pharm hesi

A client who is receiving medication for an eye disorder reports bleeding in the eye. Which medication will the nurse expect to find in the client's recent medication history? A. Ketorolac B. Trifluridine C. Natamycin D. Ciprofloxacin

Ketorolac

Which relationship reflects the relationship of naloxone to morphine sulfate? A. Aspirin to warfarin B. Amoxicillin to infection C. Enoxaparin to dalteparin D. Protamine sulfate to heparin

Protamine sulfate to heparin

Which test would the nurse identify as specific for the diagnosis of myasthenia gravis? A. ​Electromyography B. ​Pyridostigmine test C. ​Edrophonium chloride test D. ​History of physical deterioration

edrophonium chloride test

dverse outcomes of antiseizure medications such as phenytoin

unsteady gait, slurred speech, extreme fatigue, blurred vision or feelings of suicide.

2) Which client statement indicates that teaching about acetaminophen is effective? A. "I can drink beer with this but not wine." B. "I need to limit my intake of acetaminophen to 650 mg a day." C. "I should take an emetic if I accidentally overdose on acetaminophen." D. "I have to be careful about which over-the-counter cold preparations I take."

"I have to be careful about which over-the-counter cold preparations I take."

Which would the nurse include when teaching a client with Parkinson disease about carbidopa-levodopa?

.​The medication should be taken with meals.

The nurse is discharging a client with a new prescription for tiotropium to help manage the symptoms of chronic obstructive pulmonary disease. What information should the nurse include in the discharge teaching? A.​It may be a few days before you feel the full effects of tiotropium. B.​This medication cannot be used to relieve sudden breathing problems. C.​Be sure to swallow the capsules with a full glass of water. D.​A common side effect is nausea and loose stools.

​This medication cannot be used to relieve sudden breathing problems.

The nurse understands which antiepileptic medication would be used as the first-line treatment for absence seizures? A.​Phenytoin B.​Diazepam C.​Valproic acid D.​Acetazolamide

​Valproic acid

13) The nurse is caring for a client who is actively dying and has been receiving high doses of opioid analgesics. The client has become unresponsive to verbal stimuli. What action should the nurse take? A. Stop giving the analgesic B. Give an extra dose of the analgesic C. Decrease the analgesic dosage by half D. Continue the analgesic at the current dose

. Continue the analgesic at the current dose

A postoperative client receiving a continuous IV infusion of meperidine 35 mg/hr for the past four days has become increasingly restless and irritable, and begins to hallucinate. Which action should the nurse take first? A. Administer a PRN dose of the PO lithium. B. Administer naloxone IV push. C. Decrease the IV infusion rate of the meperidine. D. Increase the IV infusion rate of the meperidine.

. Decrease the IV infusion rate of the meperidine.

morphine prescribed parenterally (SQ/IM/IV), the recommended pediatric dose is

0.1 to 0.2 mg/kg

At which time would the nurse plan to administer morphine 2 mg by mouth every 2 hours as needed to a client who has burns on 55% of the body surface and requires dressing changes? A. 15 minutes before the dressing change B. 60 minutes before the dressing change C. Along with a stool softener each time it is administered D. Only if the client rates pain between 8 and 10 on the pain scale

60 minutes before the dressing change

maximal daily dose for alprazolam

8 mg/ day

Which medication increases the risk for upper gastrointestinal (GI) bleeding? Select all that apply. One, some, or all responses may be correct. A. Aspirin B. Ibuprofen C. Ciprofloxacin D. Acetaminophen E. Methylprednisolone

A, B, E

2) A client is diagnosed with trigeminal neuralgia. Which nonanalgesic can decrease the client's pain? A. Echinacea B. Leucovorin C. Allopurinol D. Carbamazepine

Carbamazepine

A health care provider prescribes morphine for a client being treated for myocardial infarction. Which physiological response will occur if the client experiences the intended therapeutic effect of morphine? A. Increased respiratory rate B. Decreased workload of the heart C. Dilation of coronary arteries D. Diminished metabolites within the ischemic heart muscle

Decreased workload of the heart

A client is treated with lorazepam for status epilepticus. Which effect of lorazepam is the reason it is given? A.​Decreases anxiety associated with seizures B.​Promotes rest after the seizure episode C.​Depresses the central nervous system (CNS) D.​Provides amnesia for the convulsive episode

Depresses the central nervous system (CNS)

The nurse is teaching a client about tricyclic antidepressants. Which potential side effects would the nurse include? Select all that apply. One, some, or all responses may be correct. A.​Dry mouth B.​Drowsiness C.​Constipation D.​Severe hypertension E.​Orthostatic hypotension

Dry mouth B.​Drowsiness C.​Constipation rthostatic hypotension

An older adult client has been prescribed zolpidem for insomnia. The nurse should monitor the client for which side/adverse effect of this medication? A.​ Tachypnea B.​ Hypotension C.​ Tachycardia D.​ Constipation

Hypotension

A nurse is providing education on the use of pregabalin to a client with a seizure disorder. Which client statement indicates further teaching is required? A.​I will record the number of seizures I experience B.​I will hold the dose if my seizures are controlled C.​I will notify my healthcare provider if I have significant mood changes D.​I will report any weight gain to my healthcare provider

I will record the number of seizures I experience

3) An adolescent is admitted with partial- and full-thickness burns of the arms and upper torso. Which are the primary purposes of administering pain medication via the intravenous route, rather than the intramuscular route? Select all that apply. One, some, or all responses may be correct. Adolescents are afraid of injections. It decreases the risk of tissue irritation. Severe pain is reduced more effectively. Impaired peripheral circulation is bypassed. It provides for more prolonged relief of pain.

It decreases the risk of tissue irritation. Severe pain is reduced more effectively.

