Pharm Exam (A) review
A nurse is providing discharge instructions for a client who has a prescription for colesevelam (WelChol). Which of the following indicates the client needs additional teaching? -"I will take my other medications 1 hr before taking this." -"I will take the medication will my breakfast." -"I will mix the medication with 30 mL of water." -"I will increase my fiber intake while taking this medication."
"I will mix the medication with 30 mL of water." (The medication comes in pill form only, so there's no mixing involved)
A nurse is taking care of a client taking atorvastatin (Lipitor). Which of the following should the nurse recognize should be monitored for this client? -CK -ESR -INR -K+
CK (Creatinine Kinase--CK--levels rise in response to enzymes released with muscle injury. Mild injury, causing muscle weakness or aches, develops in some clients on statin therapy, and this occasionally progresses to myositis.)
A nurse is monitoring a client receiving an IV infusion of magnesium sulfate for preterm labor. Which of the following findings indicates to the nurse that the client is experiencing magnesium toxicity? -Clonus -Raised blood pressure -Decreased level of consciousness -Agitation
Decreased level of consciousness (Magnesium toxicity results in CNS depression)
A nurse is administering donepezil (Aricept) to a client who has Alzheimer's disease. Which of the following documented findings should the nurse report to the provider immediately? -Dyspepsia -Diarrhea -Dizziness -Dyspnea
Dyspnea (Using the ABC priority setting framework, the greatest risk to the client is dyspnea as a result of bronchoconstriction caused by elevated acetylcholine in the lungs)
A client on digoxin (Lanoxin) is starting to experience dysrhythmias. Along with digoxin, which other scheduled medication should the nurse withhold? -Furosemide (Lasix) -Morphine -Pantoprazole (Protonix) -Penicillin
Furosemide (Lasix) (Diuretic therapy may lead to hypokalemia, which increases the risk for dysrhythmias for clients taking digoxin)
A client who is postoperative has received 2 mg of hydromorphone (Dilaudid) IV bolus every 2 hr. The client continues to rate his pain at a 7 on a scale from 0 to 10. Which of the client findings should the nurse attend to first? -Constipation -Hypotension -Weakness -Nausea
Hypotension (According to the ABC priority-setting framework, this would be the first finding for the nurse to address.)
A nurse administers naloxone (Narcan) as prescribed for a client who is 8 hr postoperative and developed adverse effects after administration of opioid analgesia. Which of the following interventions shoud the nurse plan to take following naloxone administration? (Select all that apply) -Observe the client for bleeding -Assess the client for nausea and vomiting -Check the client's pain level frequently -Monitor the client for bradycardia Repeat the dose every 15 min until the client responds
Observe the client for bleeding Assess the client for nausea and vomiting Check the client's pain level frequently (1. Naloxone has been associated with elevations in partial thromboplastin time. 2. Reversal of analgesic effects of opioids may lead to nausea and vomiting. 3. Naloxone reverses the analgesic and sedative effects of opioids.)
A nurse is administering Regular insulin 6 units subcutaneously to a client at 0700. At 1000, the client reports feeling nauseous and lightheaded. Which of the following actions should the nurse take first? -Request an antiemetic prescription for the client -Check the client's vital signs -Obtain the client's blood glucose level -Give the client 15 g of carbohydrates
Obtain the client's blood glucose level (Using the nursing process as a priority setting framework, the nurse should first collect more data to identify the cause of the client's symptoms)
A nurse is caring for a client receiving heparin IV at 1,000 units/hr. Which of the following should the nurse recognize as an adverse reaction to this medication? -Paresthesias -Pink tinged urine -Clay colored stool -Dyspepsia
Pink tinged urine (Bleeding is an adverse effect to heparin administration and may be evident as pink tinged or cloudy urine.)
A client is receiving a heparin infusion for deep vein thrombosis. The nurse should discontinue the medication infusion for which of the following patient findings? -Serum potassium 5.1 mEq/L -aPTT 2 times the control -Hemoglobin 15 g/dL -Platelets 96,000/mm3
Platelets 96,000/mm3 (A platelet count less than 100,000/mm3 while receiving heparin may indicate heparin-induced thrombocytopenia.)
A nurse is providing teaching to a client who is prescribed an MAOI. Which of the following should the nurse instruct the client to avoid while taking this medication? -Red wine -Cottage cheese -Green beans -Apple pie
Red wine (Red wine, specifically Chianti, contains tyramine that can interact with MAOIs, which will result in hypertensive crisis.)
A nurse is caring for a client that has undergone a liver transplant and is taking cyclosporine (Sandimmune). Which of the following laboratory findings indicates an adverse effect of the medication? -WBC count 8,000/mm3 -Serum creatinine 2.5 mg/dL -Serum sodium 138 mEq/L -Platelet count 150,000 mm3
Serum creatinine 2.5 mg/dL (An elevated serum creatinine level may indicate nephrotoxicity, an adverse effect of cyclosporine (Sandimmune)