PHARM FINAL
A client receiving thyroid replacement therapy develops influenza and forgets to take her thyroid replacement medicine. The nurse understands that skipping this medication puts the client at risk for developing which life-threatening complication?
Myxedema coma
What is the antidote for hydrocodone?
Naloxone
A client has been diagnosed with hypothyroidism in the local health care clinic. The nurse should caution the client with hypothyroidism to take precautions when exposed to which of the following?
Narcotic sedatives
What would indicate a need for further teaching for a patient taking phenytoin?
Patient states, "I can consume 2 glasses of wine per day"
A patient who is taking an anticonvulsant has developed double vision, nystagmus, and gingival hyperplasia. Which of the following drugs does the nurse suspect the client is taking?
Phenytoin
Calcium acetate lowers which electrolyte?
Phosphorus
The nurse is explaining to a client diagnosed with Rheumatoid Arthritis why DMARDs are prescribed to clients with autoimmune diseases. The nurse would be correct to explain to the client that DMARDs do what to help with their symptoms?
DMARDs slow down the progression of the disease and improve the quality of life for most clients.
A client diagnosed with MS has been admitted to the medical unit for treatment of an MS exacerbation. Included in the admission orders is baclofen. What should the nurse identify as an expected outcome of this treatment?
Decreased muscle spasms in the lower extremities
A 38 year old woman is returned to her room after a subtotal thyroidectomy for treatment of hyperthyroidism. Which of the following, if found by the nurse at the patient's bedside, is NOT essential?
Potassium chloride for IV administration.
Which of the following can a nurse do to help prevent drug errors? Select all that apply.
Practice the 10 rights of drug administration. Avoid distractions and concentrate on only one task at a time. Confirm any questionable orders.
The nurse is reviewing a patient's preoperative checklist in the holding area. The nurse knows that which of the following drugs should not be given to a patient with history of glaucoma?
Dexamethasone
A patient received 6 units of regular insulin three (3) hours ago. The nurse would be MOST concerned if which of the following was observed?
Diaphoresis and trembling
The nurse is preparing the client with peptic ulcer disease discharge instructions. The client asks the nurse which type of analgesic he may take. Which of the following responses by the nurse would be most accurate?
"Acetaminophen."
A client states "My doctor told me to quit taking aspirin since I've developed this ulcer. But I have to take aspirin to keep my arthritis from hurting. I don't know what to do." Which response on the part of the nurse is most appropriate?
"Aspirin is one of the medications that makes your ulcer worse. Another medicine can be ordered by the doctor for your arthritis."
A 52 year old male is diagnosed with Gout. The physician prescribes allopurinol. The nurse knows that the patient needs further teaching when he states which of the following?
"I need to avoid crowds and weigh myself daily while taking this medication."
A 26 year old female is being prescribed methylprednisone for the treatment of Systemic Lupus Erythematosus. The nurse knows that the patient needs further teaching about this medication when she makes which of the following statements?
"I need to avoid too much exposure to sunlight while taking this pill."
A 33 year old female is receiving spinal anesthesia. The nurse knows that the client understands teaching when the client states which of the following statements?
"I need to call for assistance the first time I need to get out of bed."
A 56 year old female is prescribed naproxen for treatment of pain associated with osteoarthritis. The nurse knows that the patient understands teaching when which of the following statements are made by the patient?
"I need to report any blood in my stool and monitor my blood pressure while taking this medication."
A 56 year old female is prescribed naproxen for treatment of pain associated with osteoarthritis. The nurse knows that the patient understands teaching when which of the following statements are made by the patient?
"I need to take this medicine with food to reduce GI upset, report any blood in my stool and monitor my blood pressure while taking this medication."
The physician orders metronidazole (Flagyl) 250mg PO TID for 7 days for a 35 year old client. The nurse teaches the client about the medication. Which of the following statements, if made by the client, would indicate that teaching has been effective and understood?
"I should NOT drink alcohol while I am taking this medication."
The nurse is teaching a caregiver about donepezil. Which of the following indicates that the caregiver understands teaching?