The nurse provides care for a client with a long history of alcohol abuse. Which medication would the nurse anticipate will be prescribed for the client to prevent symptoms of withdrawal? A.​Lorazepam B.​Phenobarbital C.​Chlorpromazine D.​Disulfiram

Lorazepam

The nurse is caring for a child diagnosed with seizures. While teaching the family and the child about the medication phenytoin, which concept should the nurse emphasize? A.​Omit the medication if the child is seizure-free B.​Serve a diet that is high in iron C.​A rash is normal with this medication D.​Maintain good oral hygiene and dental care

Maintain good oral hygiene and dental care

Which medication is indicated to treat shift-work sleep disorder (SWSD)? A.​Caffeine B.​Modafinil C.​Atomoxetine D.​Methylphenidate

Modafinil

Which effect would the nurse monitor to evaluate the effectiveness of carbamazepine in the management of a client's trigeminal neuralgia? A.​Pain intensity B.​Gait C.​Range of motion D.​Seizure activity

Pain intensity

A client with insomnia takes a new medication to promote sleep. Two hours later, the client is wide awake and feeling more energized than before the medication was taken. Which type of response is the client demonstrating? A.​Allergic B.​Synergistic C.​Paradoxical D.​Idiosyncratic

Paradoxical

Which concern will the nurse keep in mind when a client has been taking a benzodiazepine? A.​Rebound insomnia may occur if the medication is discontinued abruptly. B.​Lifelong treatment is often required. C.​Higher doses are needed to accommodate physiological changes during pregnancy. D.​These medications have both analgesic and antidepressant properties.

Rebound insomnia may occur if the medication is discontinued abruptly.

A client abruptly stops taking a barbiturate. Which withdrawal complication would the nurse anticipate that the client may experience? A.​Ataxia B.​Seizures C.​Diarrhea D.​Urticaria

Seizures

The nurse is teaching a group of clients diagnosed with arthritis about the use of non-steroidal anti-inflammatory agents (NSAIDs). In order to minimize side effects of these drugs, which action should the nurse emphasize? A. Eat a diet high in fiber B. Limit foods high in Vitamin K C. Take the medication with food D. Take the drug with an antacid

Take the medication with food

Which information would the nurse include in the teaching plan for the client who is prescribed sumatriptan for migraine headache? A. It should be administered when headache is at its peak. B. It should be administered by deep intramuscular injection. C. Is contraindicated in people with coronary artery disease. D. Injectable sumatriptan may be administered every 6 hours as needed.

s contraindicated in people with coronary artery disease. promoting therapeutic cerebral vasoconstriction, sumatriptan promotes undesirable coronary artery vasoconstriction. Coronary vasoconstriction may cause harm to the client with coronary artery disease

The nurse understands which anesthetic medication is commonly used for short procedures on pediatric clients? A. Fentanyl B. Morphine C. Meperidine D. Hydromorphone

Fentanyl

Almotriptan and other triptans work by

serotonin receptor agonists that work by causing vasoconstriction of intracranial arteries. The drug is most effective when taken as soon as migraine symptoms start but before the onset of acute pain

Diazepam is administered to the client with status epilepticus. In addition to decreasing central neuronal activity, which effect would the nurse anticipate?

​Relaxing of peripheral muscles

What is tiotropium?

long-acting anticholinergic bronchodilator

The nurse is teaching a client with rheumatoid arthritis about etanercept. Which statement by the client indicates that the client understood the teaching? A. "I will take the medication daily, first thing in the morning on an empty stomach." B. "The medication needs to be mixed well. I will shake the bottle to mix it." C. "I will need to come to the clinic every 6 weeks to receive an intravenous infusion." D. "I will store the medication in a refrigerator and let it warm to room temperature before injecting it."

"I will store the medication in a refrigerator and let it warm to room temperature before injecting it."

An adult client is given a prescription for a scopolamine patch (Transderm Scop) to prevent motion sickness while on a cruise. Which information should the nurse provide to the client? A.​ Apply the patch at least 4 hours prior to departure. B.​ Change the patch every other day while on the cruise. C.​ Place the patch on a hairless area at the base of the skull. D.​ Drink no more than 2 alcoholic drinks during the cruise.

Apply the patch at least 4 hours prior to departure.

A client is admitted to the emergency department with crushing chest pain. A diagnosis of acute coronary syndrome is suspected. Which medication is indicated to prevent progression to a myocardial infarction? A. Aspirin B. Atropine C. Gabapentin D. Epinephrine

Aspirin

Which medication would the nurse anticipate the health care provider will prescribe to relieve the pain experienced by a client with rheumatoid arthritis? A. Aspirin B. Hydromorphone C. Meperidine D. Alprazolam

Aspirin

A client develops tinnitus. Which of the client's medications would the nurse suspect is the cause of this new development? A. Digoxin 0.25 mg, one tablet daily B. Aspirin 325 mg, two tablets every 4 hours C. Captopril 25 mg, one tablet three times daily D. Diphenhydramine 25 mg, one tablet every 4 to 8 hours prn

Aspirin 325 mg, two tablets every 4 hours

A client suspected of having myasthenia gravis is scheduled for an edrophonium chloride test. To treat a common complication associated with the test, the nurse will have which medication available? A.​ Atropine B. ​Phenytoin C. ​Neostigmine D. ​Diphenhydramine

Atropine

Why should the nurse should question the use of atropine with a client who has glaucoma

Atropine is contraindicated in clients with angle-closure glaucoma because it can cause pupillary dilation with an increase in aqueous humor.

A nurse is providing education on the use of carbidopa/levodopa to a client with Parkinson's disease. What will the nurse include in the teaching?

