal atrial tachycardia. The order reads digoxin 10 mcg/kg orally. The child weighs 44 lbs (20 kg). How many micrograms should the nurse administer? Record the answer as a whole number.
200
nurse is required to monitor the blood concentration levels of the drug in a client receiving IV lidocaine for cardiac arrhythmia. Which blood concentration level should the nurse to report to the health care provider immediately?
6 mcg/mL
A client has suddenly stopped corticosteroid therapy because the symptoms are now under control. The nurse should assess the client for signs and symptoms similar to what disorder?
Addison disease
A primary health care provider has prescribed levothyroxine to a client with hypothyroidism. Which information would the nurse include in the teaching plan to promote an optimal response to the drug therapy?
Administer the drug early in the morning before breakfast.
A client is prescribed methimazole for the treatment of hyperthyroidism. Which is a rare adverse effect or set of effects related to the administration of methimazole?
Agranulocytosis
What is the most prevalent mineralocorticoid that regulates fluid balance?
Aldosterone
The nurse should assess for an enlarged thyroid by palpating which area?
Anterior neck
The nurse is caring for a client who has been prescribed an antiarrhythmic agent. What nursing assessment should the nurse prioritize?
Apical heart rate and blood pressure
A client taking methimazole develops a rash. What is the nurse's best recommendation to treat the rash?
Apply a soothing cream until the rash subsides.
A client is being treated with corticosteroids for chronic adrenocortical insufficiency. When should the client be instructed to take the medication?
Between 06:00 and 09:00
A nurse would expect to administer which class of medication to treat osteoporosis?
Bisphosphonates
A client receiving warfarin is prescribed disopyramide. The nurse would monitor for signs and symptoms of what as most important?
Bleeding
The nurse knows that which assessment finding suggests hyperthyroidism?
Blood pressure 145/87
The nurse is providing education to a client who has been prescribed tizanidine. What adverse effect should the nurse mention during teaching? You
Hypotension
A 54-year-old woman with a history of asthma is prescribed prednisone to treat an exacerbation of her condition. The nurse is explaining to the client how this medication decreases the immune response. What mechanism of action of the drug causes this?
Decrease in the number of eosinophils
An older adult is prescribed an antiarrhythmic drug. The nurse should immediately report which of the following adverse effects?
Decrease in urinary output and weight gain.
The nurse is caring for a client newly diagnosed with hypothyroidism. The client also takes theophylline to control asthma symptoms. What change may need to be made to the client's theophylline dose?
Decrease theophylline dosage immediately.
A nurse is caring for a client who has been prescribed alendronate for the treatment of postmenopausal osteoporosis. The client informs the nurse that she is also taking antacids for the relief of gastric upset. What effect of the interaction between the two drugs should the nurse anticipate in the client?
Decreased effectiveness of alendronate
A client diagnosed with chronic atrial fibrillation is concerned about not being prescribed medication to manage the situation. Upon what information should the nurse base his/her response to the client's concern?
Drug treatment is believed to increase the risk of death in clients diagnosed with chronic atrial fibrillation.
A woman with an inflammatory skin disorder has begun taking prednisone in an effort to control the signs and symptoms of her disease. The nurse who is providing care for this client should prioritize which potential nursing diagnoses in the organization of the client's care?
Fluid volume excess
The nurse is caring for a client taking antirheumatic drugs, which have caused dyspepsia. The nurse knows the client will exhibit which signs or symptoms?
Fullness or epigastric discomfort.
The nurse would administer alendronate cautiously to a client with which of the following?
Gastritis
A hospitalized client's serum glucose level is 160mg/dL. Which hormone is most likely being secreted and leading to this elevated lab value?
Glucocorticoid
A client reports that he uses an herbal product to treat his osteoarthritis. Which herbal product would the nurse most likely expect the client to use?
Glucosamine
The nurse is caring for a client who is receiving amiodarone. Which assessment would be considered a priority?
Heart rate checks
A client presents at the clinic reporting weight loss despite an increased appetite. For which condition should this client be assessed?
Hyperthyroidism
The nurse is providing education to a client who has been prescribed tizanidine. What adverse effect should the nurse mention during teaching?
Hypotension
What class of antiarrhythmics blocks potassium channels, prolonging phase 3 of the action potential and slowing the rate and conduction of the heart?