"I should give this to my parent at night to avoid syncope"
A client with SIADH is prescribed furosemide. Which of the following statements indicates that the client needs further teaching about this medication?
"I should limit my intake of potassium rich foods while taking this medication"
The nurse teaches a client how to prepare for a barium enema. Which statement by the client would indicate a correct understanding of the teaching?
"I'll cleanse my bowel with laxatives and enemas before the test."
A nurse is teaching a client recovering from Addisonian crisis about the need to take fludrocortisone acetate and hydrocortisone at home. Which statement by the client indicates an understanding of the instructions?
"I'll take two-thirds of the dose when I wake up and one-third in the late afternoon"
A client is prescribed demeclocycline for treatment of SIADH. Which of the following indicates that the client needs further teaching when discussing this medication?
"It is safe to take my calcium, iron and magnesium supplements at the same time as this medication."
A 58 year old male has been prescribed allopurinol for gout. Which of the following should the nurse include in testing?
"Take this medication with food and increase your fluid intake to 2-3 Liters a day."
A client is taking tizanidine for symptom management related to Multiple Sclerosis. Which of the following would indicate that the client needs further teaching about this medication?
"This drug causes peripheral edema so I should expect some weight gain"
A client diagnosed with Rheumatoid Arthritis is prescribed methotrexate and folic acid supplementation. Which of the following statements indicates to the nurse that the client needs further teaching about folic acid?
"This medication is to help my platelet number stay up as a result of methotrexate."
The nurse is discussing the insulin glargine with a graduate nurse. Which of the following statements made by the graduate nurse indicates that further discussion and feedback is needed?
"When mixing insulins, this type of insulin is always drawn up first."
Which solution is classified as hypotonic?
0.45% Normal Saline
A client is admitted with severe bleeding from a fractured femur. Which intravenous fluid does the nurse anticipate as the most appropriate for use to replace potential fluid losses?
0.9% sodium chloride (0.9%NaCl)
The physician has ordered 500 mL of 5% Dextrose in Lactated Ringers solution at 120 mL/hr. The IV tubing delivers 10 gtt/mL. How many drops per minute should fall in the drip chamber?
20 gtt/min
What is the maximum time for a bag of TPN to hang?
24 hours
What is the maximum 24 hour dose for acetaminophen?
4 grams
The health care provider ordered an IV solution for a dehydrated client with a head injury. Select the IV solution that the nurse knows would be contraindicated?
5% Dextrose in Water
A 17 year old female client who sustained a head injury in a motorcycle collision two days ago is responsive only to pain. Which intravenous fluid order would the nurse question because it could increase the risk of complications?
5% of dextrose in water
A patient has just been diagnosed with Type 2 diabetes. The physician has prescribed an oral antidiabetic agent that will inhibit the production of glucose by the liver and thereby aid in the control of blood glucose. What type of oral antidiabetic agent did the physician prescribe for this patient?
A biguanide
A patient with Type 1 diabetes with complaints of severe abdominal pain and vomiting is admitted to the emergency department by ambulance. On admission, the client has fruity sweet breath with Kussmaul's respirations. Laboratory values include arterial blood glucose of pH 7.32, PCO2 34mmHg, and HCO3 11 mEq/L; and a plasma glucose of 518 mg/dl. Blood pressure is 110/72. What intervention does the nurse anticipate will be prescribed initially?
A continuous low-dose Regular insulin infusion and an infusion of normal saline.
Which of the following does NOT affect the flow rate of intravenous solutions?
Electrolyte additives
What are some indications for intravenous therapy?
Electrolyte replacement and nutritional support
The nurse is assisting the anesthesiology provider during induction using general anesthesia. The nurse knows that the highest risk for aspiration occurs during which of the following stages of general anesthesia?
Excitement, delirium stage
A patient is prescribed a succinimide. The nurse knows that the client is diagnosed with what type of seizure?