Avoid eating meals that are high in protein

A client who is addicted to heroin has major surgery. Afterward, the client receives methadone. Which purpose does the methadone serve? A. Allows symptom-free termination of opioid addiction B. Switches the user from illicit opioid use to use of a legal drug C. Provides postoperative pain control without causing opioid dependence D. Counteracts the depressive effects of long-term opioid use on thoracic muscles

B Methadone is used in the medically supervised withdrawal period to treat physical dependence on opiates; methadone therapy substitutes a legal drug for an illegal one

The anticholinesterase medication pyridostigmine is prescribed for the client with myasthenia gravis. When providing medication teaching, the nurse explains that the client should expect a decrease in which function? A. ​Bowel function B. ​Heart rate C. ​Skeletal muscle contraction D. ​Urinary frequency

B. ​Heart rate

The nurse is caring for a client who is receiving aspirin therapy. Which clinical indicator would be related to this therapy? A. Urinary calculi B. Atrophy of the liver C. Prolonged bleeding time D. Premature erythrocyte destruction

C. Prolonged bleeding time

The nurse in the neurology office is reviewing information about levetiracetam with a 30-year-old female client with a history of seizures. Which instruction about the medication should the nurse make sure to include? A.​"Call the office immediately if you feel like hurting or killing yourself." B.​"You should avoid becoming pregnant while taking this medication." C.​"You should stay away from large crowds and sick children." D.​"You might experience irregular menses and intermittent bleeding."

Call the office immediately if you feel like hurting or killing yourself."

A client is diagnosed with trigeminal neuralgia. Which nonanalgesic can decrease the client's pain? A.​Echinacea B.​Leucovorin C.​Allopurinol D.​Carbamazepine Rationale Carbamazepine is an anticonvulsant that can be used to control neurological pain such as trigeminal neuralgia. Echinacea is an herbal medication used by some to treat respiratory infections, but not neuralgic pain. Leucovorin is used as rescue medication with methotrexate to prevent cellular damage; it does not relieve neurological pain. Allopurinol is used in the treatment of gout but does not relieve pain.

Carbamazepine

An 18-month-old toddler is being treated with intravenous diazepam every 4 hours for generalized tetanus. Which response to the medication would the nurse anticipate? A.​Control of hypertonicity and prevention of seizures B.​Control of laryngospasms and neck and jaw rigidity C.​Prevention of excess oxygen and caloric expenditure D.​Prevention of restlessness and resistance to assisted ventilation

Control of laryngospasms and neck and jaw rigidity

The nurse is caring for a client who was recently prescribed atropine as a treatment for symptomatic bradycardia. Which condition should the nurse question as a contraindication when taking this medication? A.​Urinary incontinence B.​Right-sided heart failure C.​Glaucoma D.​Increased intracranial pressure

Glaucoma

The nurse is caring for a client with Parkinson's disease. Which finding indicates that the client might be experiencing an adverse side effect from the dopamine-enhancing drugs? Urinary retention B.​Hallucinations C.​Kidney failure D.​Hypertensive urgency

Hallucinations

Which primary reason identifies why oxazepam is given during detoxification? A.​Prevents injury when seizures occur B.​Enables the client to sleep better during periods of agitation C.​Encourages the client to accept treatment for alcoholism D.​Minimizes withdrawal symptoms the client may experience

Minimizes withdrawal symptoms the client may experience

A client with a history of heart disease has been prescribed prophylactic aspirin daily. Which action should the nurse implement to help prevent aspirin toxicity? A. Monitor serum albumin B. Measure daily protein intake C. Assess serum potassium level D. Teach the client that tinnitus is an expected side effect

Monitor serum albumin

A school-age child with a seizure disorder has been on long-term carbamazepine therapy. Which intervention would the nurse incorporate into the plan of care? A. Assessing the mouth for gingivitis B. Checking the pupillary reaction to light C. Keeping an accurate intake and output record D. Monitoring the child's complete blood cell counts

Monitoring the child's complete blood cell counts

6) The nurse is caring for a client hospitalized with a myocardial infarction. Which analgesic is the medication of choice for this client? A. Ketorolac B. Meperidine C. Flurazepam D. Morphine sulfate

Morphine sulfate

2) The client is using nonsteroidal anti-inflammatory drugs (NSAIDs) to manage arthritis pain. The nurse should caution the client about which potential side effect? A. Urinary incontinence B. Nystagmus C. Constipation D. Occult bleeding

Occult bleeding

Which finding would the nurse report to the health care provider when caring for a client prescribed temazepam at bedtime? Anxiety Drowsiness Sleep driving Morning headache

Sleep driving

A health care provider prescribes tolterodine for a client with an overactive bladder. Which action is important to include in client teaching? A.​Maintain a strict record of fluid intake and urinary output. B.​Chew the extended-release capsule thoroughly before swallowing. C.​Report episodes of diarrhea or any increase in respiratory secretions. D.​Avoid activities requiring alertness until the response to medication is known.

Report episodes of diarrhea or any increase in respiratory secretions.

The nursing is preparing to administer phenytoin IV push to a client. The client has dextrose 5% in water infusing continuously. Which action is appropriate? A.​Pinch the line above the infusion port during the administration B.​Hold the medication and collaborate with the provider prior to administration C.​Stop the infusion and flush the port with normal saline prior to administration D.​Ask the pharmacy to mix the medication into an IV piggyback (IVPB) infusion

Stop the infusion and flush the port with normal saline prior to administration

Pyridostigmine is prescribed for a client with myasthenia gravis. Why would the nurse instruct the client to take pyridostigmine about 1 hour before meals? A. ​This timing limits first pass metabolism. B. ​Taking it on an empty stomach increases absorption. C. ​Taking it before meals decreases gastric irritation. D. ​Taking it before meals improves the ability to chew.

Taking it before meals improves the ability to chew.

A client has completed therapy and requests to discontinue treatment with benzodiazepines. Which information would the nurse provide to prevent injury? A.​Taper dose over several months. B.​Switch to using an antidepressant. C.​Refrain from renewing prescription. D.​Monitor for signs of increased anxiety.

Taper dose over several months.

A nurse has administered acetaminophen for pain relief to an infant. Based on the client's development stage, which action is most important to include in the medication administration record? A. The dose administered based on the client weight B. The client pain level after administration of the medication C. The time the dose was administered to the client D. The client vital signs before the medication was administered

The dose administered based on the client weight

Which rationale explains why the nurse would question a benzodiazepine prescription for an individual experiencing acute grief? A.​The depression is magnified, and the risk of suicide increases. B.​Brain activity is suppressed, and the risk of depression increases. C.​Lethargy results, and it prevents a return to interpersonal activity. D.​The period of denial is extended, and the grieving process is suppressed.