III
A 55-year-old female client has just been diagnosed with multiple sclerosis. The client is admitted to the hospital with an acute exacerbation of the disease. What treatment would the nurse expect to see ordered for this client?
IV steroids
A client has been prescribed IV amiodarone for emergency treatment of a serious ventricular arrhythmia. The nurse monitors the client's ECG anticipating a noted change how long after the medication is delivered?
Immediately
A client is administered diltiazem IV, followed by propranolol IV. The nurse should assess for what potential side effect of this medication combination?
Impaired myocardial contractility
The pharmacology instructor is providing education regarding propylthiouracil to the nursing students. What would the instructor identify as the primary mode of action for this medication?
Inhibition of production of thyroid hormone
The nurse is providing education to a client newly prescribed propylthiouracil. What information should the nurse provide about the drug's primary mode of action?
Inhibits production of thyroid hormone
The nurse is caring for a client whose current medication regimen includes baclofen 60 mg PO daily. What assessment should the nurse prioritize when assessing for therapeutic effects?
Inspection for muscle spasticity and range of motion assessment
A patient is admitted to the hospital for severe back spasms and pain. Which of the following intravenous skeletal muscle relaxants will also provide pain relief?
Methocarbamol (Robaxin)
A critical care nurse is caring for a client after open-heart surgery. What nursing intervention would the nurse initiate to help detect life-threatening arrhythmias and manage and minimize any that occur?
Monitor cardiac rhythm continuously.
An older adult is prescribed a skeletal muscle relaxant for reports of neck pain. What is the top priority of care for the nurse to teach the family?
Monitor the client before ambulating.
A clinic nurse is following a 62-year-old woman who is taking quinidine for a cardiac arrhythmia. What nursing action will address the most common adverse effects of quinidine therapy?
Monitor the client for signs and symptoms of GI upset
For what condition would the nurse expect to administer lidocaine intravenously?
Multiple premature ventricular contractions (PVCs)
A client has been prescribed disopyramide (Norpace) to treat a tachyarrhythmia. Which factor would necessitate that the dose be reduced?
Renal impairment
What client factor would result in the nurse administering a reduced dosage of disopyramide?
Renal impairment
A client has a complex cardiac history that includes recurrent ventricular fibrillation. After the failure of more conservative treatments, the care team has introduced oral amiodarone. What assessments should be prioritized by the nurse who is providing care for this client?
Respiratory assessment Amiodarone has several adverse effects that are potentially fatal. Pulmonary toxicity is the most important of these serious adverse effects
The nurse is discussing possible adverse effects of quinidine with a client who has been prescribed the drug. Which of the following should the nurse include in the discussion?
Ringing in the ears
A client has been prescribed a subcutaneous medication to treat rheumatoid arthritis (RA). The nurse should teach the client to do which?
Rotate sites when administering the injections.
The nurse is providing client education prior to administering propylthiouracil. During teaching, the nurse should inform the client about the need for what form of follow-up?
Routine liver function testing
After teaching a group of students about growth hormone agonists and antagonists, the instructor determines that additional teaching is needed when the students identify which agent as a growth hormone antagonist?
Somatropin
The client has been prescribed medication to treat rheumatoid arthritis (RA). The nurse should tell the client to notify the healthcare provider if the client experiences which problems? Select all that apply.
Sore mouth Fever Itching Nausea
A 6-year-old child has been brought to the emergency department in apparent status asthmaticus. The care team recognizes the need to intubate the client, who is inconsolably agitated. The nurse should anticipate a STAT prescription for what medication?
Succinylcholine
An adult client has been prescribed oral prednisone for the treatment of an acute dermatological condition. When teaching this client about this course of treatment, what teaching point should the nurse emphasize?
The importance of gradually reducing rather than abruptly stopping the drug
An adult client with a long-standing arrhythmia has been taking oral propranolol for the last several months, resulting in acceptable symptom control. What is a priority teaching point for the nurse to communicate to this client?
The importance of not stopping the medication abruptly
For which patient would cyclobenzaprine not be prescribed for muscle spasms?
The patient who is having muscle spasms because of cerebral palsy
A nurse is the cardiac care unit is preparing to hang an intravenous dose of dofetilide (Tikosyn) for a client who has just been admitted. What is the most likely goal of this intervention?
To convert the client's atrial fibrillation to normal sinus rhythm
When performing discharge teaching for a client taking an antiarrhythmic, which instruction would the nurse include? Select all that apply.