Absence seizures
What is the antidote for salycilate
Activated charcoal
Which statement about fluid replacement is accurate for a client with hyperosmolar hyperglycemic nonketotic syndrome (HHNS)?
Administer 2 to 3 Liters of I.V. fluid rapidly
A client scheduled for outpatient surgery will receive intravenous midazolam hydrochloride (Versed) as the preoperative medication. The nurse should prepare a teaching plan for the client that indicates that the medication is intended to produce which of the following effects?
Amnesia
A client who takes numerous medications is being prepared for surgery. The nurse reviewing the client medication list knows that which of the following medications can be taken the day of surgery with a sip of water due to the fact that these medications should not be abruptly withdrawn?
Antihypertensives, corticosteroids, and antidysrhythmics
A nurse is caring for a client who experiences debilitating cluster headaches. The client should be taught to take appropriate medications at what point in the course of the onset of a new headache?
As soon as the client senses the onset of symptoms
A 54 year old male who is newly diagnosed with Diabetes Type 2 has been prescribed Metoclopramide. The nurse knows that this medication has been prescribed to treat which of the following microvascular complications?
Autonomic neuropathy
The nurse prepares to administer an H2 receptor antagonist to a client diagnosed with a sliding esophageal hernia. Which of the following drugs is an H2 receptor antagonist?
Famotidine (Pepcid)
A patient is receiving infliximab for the treatment of Crohn's disease. The nurse knows to monitor for which of the following side effects?
Fever, chills, itching
A 55 year old patient is being treated for Addison's disease. The nurse knows that the patient understands teaching about avoiding foods/medications that could increase potassium levels when the patient lists which of the following foods/medications to avoid? SELECT ALL THAT APPLY.
Bananas Milk and milk products Baked potatoes Orange juice
A client is being treated weekly with Alendronate (Fosamax). The nurse knows that this medication is a _______________ used to treat _______________.
Bisphosphonate, Osteoporosis
A patient is prescribed bromocriptine mesylate (Parlodel). Which information does the nurse teach the patient?
Get up slowly from lying position.
A nurse is administering Magnesium Sulfate for a client with a magnesium level of1.0 mEq/L. During administration of this medication, the nurse knows to administer which drug in case of magnesium toxicity?
Calcium gluconate
A patient who is postoperative day 1 following neck dissection surgery has rung his call bell complaining of numb fingers, stiff hands, and a tingling sensation in his lips and around his mouth. The nurse should anticipate that this patient may require the IV administration of:
Calcium gluconate
A patient is being seen in the primary health clinic with hypoparathyroidism. The nurse knows to include diet modification instructions to the patient. Which of the following diet instructions should the nurse include in teaching? SELECT ALL THAT APPLY
Calcium supplements and Vitamin D supplements are not necessary. Avoid egg yolk and spinach .Diet should be low in calcium. Avoid milk or milk products.
Ergotamine tartrate (Gynergen) is prescribed as abortive therapy for a client's migraine headaches. The client's report of which of the following indicates effectiveness.
Prevention of a full blown migraine
A client is returning to the nursing unit following a unilateral adrenalectomy. Hydrocortisone IV is prescribed. The nurse is aware that the primary reason for this is:
Prevention of addisonian crisis
The nurse is assessing a client who has been taking prednisone following an exacerbation of inflammatory bowel disease. The nurse should recognize which of the following findings, all side effects of prednisone, as the priority?
Client reports elevation in body temperature.
A client with Type 2 diabetes controlled with a biguanide oral diabetic medication is scheduled for a computed tomography (CT) with contrast of the abdomen to evaluate pancreatic function. Which of the following interventions is the most important for the nurse implement?
Hold the biguanide medication for 24-48 hours prior to the test.
You administer NPH insulin at 1900 per your patient's regular insulin routine. What statement by the patient indicates further patient education is needed.
I don't need to eat before I go to bed since NPH insulin does not peak and therefore I do not need to eat at a specific time to avoid Hypoglycemia
A client in end stage renal failure presents to the emergency department with a potassium level of 6.6 mEq/L. Which of the following drugs would the nurse anticipate being ordered? Select all that apply.