The period of denial is extended, and the grieving process is suppressed.

the nurse is teaching a client diagnosed with depression about a new prescription of nortriptyline. What information would be essential for the nurse to emphasize about this medication? A.​Episodes of diarrhea can be expected B.​The medication must be stored in the refrigerator C.​The use of alcohol should be avoided D.​Symptom relief occurs in a few days

The use of alcohol should be avoided

The nurse is educating a client about newly prescribed alprazolam. Which information should the nurse include in the teaching? A.​Tardive dyskinesia is common early in treatment. B.​Administration of paroxetine may be needed to prevent adverse effects. C.​The use of grapefruit juice should be avoided. D.​Hyperactivity is seen with long-term use.

The use of grapefruit juice should be avoided.

A client with a known history of opioid addiction has a surgical repair of multiple stab wounds to the abdomen. After surgery, the client's pain is not relieved by the prescribed morphine injections. Which phenomenon is the client experiencing when they fail to achieve pain relief? A. Tolerance B. Habituation C. Physical addiction D. Psychological dependence

Tolerance

Which medication class includes amitriptyline? A.​Tricyclics B.​Monoamine oxidase inhibitors (MAOIs) C.​Selective serotonin reuptake inhibitors (SSRIs) D.​Serotonin-norepinephrine reuptake inhibitors (SNRIs) Rationale

Tricyclics

Which symptom of levodopa toxicity will a client taking levodopa be taught as a reason to contact the primary health care provider? A.​Nausea B.​Dizziness C.​Twitching D.​Constipation

Twitching

Which adverse effect of imipramine requires further assessment and possible immediate medical intervention? A.​Dry mouth B.​Weight gain C.​Blurred vision D.​Urinary hesitancy

Urinary hesitancy

1) Which medication is indicated for emergency treatment of bleeding esophageal varices? A.​Vasopressin B.​Neostigmine C.​Lansoprazole D.​Phytonadione

Vasopressin

A client who has been taking the prescribed dose ofzolpidem for 5 days returns to the clinic for a follow-up visit. Which statement by the client indicates the medication has been effective? A.​"I have less pain." B.​"I have been sleeping better." C.​"My blood glucose is under control." D.​"My blood pressure is coming down."

.​"I have been sleeping better."

10) Which would the nurse include in the client's medication teaching on the administration of aspirin 650 mg every 6 hours as needed for arthritic pain? Select all that apply. One, some, or all responses may be correct. A. 'Report persistent abdominal pain.' B. 'Do not chew enteric-coated tablets.' C. 'Take the aspirin with meals or a snack.' D. 'See a dentist if bleeding gums develop.' E. 'Switch to acetaminophen if tinnitus occurs.'

A, B, C

8) A health care provider prescribes aspirin therapy for a client with arthritis. The nurse will advise the client to report which adverse effects? Select all that apply. One, some, or all responses may be correct. A. Ongoing nausea B. Constipation C. Easy bruising D. Decreased pulse E. Ringing in the ears

A, C, E

A. "This combination medication will better help to manage your pain." B. "The combination medication will reduce the chance of addiction." C. "This medication will minimize any side effects from the codeine." D. "This medication combination will allow healing to occur faster." Rationale:

A. The use of acetaminophen with codeine potentiates the effect of the codeine, thus providing greater/better pain relief

A client is diagnosed with rheumatoid arthritis (RA). Which types of drugs might the nurse expect to be ordered as a combination drug therapy regimen? Select all that apply. A. Glucocorticoids Correct Answer B. Biological-response modifiers Correct Answer C. Antimicrobial agents D. Diuretics E. Anti-inflammatory drugs Correct Answer

A. Glucocorticoids Correct Answer (Blank) B. Biological-response modifiers Correct Answer (Blank) Anti-inflammatory drugs Correct Answer

The nurse is caring for an 81-year-old client with colorectal cancer. Previously, the client's pain was managed with acetaminophen with codeine. However, the client is now experiencing frequent, severe pain and intravenous morphine has been prescribed. What should the nurse recognize about this order? A. Inappropriate due to the potential of respiratory depression B. Inappropriate and demonstrates lack of knowledge related to pain control C. Appropriate despite the risk of diarrhea and abdominal upset D. Appropriate pain management and should be available around the clock

A. Inappropriate due to the potential of respiratory depression

Which effect would the nurse monitor to evaluate the effectiveness of carbamazepine in the management of a client's trigeminal neuralgia? A. Pain intensity B. Gait C. Range of motion D. Seizure activity

A. Pain intensity

7) Which manifestation is an adverse effect of intravenous lorazepam? Select all that apply. One, some, or all responses may be correct. A.​Amnesia B.​Drowsiness C.​Sleep driving D.​Blurred vision E.​Respiratory depression

A.​Amnesia B.​Drowsiness C.​Sleep driving D.​Blurred vision E.​Respiratory depression

Which administration guidelines would the nurse follow when administering midazolam to an older client? A.​The increments should be smaller, and the rate of injection should be slower. B.​The medication should be given as a rapid intravenous push. C.​It is important to monitor for spikes in blood pressure elevation during administration. D.​During the procedure, the medication should be given as needed for pain management.

A.​The increments should be smaller, and the rate of injection should be slower.

When assessing an adolescent who recently overdosed on acetaminophen (Tylenol), it is most important for the nurse to assess for pain in which area of the body? A. Flank. B. Abdomen. C. Chest. D. Head.

Abdomen

An adult client has prescriptions for morphine sulfate 2.5 mg IV every 6 hours and ketorolac (Toradol) 30 mg IV every 6 hours. Which action should the nurse implement? A. Administer both medications according to the prescription. B. Hold the ketorolac to prevent an antagonistic effect. C. Hold the morphine to prevent an additive drug interaction. D. Contact the healthcare provider to clarify the prescription.

Administer both medications according to the prescription.

Which action is likely to reduce the pancreatic and gastric secretions of a client with pancreatitis? A.​Encourage clear liquids. B.​Obtain a prescription for morphine. C.​Assist the client into a semi-Fowler position. D.​Administer prescribed anticholinergic medication.