To relieve dry mouth take frequent sips or water or chew (sugar-free) gum. Do not take any nonprescription medications without permission of the health care provider. Keep all appointments with the health care provider.
While learning about corticosteroids in pharmacology class, a student asks the instructor to offer an example of indications for use. What could the instructor mention?
Treatment of a disease with an inflammatory component
The teaching plan for a client taking amiodarone should include which instruction?
Use a reliable form of birth control while taking this medication.
After successful treatment for a myocardial infarction, a 69-year-old man has developed a ventricular arrhythmia. His care team has opted for treatment with a Class II antiarrhythmic. The nurse would understand that this client is likely to be prescribed:
acebutolol.
Which hormone is released in the presence of low blood volume?
antidiuretic hormone (ADH)
A client has been experiencing increased muscle spasticity since being diagnosed with multiple sclerosis. What drug is most likely to meet this client's needs?
baclofen
The nurse is caring for a black client who received a kidney transplant and receives methylprednisolone for immunosuppression. What is the nurse's priority assessment specific to this client?
blood glucose levels
A child has responded favorably to treatment with somatropin and has grown several centimeters in recent months. When monitoring this client's progress during therapy, the nurse should be aware of the results from what diagnostic tests? Select all that apply.
blood glucose levels thyroid function tests eye examinations
A client has questions about the new medication prescribed for cardiac rhythm after having cardioversion performed. How does a sodium channel blocker decrease the likelihood of arrhythmias ?
by prolonging the heart's refractory period
A history of what medical condition would contraindicate the use of cyclobenzaprine for acute muscle spasms?
cardiac arrhythmias
female client has a diagnosis of adrenocortical insufficiency and is steroid dependent. The client is to undergo surgery to remove her uterus. The nurse will explain to the client that in order to promote recovery after the stress of the surgery, her steroid dosage will be:
increased.
Hypothalamic hormones must be given by what route to avoid destruction? Select all that apply.
injection nasal inhalation
When describing thyroid function, the nurse would emphasize the need for intake of:
iodine.
A 31-year-old client is being treated with fludrocortisone for Addison disease. In addition to monitoring the client's urinary output, what other assessment should the nurse prioritize?
Blood pressure
A 2-year-old client is placed on a course of prednisone following a series of hypersensitivity responses. What instruction the nurse provide the client's family about this drug?
"Don't stop this medication suddenly; you will have to taper dosage gradually."
A nurse reviews the current medication administration record of a client who has recently been prescribed octreotide for possible drug-to-drug interactions. The nurse performs this important safety action in order to prevent drug interactions that could result in which adverse effect?
Cardiac complications
A nurse is overseeing the care of a young man whose ulcerative colitis is being treated with oral prednisone. Which action should the nurse take in order to minimize the potential for risks associated with prednisone treatment?
Carefully assess the client for infections.
The nurse is preparing discharge teaching for a client prescribed chronic antiarrhythmic medication therapy. Which signs/symptoms should be reported to the health care provider immediately? (Select all that apply.)
Chest pain Dyspnea Heart palpations
Which best describes the action of class II antiarrhythmics?
Competitive block beta receptor sites in the heart and kidneys
A client has started therapy for arrhythmias with quinidine. The nurse should tell the client to return to the clinic during the first few months of therapy to have which lab test drawn?
Complete blood count (CBC)
A male client taking oral prednisone informs the home care nurse that the medication is upsetting his stomach. What guidance can the nurse provide to help the client?
Confirm that the client takes the medication with a meal.
A client taking medication to treat an acute attack of gout should do which of the following?
Contact the health care provider if a mild skin rash appears.
An adult client with no known history of cardiovascular disease presents with atrial flutter. The client is prescribed propafenone PO 150 mg every 8 hours for 24 hours. What is the cardiac care nurse's priority assessment during this period?
Continuous ECG monitoring
A client diagnosed with hypothyroidism admits knowing the term "thyroid gland" but not knowing its function. The nurse should explain the fact that thyroid hormone is responsible for which action?
Controlling the rate of cell metabolism throughout the body
Which would lead the nurse to suspect that a client who is receiving desmopressin is experiencing water intoxication?
Convulsions
After administering desmopressin to a client with diabetes insipidus, which would the nurse identify as indicating drug effectiveness?