IV Insulin Sodium polystyrene sulfonate Dextrose 50%
A patient has been brought to the emergency department by paramedics after being found unconscious. The patient's Medic Alert bracelet indicates that the patient has type 1 diabetes and the patient's blood glucose is 22 mg/dL. The nurse should anticipate what intervention?
IV administration of 50% dextrose in water
You are educating your patient about the treatment options for Guillian-Barre syndrom. Which statement is correct about Intravenous Immunoglobulin(IVIG) therapy?
IVIG is where IV Immunoglobulin from a donor is given to a patient to stop the antibodies that are damaging my nerves
The doctor prescribes sucralfate (Carafate) to a client diagnosed with a peptic ulcer. The nurse knows that sucralfate is given for which of the following reasons?
Protect the ulcer's surface by forming a barrier and allowing for the healing of the ulcer.
What is the chemical classification of Nexium (esomeprazole)?
Proton Pump Inhibitor
While a 6 year old surgical client is being extubated, the anesthesia provider notes inspiratory stridor, and sternal retractions. Based on the assessment data, which of the following interventions should the surgical team implement?
Provide positive pressure ventilation, oxygen, IV muscle relaxants and steroids
The nurse should implement which of the following nursing interventions for the client experiencing respiratory alkalosis?
Rebreathing CO2 via paper bag
the nurse is caring for a client who is in status epilepticus. What medication should the nurse anticipated administering to halt the seizure immediately?
Intravenous diazepam
Which statement about glucagon secretion is correct?
It acts to increase blood glucose levels.
The nurse is providing client teaching to a client with early stage Alzheimer disease (AD) and her family. The client has been prescribed donepezil hydrochloride. What should the nurse explain to the client and family about this drug?
It slows the progression of AD.
A client is admitted to the emergency department with hypovolemia. Which of the following intravenous solutions would the nurse anticipate administering?
Lactated Ringers
Which IV solution contains sodium, chloride, potassium, and Calcium?
Lactated Ringers
A client is being treated for acute osteomyelitis. The nurse notes that the results of the client's bone biopsy revealed that the osteomyelitis was caused by a gram negative bacteria. The nurse anticipates what antibiotic being prescribed for this patient?
Levaquin, a fluoroquinolone antibiotic
Which of the following is the drug of choice for control of status epilepticus?
Lorazepam
A client is being sent home following an EGD with a prescription to treat GERD. Which of the following medications neutralizes stomach acid?
Magnesium Hydroxide (Maalox)
The nurse is educating a client with Myasthenia gravis about medications. THe nurse is sure to include which of the following?
Medication must be taken on time
You are reviewing a patient's medication list. Which of the following medications could result in a change in the patient's diabetic management?
Methylprednisone
What priority nursing action does the nurse plan to implement with a patient who has had potassium chloride added to the IV infusion for several days?
Monitor lab values; assess heart rate
A Type 1 Diabetic reports to the primary care clinic with reports of fasting blood glucose at 260 mg/dL or higher every morning for the past week. The client's home medications are detemir insulin 40 units HS and sliding scale insulin aspart before meals and NPH insulin daily at 3pm. Which of the following does the nurse suspect that the patient may be experiencing?
Somogyi's Effect
What is the first task the nurse must do if she/he suspects that the patient may be experiencing infusion complications of hypersensitivity, infiltration, extravasation, or phlebitis?
Stop the infusion
An older client with a past medical history of hypertension and myocardial infarction is recovering from surgery. Vital signs have been stable and an IV of D51/2NS is infusing at 100ml/hr. The client now complains of trouble breathing at rest and a moist cough is becoming restless and the pulse oximetry reading has fallen to 92%. What action should the nurse take first?
Stop the intravenous infusion
Which of the following statements should the nurse include when teaching a client about oral potassium supplementation?
Take your potassium tablet after you have eaten breakfast"
The nurse should ensure that calcium gluconate or calcium chloride for IV administration is available in the postoperative management of the patient having thyroid surgery to treat which of these emergencies?