Administer prescribed anticholinergic medication.

4) A client takes acetaminophen routinely. The nurse will advise the client to avoid which substance? A. Alcohol B. Caffeine C. Diphenhydramine D. Ibuprofen

Alcohol

1) Which treatment would the nurse be referring to when explaining to a client with trigeminal neuralgia that treatment is effective on a temporary (6- to 18-month) basis? A. Weekly intravenous injections of cobra venom B. A lidocaine injection at the ventral root of the 11th spinal nerve C. Microvascular decompression of the blood vessels at the nerve root D. An alcohol injection at the peripheral branch of the fifth cranial nerve

An alcohol injection at the peripheral branch of the fifth cranial nerve

A client with Parkinson's disease is taking carbidopa-levodopa (Sinemet). Which observation by the nurse would indicate that the desired outcome of the medication is being achieved?

B.​ Lessening of tremors.

1) The nurse has given discharge instructions to a client who suffers from sensory neuropathy due to diabetes. The client was prescribed gabapentin. Which of the following statements indicates that the client understands the nurse's instructions regarding the medication? A.​"The medication might cause me to have insomnia." B.​"I can stop taking the medication at any time." C.​"My doctor prescribed it for the pain in my legs." D.​"It is safe to take extra doses if my pain becomes worse."

C.​"My doctor prescribed it for the pain in my legs."

Which instruction would the nurse give to clients prescribed psychotropic medications who are experiencing anticholinergic-like side effects? A.​'Restrict fluid intake.' B.​'Eat a diet high in carbohydrates.' C.​'Suck on sugar-free hard candies.' D.​'Avoid products that contain aspirin.'

C.​'Suck on sugar-free hard candies.'

1) Which response would the nurse give to a client taking ibuprofen for rheumatoid arthritis who asks the nurse if acetaminophen can be substituted? A. "Yes, both are antipyretics and have the same effect." B. "Acetaminophen irritates the stomach more than ibuprofen does." C. "Acetaminophen is the preferred treatment for rheumatoid arthritis." D. "Ibuprofen has anti-inflammatory properties, and acetaminophen does not."

D. "Ibuprofen has anti-inflammatory properties, and acetaminophen does not."

A client has a tonic-clonic seizure. The nurse anticipates that the health care provider will prescribe the intravenous administration of which medication? A.​Naloxone B.​Diazepam C.​Epinephrine HCl D.​Atropine

Diazepam

A client is admitted to the acute medical unit for severe amphetamine intoxication. Which medications are indicated to counteract the effects of stimulant intoxication? Select all that apply. One, some, or all responses may be correct. A.​Diazepam B.​Propranolol C.​Benztropine D.​Bupropion E.​Amitriptyline

Diazepam B.​Propranolol

A client is experiencing anaphylaxis from an insect sting. Which medication should the nurse administer? A.​ Dopamine. B.​ Ephedrine. C.​ Epinephrine. D.​ Diphenhydramine.

Epinephrine

A toddler ingested half a bottle of aspirin tablets. Which finding should the nurse expect to see in this child? A. Dyspnea B. Hypothermia C. Edema D. Epistaxis

Epistaxis

A nurse is reviewing analgesic prescriptions for a client with a history of liver cirrhosis. The prescriptions state to administer PRN for pain. Which medication is the nurse most likely to administer to this client? A. Fentanyl B. Acetaminophen C. Ibuprofen D. Ketorolac

Fentanyl

Which medication would the nurse expect to administer to actively reverse the overdose sedative effects of benzodiazepines? A.​Lithium B.​Flumazenil C.​Methadone D.​Chlorpromazine

Flumazenil

An 80-year-old client with depression requires the prescription of antidepressant medication. Which tricyclic antidepressant medication causes fewer complications in older clients? A.​Doxepin B.​Amoxapine C.​Nortriptyline D.​Trimipramine

Nortriptyline

A school-age child with a seizure disorder has been on long-term carbamazepine therapy. Which intervention would the nurse incorporate into the plan of care? A.​Assessing the mouth for gingivitis B.​Checking the pupillary reaction to light C.​Keeping an accurate intake and output record D.​Monitoring the child's complete blood cell counts

Monitoring the child's complete blood cell counts

A client has increased intracranial pressure and is unconscious with a heart rate of 60 beats/min, respirations 16 breaths/min, and blood pressure 142/64 mm Hg. The nurse reviews the treatment plan and questions which prescription? A. Mannitol B. Dexamethasone C. Chlorpromazine D. Morphine

Morphine

3) The nurse teaches the client about effects of carbamazepine that would be reported to the primary health care provider. Which effects would the nurse include? Select all that apply. One, some, or all responses may be correct. A.​Nausea B.​Dizziness C.​Unusual bleeding or bruising D.​Sensitivity to bright light or sun E.​Breast enlargement

Nausea, Unusual bleeding or bruising

A client is admitted to the emergency department after experiencing a seizure. Which action would the nurse take first? Ask the emergency provider for a prophylactic anticonvulsant. Obtain a history of seizure type and incidence. Ask the client to remove any dentures and eyeglasses. Observe the client for increased restlessness and agitation.

Obtain a history of seizure type and incidence.

A client who takes four 325-mg tablets of buffered aspirin four times a day for severe arthritis complains of dizziness and ringing in the ears. Which complication would the nurse conclude that the client probably is experiencing? A. Salicylate toxicity B. Allergic reaction C. Withdrawal symptoms D. Aspirin tolerance

Salicylate toxicity

A client with Parkinson's disease is prescribed benztropine (Cogentin). For which of the following should the nurse call the health care provider immediately? A.​The client is complaining of dizziness when standing up. B.​The client is exhibiting bradykinesia and slurred speech. C.​The client's heart rate increased from 80 to 95 beats per minute. D.​The client has a history of primary angle-closure glaucoma.

The client has a history of primary angle-closure glaucoma.