Decreased reports of thirst
A client diagnosed with diabetes insipidus is taking vasopressin (Desmopressin). What outcome would indicate to the nurse that the desmopressin is producing a therapeutic effect?
Decreased urine output
An adult client is admitted to the emergency department after a motorcycle crash. Assessment confirms that the client is unconscious with a widened pulse pressure. Currently, one eye is dilated and one constricted. He has a widened pulse pressure. What corticosteroid will most likely be administered parenterally to address the cause of the client's signs/symptoms?
Dexamethasone
The nurse is caring for a client who is receiving cyclobenzaprine for relief of muscle spasms. What adverse effect should the nurse assess for?
Drowsiness
When developing a teaching plan for a client who is to receive carisoprodol, which sign or symptom would the nurse include as the most common adverse reaction?
Drowsiness
When describing desmopressin, the nurse understands that this drug can be administered by which route? Select all that apply.
Intranasal Oral Intravenous Subcutaneous
An older adult has been prescribed a thyroid hormone replacement medication. The nurse should first clarify which prescription?
Levothyroxine (Synthroid) 150 mcg orally once per day
The nurse is caring for a client who has been prescribed quinidine. The nurse should advocate for a lower-than-normal dose if the client has a history of what medical diagnosis?
Liver disease
A client admitted to the hospital with hyperthyroidism treated with propylthiouracil suddenly develops a skin rash. Which action would the nurse implement first?
Notify the primary health care provider.
A client has been newly diagnosed with acromegaly. Which medication would the nurse expect the health care provider to prescribe?
Octreotide
A nurse is preparing to administer fludrocortisone. The nurse would administer the drug by which route?
Oral
Based on the metabolic action of glucocorticoids, a client who is on long-term glucocorticoid therapy is at risk of developing what disease?
Osteoporosis
A client is started on antiarrhythmic therapy to treat atrial fibrillation. The nurse caring for this client knows which occurrence is a potential side effect of this medication?
Other arrhythmias
The nurse would expect to administer tiludronate to a client with which condition?
Paget disease
A client with a history of atrial fibrillation has undergone cardioversion. What drug would the nurse anticipate administering for long-term stabilization of this client?
Quinidine (generic)
A client's health care provider has prescribed baclofen in an effort to treat neuropathic cancer pain. What education should the nurse prioritize when teaching the client about this new medication?
The importance of ensuring safety related to possible sedation
Levothyroxine is classified in which pregnancy category?
category A
A group of nursing students demonstrate understanding about the antithyroid drugs methimazole and propylthiouracil when they identify these drugs as belonging to which pregnancy category?
category D
Parents of a 10-year-old child with asthma are concerned about their child's lack of growth. The parents say that the child is much shorter than anyone in the class and want to know what could have caused the problem. What medication may this child have taken that contributed to the growth suppression?
glucocorticoid
The anterior pituitary gland produces seven hormones. Of the hormones produced by the anterior pituitary gland, which one acts directly on their target tissues? Select all that apply.
growth hormone (GH) prolactin
A nurse is caring for a 78-year-old client with rheumatoid arthritis. The health care provider has prescribed cortisone, a corticosteroid, to the client. The nurse would administer the drug cautiously to a client with which condition? Select all that apply.
heart failure decreased muscle mass osteoporosis
A nurse is providing discharge instructions to a client who will be taking fludrocortisone at home. The nurse will encourage the client to eat a diet that is:
low in sodium, high in potassium.
A nurse is preparing to administer a scheduled dose of levothyroxine to an elderly client who is being treated in the hospital for a respiratory infection. Prior to administering the drug, the nurse should perform what assessment?
measurement of blood pressure
Diabetes insipidus is treated with replacement of which hormones?
vasopressin
What is the regulatory function of vasopressin?
water balance
The nurse should advise a client who is taking levothyroxine for the first time that resolution of hypothyroid symptoms may not occur for how long after therapy is started?
weeks
A client diagnosed with hyperthyroidism is unsure about the need for the prescribed propranolol, stating, "I looked this up online and it's for high blood pressure, not thyroid problems." What statement concerning beta-adrenergic blockers should the nurse use as a basis for the response?
It will block stimulation of the sympathetic nervous system.
The anesthetist has informed the perioperative nurse that the surgical client will be receiving succinylcholine as an adjunct to anesthesia to induce paralysis. The anesthetist administers the medication and the perioperative nurse observes intense muscle contractions a few seconds later. What is the nurse's best action?