Tetany
A client has been treated with etanercept (Enbrel), a biologic response modifier, for RA for 3 weeks. The nurse understands the importance of checking what assessment information for a client taking this medication regimen for RA?
The WBC count, temperature and any signs of infection
A client is receiving discharge teaching after being diagnosed with Type 1 Diabetes. Which of the following insulin administration principles should the nurse include? SELECT ALL THAT APPLY
The abdomen has the fastest absorption rate Always use an insulin syringe to inject your insulin Do not leave your insulin in your vehicle
A 50 year old man is scheduled for a colonoscopy this morning. Last night he had Magnesium Citrate and a soapsuds enema. This morning he passes a medium amount of soft, brown stool. What should the nurse know and report to the physician?
The bowel prep is incomplete.
The visiting nurse evaluates the progress of a client recently diagnosed with Diabetes Type 1. As part of the treatment plan, the client receives Humulin N 32 units and Humulin R 8 units each morning. Which of the following actions, if performed by the client while preparing the morning insulin injection, would require an intervention by the nurse?
The client draws up 32 units of the clear insulin followed by 8 units of cloudy insulin for a total of 40 units.
A client diagnosed with diabetes insipidus is receiving Desmopressin acetate intranasally. Which assessment data indicates that the medication is effective?
The client is urinating every 4 hours.
A patient is prescribed Carbidopa/Levodopa for Parkinson's disease. The nurse needs to include which of the following in the discharge instructions?
The effects of this drug will diminish by the end of year 5
A patient with Parkinson's disease is taking Carbidopa/Levodopa and is experiencing an on-off syndrome. What does the nurse recognize that the patient's clinical symptoms will be?
The patient will have periods of near immobility, followed by a sudden return of effectiveness of the medication
The patient diagnosed with hypothyroidism is prescribed Levothyroxine. Which assessment data indicates the medication has been effective?
The patient's temperature is within normal limits
A client has an intravenous potassium replacement ordered for treatment ofhypokalemia. Which of the following pertaining to potassium chloride (KCL) guides the nurse's administration of this drug?
The rate of administration should be slow not to exceed 10 mEq/hr
Which of the following classifications of Oral Antidiabetic medications works by reducing peripheral insulin resistance and helps promote glucose uptake in peripheral tissues?
Thiazolidinediones
A 19 year-old patient is receiving discharge teaching after being diagnosed with absence seizures. The patient is prescribed Ethosuximide. The nurse is instructing the patient about adverse reactions. Which of the following should the nurse include in her discussion?
This medication causes nausea, so take it with food.
A patient is placed in the holding area before surgery. After the patient has been prepared for surgery, the anesthesia provider administers Midazolam. The nurse knows that this medication was given for which of the following purposes?
To relieve anxiety
When the nurse is conducting an initial assessment, which specific data should the nurse obtain from the client who is suspected of having peptic ulcer disease?
Use of non-steroidal anti-inflammatory drugs (NSAIDS)
Hydroxychloroquine is prescribed for a client with rheumatoid arthritis. The nurse educates a patient for signs of an adverse effect related to the medication. Which of the following adverse effects should the patient understand is very serious and should be reported immediately?
Vision disturbances
A client is diagnosed with Multiple Sclerosis (MS) and is prescribed methylprednisolone. What should the nurse include in teaching about the side effects of this medication? Select all that apply
Weight Gain Hyperglycemia Peripheral edema Mood swings Risk for infection
A client takes hydrochlorothiazide, a potassium-wasting diuretic, for control of blood pressure. Which symptom of hypokalemia does the nurse teach the client to report?
fatigue and muscle weakness
A client is being sent home from the GI clinic with a prescription to treat GERD. Which of the following medications inhibit acid production?
lansoprazole (Prevacid)
A patient is placed in the holding area before surgery. After the patient has been prepared for surgery, the anesthesia provider gives the client Scopalamine. The nurse knows that this medication was given for which of the following reasons?
to dry secretions