1) A nurse is preparing to administer indomethacin to a client with acute pain. Which medication on the client's medical record will prompt the nurse to monitor the client more frequently? A. Pantoprazole B. Warfarin C. Simvastatin D. Alprazolam

Warfarin

Warfarin is prescribed for the client who takes phenytoin for a seizure disorder. Which medication interaction complicates seizure therapy? A.​Warfarin inhibits the metabolism of phenytoin. B.​Warfarin decreases phenytoin absorption. C.​Phenytoin competes with warfarin for receptor occupation. D.​Warfarin promotes excretion of phenytoin.

Warfarin inhibits metabolism of phenytoin, which can result in phenytoin toxicity.

During the admission process, the client reports heavy alcohol use for at least one year. What effect does the nurse anticipate the hospitalized client will experience when alcohol consumption stops? A.​Bradycardia B.​Somnolence C.​Withdrawal D.​Tachypnea

Withdrawal

Which adverse effect would the nurse continually assess for in a client receiving valproic acid? A.​Yellow sclerae B.​Motor restlessness C.​Ringing in the ears D.Torsion of the neck

Yellow sclerae are a sign of jaundice; pancreatitis and hepatic failure are life-threatening adverse effects of valproic acid. The client must have frequent liver function tests

Which action would the nurse implement for a client who has overdosed on barbiturates? Select all that apply. One, some, or all responses may be correct. A.​Apply ice packs. B.​Maintain airway. C.​Administer naloxone. D.​Give activated charcoal. E.​Give intravenous fluids.

airway, Give activated charcoal, ​give intravenous fluids.

The nurse teaches the client about effects of carbamazepine that would be reported to the primary health care provider.

nausea, unusual bleeding or bruising

When a client exhibits severe bradycardia, which type of medication will the nurse be prepared to administer? A.​Nitrate B.​Anticholinergic C.​Antihypertensive D.​Cardiac glycoside

​Anticholinergic

Which class of medication would the nurse anticipate preparing to administer to a client with alcohol dependence admitted to a detoxification unit? A.​Opiate B.​Antipsychotic C.​Antidepressant D.​Benzodiazepine

​Benzodiazepine

A client with Parkinson disease is admitted to the hospital. Which medication is prescribed to improve the physical manifestations of Parkinson disease?

​Carbidopa-levodopa

A client with Parkinson disease is admitted to the hospital. Which medication is prescribed to improve the physical manifestations of Parkinson disease? A.​Carbidopa-levodopa B.​Isocarboxazid C.​Dopamine D.​Pyridoxine (vitamin B 6) Rationale

​Carbidopa-levodopa

Which body system is affected by excessive use ofamphetamine / dextroamphetamine? A.​Renal B.​Cardiac C.​Musculoskeletal D.​Gastrointestinal

​Cardiac

A client begins treatment with pyridostigmine bromide therapy for myasthenia gravis. Which action would the nurse perform in administration of the medication? A. ​Administer the medication after meals. B. ​Administer the medication on an empty stomach. C. ​Evaluate the client's psychological responses between medication doses. D. ​Evaluate the client's muscle strength every hour after the medication is given.

​Evaluate the client's muscle strength every hour after the medication is given.

Which medication acts as an antidote to benzodiazepine? A.​Zolpidem B.​Temazepam C.​Suvorexant D.​Flumazenil

​Flumazenil

The daughter of a client with Alzheimer's disease asks the nurse, "Will the medication my mother is taking cure her dementia?" What is the best response by the nurse? A.​"It will help your mother live independently again." B.​"It is used to halt the progression of Alzheimer's disease." C.​"It will not improve dementia but can help control emotional responses." D.​"It will provide a steady improvement in memory."

.​"It will not improve dementia but can help control emotional responses."

1) The mother of an infant recently prescribed phenobarbital for seizures calls the pediatric clinic and states that the infant is lethargic and sleeps for long periods. Which response by the nurse is most appropriate? A.​'There's a medication that will prevent this problem.' B.​'This means that your baby's dosage needs to be adjusted.' C.​'This is a temporary response to the medication; it usually stops after a few weeks.' D.​'Many infants experience the same problem, but your baby needs the medication.' Rationale

.​'This is a temporary response to the medication; it usually stops after a few weeks.'

A client with a history of methamphetamine use is admitted to the medical unit. Which clinical manifestation would the nurse expect when assessing the client who is under the influence on admission? A. ​Constricted pupils B.​Intractable diarrhea C.​Increased heart rate D.​Decreased respirations

.​Increased heart rate

The nurse is providing discharge education to a client who is prescribed alprazolam for a panic disorder. What concept should the nurse emphasize concerning the drug action? A.​Short-term relief can be expected B.​The medication acts as a stimulant C.​The medication works by suppressing dopamine D.​If you miss a dose, double the next scheduled dose

.​Short-term relief can be expected

Which client should the nurse identify as being at highest risk for complications during the use of an opioid analgesic? A. An older client with Type 2 diabetes mellitus. B. A client with chronic rheumatoid arthritis. C. A client with a open compound fracture. D. A young adult with inflammatory bowel disease.

A young adult with inflammatory bowel disease. The principal indication for opioid use is acute pain, and a client with inflammatory bowel disease is at risk for toxic megacolon or paralytic ileus related to slowed peristalsis, a side effect of morphine. Adverse effects of morphine do not pose as great a risk for clients with diabetes or a fracture as for the client with bowel disease.

Which instruction about phenytoin will the nurse provide during discharge teaching to a client with epilepsy who is prescribed phenytoin for seizure control? A.​"Antiseizure medications will probably be continued for life." B.​"Phenytoin prevents any further occurrence of seizures." C.​"This medication needs to be taken during periods of emotional stress." D.​"Your antiseizure medication usually can be stopped after a year's absence of seizures."

A.​"Antiseizure medications will probably be continued for life."