Recognize the expected effects of succinylcholine administration.
A client with spastic hypertonia resulting from cerebral palsy has not responded appreciably to oral baclofen. During the client's care conference, the nurse should anticipate a discussion about what possible treatment?
Intrathecal baclofen infusion
A client is admitted to the emergency department in ventricular fibrillation. The client is administered amiodarone hydrochloride. What is the major effect of this medication?
It slows the conduction through the AV node.
A client with a diagnosis of asthma has responded well to treatment with oral corticosteroids, and a switch to inhaled corticosteroids is planned. What strategy for managing this change in treatment should be implemented?
The inhaled drug should be started during tapering of the oral drug.
What adverse effects should the nurse discuss with a client prescribed long-term systemic corticosteroid therapy? Select all that apply.
hyperglycemia peptic ulcers mood disorders cataracts
Growth hormones cause all of the following EXCEPT:
Suppression of triglyceride synthesis.
When describing the effects of antiarrhythmics, which is associated with all antiarrhythmic medications? Select all that apply.
New arrhythmias Worsen existing arrhythmias Increased blood pressure
A nurse must be aware that thyroid hormone can worsen control of which disease or condition necessitating close client observation?
diabetes
Propranolol is ordered for a client who has a cardiac arrhythmia. It will be important for the nurse to determine if the person has a history of:
hypersensitivity to beta blockers.
A nurse is working with a 39-year-old client who is experiencing muscle spasms associated with multiple sclerosis. The client reports needing help with basic care The client's health care provider has prescribed baclofen (Lioresal). The nurse and the client agree that an appropriate goal related to helping to maintain self-worth would be to:
increase self-care in activities of daily living.
The nurse's subsequent cardiac assessments and monitoring of a client prescribed disopyramide should be planned in the knowledge that this drug increases the client's risk for developing what health problem?
new arrhythmias
What is the safest precaution to take when administering an antiarrhythmic drug intravenously (IV)? Choose the BEST response.
Place the client on a cardiac monitor.
Which hormone regulates the production and release of thyroid hormone?
Thyroid-stimulating hormone (TSH)
A client has been prescribed baclofen and will be taking the drug on an outpatient basis. The client asks the nurse if it is still okay to drink wine with meals or end the day with a "nightcap." What is the nurse's best response?
"The combination of baclofen and alcohol could depress your nervous system to a dangerous level."
While learning about corticosteroids in pharmacology class, a student asks the instructor what a clinical indication for the use of corticosteroids would be. What would be the instructor's best response?
A disease with an inflammatory component
The nurse is working with a client who has been prescribed tizanidine for the treatment of muscle spasticity. When monitoring the client's risk for injury, what assessment should the nurse prioritize?
Assessment of the client's blood pressure following administration
A client, diagnosed with a cardiac arrhythmia, will not require medication therapy. The client expresses concern about the lack of proposed treatment. What response should the nurse provide to best address the client's concern?
The arrhythmia you have isn't interfering with getting oxygen to your body tissues so there is no need to treat it."
A client with a spinal cord injury is experiencing increasing muscle spasticity and the care team is considering the use of dantrolene. The nurse should identify what possible contraindication to the safe and effective use of this medication?
The client has hepatitis C
A client in the clinic complains of depression (secondary to chronic back pain) and of not being able to "get around as good as I used to." The client has been prescribed a skeletal muscle relaxant. What is the nurse's most therapeutic response?
"Therapy may take weeks or longer before you feel optimal relief."
A 29-year-old client who experienced a lower back injury has seen his range of motion decrease and his pain increase over the past several weeks. As a result, he has been prescribed cyclobenzaprine. What nursing diagnosis should the nurse prioritize in light of the client's drug regimen?
Risk for Injury related to CNS depression
When reviewing the medical record of a client who is to receive dantrolene, which condition would alert the nurse to the need for close monitoring?
The client has respiratory depression from opioid analgesia
A client's current drug regimen includes intranasal administration of desmopressin acetate. In this client's plan of nursing care, what is the most likely desired outcome of treatment?
The client's urine output will not exceed 80 mL/h.
The nurse can determine that the client taking uric acid inhibitors is drinking enough fluids when which of the following occurs?
The daily urine output is about two liters.