Which statement by the nurse reflects teaching for a client recently initiated on anticonvulsants? Select all that apply. One, some, or all responses may be correct. A.​'It is important to take the medication at the same time every day with meals.' B.​'It is important to not drink excessive amounts of caffeine-containing beverages or alcohol.' C.​'Avoid driving or hazardous activities until any side effects such as drowsiness can be determined.' D.​'Some anticonvulsants interfere with vitamin and mineral absorption, so you may need a supplement.' E.​'Oral hygiene, such as gum massage and tooth brushing, is important to combat the gingival hyperplasia that some anticonvulsant medication can cause.'

A.​'It is important to take the medication at the same time every day with meals.' B.​'It is important to not drink excessive amounts of caffeine-containing beverages or alcohol.' ​'Oral hygiene, such as gum massage and tooth brushing, is important to combat the gingival hyperplasia that some anticonvulsant medication can cause.'

The nurse is preparing to administer newly prescribed intravenous phenytoin to a client. When reviewing the client's medical record, which prescription should the nurse question? A.​Continuous infusion of dextrose 5% in 0.9% saline B.​NPH insulin 40 units before meals C.​Labetalol 100 mg orally twice per day Your Answer D.​Ketorolac 15 mg IV push as needed for pain

A.​Continuous infusion of dextrose 5% in 0.9% saline Phenytoin is not compatible with most IV fluids, especially those with dextrose.

Which statement accurately describes nortriptyline? Select all that apply. One, some, or all responses may be correct. A.​Overdosage is often lethal. B.​Constipation and urinary retention may occur. C.​It is a selective serotonin reuptake inhibitor (SSRI). D.​Weight gain is a common side effect. It increases effectiveness of monoamine oxidase inhibitors (MAOIs).

A.​Overdosage is often lethal. B.​Constipation and urinary retention may occur. Weight gain is a common side effect.

2) A client has been taking alprazolam for three days. For which expected effect of the medication should the nurse evaluate the client? A.​The client reports sleeping through the night. B.​The client reports feeling less depressed. C.​The client denies having auditory hallucinations. D.​The client denies having suicide ideation.

A.​The client reports sleeping through the night.

Which medication is safest to take for pain in the week before a surgical procedure? A) Naproxen B. Aspirin C. Ketorolac D. Acetaminophen

Acetaminophen

A nurse is assessing a client who takes prescribed oral indomethacin. Which client statement indicates an intended response to the medication? A. My appetite is greater in the mornings B. I am able to rotate my wrists without pain C. I no longer have to urinate in the middle of the night D. My endurance while exercising has improved

B. I am able to rotate my wrists without pain

A client who is addicted to opioids undergoes emergency surgery. During the postoperative period, the health care provider decreases the previously prescribed methadone dosage. Which clinical manifestations will the nurse monitor for when assessing this client? A. Constipation and lack of interest in surroundings B. Agitation and attempts to escape from the hospital C. Skin dryness and scratching under the incision dressing D. Lethargy and refusal to participate in therapeutic exercises

B. anxiety will increase, and the client will become agitated and may try to leave the hospital to secure drugs

A client with myasthenia gravis has been receiving neostigmine and asks about its action. Which information would the nurse consider when formulating a response? A. ​Stimulates the cerebral cortex B. ​Blocks the action of cholinesterase C. ​Replaces deficient neurotransmitters D. ​Accelerates transmission along neural sheaths

B. ​Blocks the action of cholinesterase

12) The health care provider prescribes a cholinergic medication to treat a client's urinary problem. Which effect would the nurse anticipate? A.​Urinary frequency decreases. B.​Urinary retention is prevented. C.​Pain is controlled. D.​Urinary urgency decreases.

B.​Urinary retention is prevented.

Which medications should the nurse caution the client about taking while receiving an opioid analgesic? A. Antacids. B. Benzodiazepines. C. Antihypertensives. D. Oral antidiabetics.

Benzodiazepines

A client receiving fluphenazine decanoate develops dystonia/extrapyramidal side effects early in therapy. Which medication would the nurse anticipate administering to reverse this side effect? A. ​Nafarelin B.​Fluoxetine C.​Trandolapril D.​Benztropine

Benztropine

A client develops extrapyramidal effects after taking a neuroleptic medication, and the nurse notes extrapyramidal effects. Which medication can limit these side effects? A. ​Zolpidem B.​Hydroxyzine C.​Dantrolene D.​Benztropine mesylate

Benztropine mesylate

Aspirin is prescribed for a client with rheumatoid arthritis. Which clinical indicators of aspirin toxicity will the nurse teach the client to report? Select all that apply. One, some, or all responses may be correct. Bradycardia Joint pain Blood in the stool Ringing in the ears Increased urine output

Blood in the stool Ringing in the ears

A child with juvenile idiopathic arthritis is prescribed nonsteroidal anti-inflammatory drug (NSAID) therapy at home. Which important toxic effect of NSAIDs would the nurse include in discharge instructions to the child and family? A. Diarrhea B. Hypothermia C. Blood in the urine D. Increased irritability

Blood in the urine

Which medication will the nurse question when it is prescribed for a client with acute pancreatitis? A. Ranitidine B. Cimetidine C. Meperidine D. Promethazine

C Meperidine should be avoided because accumulation of its metabolites can cause central nervous system irritability and even tonic-clonic seizures (grand mal seizures).

A client is prescribed the benzodiazepine alprazolam for the management of panic attacks. Which action by the patient makes the nurse confident that the medication information discussed has been understood? A.​The client removes the pepperoni from a pizza. B.​The client asks for an extra bottle of flavored water to drink with dinner. C.​The client requests a prescription for oral contraceptives before being discharged. D.​The client states that chewable antacids may be taken to relieve heartburn.

C.​The client requests a prescription for oral contraceptives before being discharged. Benzodiazepines increase the risk of congenital anomalies and so should not be taken by pregnant women.

5) Which would the nurse include when teaching a client with Parkinson disease about carbidopa-levodopa? A.​Multivitamins should be taken daily. B.​A high-protein diet should be followed. C.​The medication should be taken with meals. D.​Alcohol consumption should be in moderation.

C.​The medication should be taken with meals.

3) Status epilepticus develops in an adolescent with a seizure disorder who is taking antiseizure medication. Which reason would the nurse identify as the most common reason for the development of status epilepticus? A.​The provider failed to account for a growth spurt. B.​The amount prescribed is insufficient to cover activities. C.​The prescribed antiseizure medication probably is not taken consistently. D.​The client is prescribed a medication that is ineffective in preventing seizures. Rationale

C.​The prescribed antiseizure medication probably is not taken consistently.

32) In addition to hydration, parenteral lorazepam is prescribed for a client during alcohol withdrawal delirium. Which primary purpose accurately explains why this medication is given during detoxification? A.​To prevent injury when seizures occur B.​To enable the client to sleep better during periods of agitation C.​To reduce the anxiety tremor state and prevent more serious withdrawal symptoms D.​To calm the client and promote acceptance of the treatment plan

C.​To reduce the anxiety tremor state and prevent more serious withdrawal symptoms

The nurse prepares for intravenous administration of edrophonium chloride (Tensilon). What is the expected outcome for this client following administration of this pharmacologic agent? A.​ Progressive difficulty with swallowing. B.​ Decreased respiratory effort. C.​ Improvement in generalized fatigue. D.​ Decreased muscle weakness.

C: Administration of edrophonium chloride (Tensilon), a cholinergic agent, will temporarily reduce muscle weakness, the most common complaint of newly-diagnosed clients with myasthenia gravis

11) The client with a seizure disorder receives intravenous (IV) phenytoin. The nurse will monitor closely for which condition? A.​Cardiac dysrhythmias B.​Hypoglycemia C.​Polycythemia D.​Paradoxical excitation

Cardiac dysrhythmias

The health care provider prescribes alprazolam 5 mg by mouth three times a day for a client with anxiety. Which intervention will the nurse take before administering this prescription? A.​Assess the apical pulse. B.​Check the blood pressure. C.​Encourage the ventilation of feelings. D.​Clarify the prescription with the health care provider.

Clarify the prescription with the health care provider.

A nurse is evaluating a client who takes naproxen for pain associated with osteoarthritis. Which documented statement indicates the expected outcome was met? A. Decreased erythema noted to joints B. Muscle strength 3/5 to lower extremities C. Client observed with steady gait upon ambulation D. Deep tendon reflexes +3

Client observed with steady gait upon ambulation

The nurse is completing a health history of a client diagnosed with Alzheimer's disease. The nurse reviews a list of the client's medications and supplements routinely taken at home. Which treatment should be a cause for concern by the nurse? A.​Donepezil B.​Ginkgo biloba C.​Omega-3 fatty acids D.​Coconut oil

Coconut oil

Two weeks after starting phenobarbital sodium, the client develops new symptoms. Which symptom is probably caused by the medication? A.​Cognitive impairment B.​Frequent urination C.​Abdominal pain D.​Mania

Cognitive impairment

Which mechanism of action explains why naloxone is administered for a heroin overdose? A. Competition with opioids for occupancy of opioid receptors B. Blunts severity of withdrawal symptoms as heroin wears off C. Accelerated metabolism of heroin and stimulation of respiratory centers D. Stimulation of cortical sites that control consciousness and cardiovascular function

Competition with opioids for occupancy of opioid receptors

Carbidopa-levodopa is prescribed for a client with Parkinson's disease. Which instruction will the nurse include when teaching the client about this medication? A.​'Take this medication between meals.' B.​'Blood levels of the medication should be monitored weekly.' C.​'It can cause happy feelings followed by feelings of depression.' D.​'You may experience dizziness when moving from sitting to standing.'

You may experience dizziness when moving from sitting to standing.'

A 65-year-old client is receiving amitriptyline. Which recommendation will the nurse make to the client concerning this medication? A.​'Obtain a complete cholesterol and lipid profile.' B.​'Have an eye examination to check for glaucoma.' C.​'Check your temperature daily for nighttime increases.' D.​'Watch for excessive sweating and possible weight loss.'

Have an eye examination to check for glaucoma.'

Which medications would the nurse identify as commonly used as an adjunct during conscious sedation for minor surgeries?

​Midazolam

Which primary anxiolytic medication would the nurse anticipate developing a teaching plan for when a client with social anxiety disorder has a history of exhibiting an intense, irrational fear of being scrutinized by others? Select all that apply. One, some, or all responses may be correct. A.​Sertraline B.​Paroxetine C.​Alprazolam D.​Venlafaxine E.​Clonazepam

C.​Alprazolam, Clonazepam

A client has a tonic-clonic seizure caused by an overdose of aspirin. Which action would the nurse take next? A.​Check reflexes every 2 hours. B.​Insert a urinary retention catheter. C.​Monitor vital signs every 15 minutes. D.​Prepare a setup for a central venous pressure (CVP) line.

C.​Monitor vital signs every 15 minutes.

Which mechanism of action would the nurse identify for levodopa therapy prescribed to a client diagnosed with Parkinson disease? A.​Blocks the effects of acetylcholine B.​Increases the production of dopamine C.​Restores the dopamine levels in the brain D.​Promotes the production of acetylcholine

C.​Restores the dopamine levels in the brain

Which action is the nurse's responsibility when administering prescribed opioid analgesics? Select all that apply. One, some, or all responses may be correct. A. Count the client's respirations. B. Document the intensity of the client's pain. C. Withhold the medication if the client reports pruritus. D. Verify the number of doses in the locked cabinet before administering the prescribed dose. E. Discard the medication in the client's toilet before leaving the room if the medication is refused.

Count the client's respirations. B. Document the intensity of the client's pain. D. Verify the number of doses in the locked cabinet before administering the prescribed dose.

A client with myasthenia gravis begins taking pyridostigmine. Two days later, the client develops loose stools and increased salivation. Which conclusion would the nurse make about these new developments? A. ​The client is experiencing a myasthenic crisis. B. ​The medication is causing cholinergic side effects. C. ​The medication is triggering a paradoxical reaction. D. ​The client is exhibiting toxic effects of the medication.

​The medication is causing cholinergic side effects.