Pharm midterm exam

A client who is receiving phenytoin to control a seizure disorder questions the nurse regarding this medication after discharge. How will the nurse respond?

"Antiseizure drugs will probably be continued for life."

Alprazolam is prescribed for a client who is anxious. For what therapeutic effect will the nurse monitor the client?

Resting quietly

A 30-year-old who began lithium carbonate therapy 3 weeks ago is having blood drawn for a lithium drug level. Which range will the nurse recognize as therapeutic?

0.4 to 1.3 mEq/L (0.4 to 1.3 mmol/L)

A depressed client has been prescribed a tricyclic antidepressant. How long should the nurse inform the client that it will take before the client notices a significant change in the depression?

2 to 4 weeks

A client with a diagnosis of bipolar I disorder, manic episode, is started on a regimen of an antipsychotic agent and lithium carbonate. The nurse explains to the client that the rationale behind this regimen is that the antipsychotic has which action?

Acts to quiet the client while allowing time for the lithium to reach a therapeutic level

A client is taking phenytoin to treat clonic-tonic seizures. The client's phenytoin level is 16 mg/L. Which action should the nurse take?

Administer the next dose of the medication as prescribed.

Which action may cause lipohypertrophy in a client who is receiving insulin injections?

Administering insulin into the same site each time

A monoamine oxidase inhibitor (MAOI) is prescribed. What should the nurse instruct the client to avoid while taking this drug?

Aged cheeses

An older adult with cerebral arteriosclerosis is admitted with atrial fibrillation and is started on a continuous heparin infusion. What clinical finding enables the nurse to conclude that the anticoagulant therapy is effective?

An activated partial thromboplastin (APTT) twice the usual value

A client receiving morphine is being monitored by the nurse for signs and symptoms of overdose. Which clinical findings support a conclusion of overdose? Select all that apply.

Lethargy Bradycardia Slow respirations

A primary healthcare provider prescribes atenolol 20 mg by mouth four times a day for a client who has had double coronary artery bypass surgery. What information is most important for the nurse to include in the discharge teaching plan for this client?

Avoid abruptly discontinuing the medication.

A client is receiving hydrochlorothiazide (HCTZ). What should the nurse monitor to best determine the effectiveness of the client's hydrochlorothiazide therapy?

Blood pressure

An adolescent with a major depressive disorder is prescribed venlafaxine (Effexor). What signs or symptoms related to the medication should the nurse communicate immediately to the prescribing provider? Select all that apply.

Blurred vision Suicidal ideation Difficult urination

A beta-blocker, atenolol (Tenormin), is prescribed for a client with moderate hypertension. What information should the nurse include when teaching the client about this medication? Select all that apply.

Change positions slowly Count the pulse before taking the medication Mild weakness and fatigue are common side effects

A client with rheumatoid arthritis has been taking a steroid medication for the past year. For which complication of prolonged use of this medication should the nurse assess the client?

Decreased white blood cells

A client is to be discharged on a regimen of lithium carbonate. What will the nurse include in the discharge teaching plan?

Encouraging the client to have the lithium blood level tested regularly

A client is receiving furosemide (Lasix) to relieve edema. The nurse should monitor the client for which response to the medication?

Excessive loss of potassium ions

After the nurse provides education about hydrochlorothiazide, the client will agree to notify the healthcare provider regarding the development of which symptom?

Generalized weakness

At 4:30 PM, a client who is receiving human insulin (Humulin N) every morning states, "I feel very nervous." The nurse observes that the client's skin is moist and cool. What is the nurse's most accurate interpretation of what the client is likely experiencing?

Hypoglycemia

A 13-year-old-child with type 1 diabetes is receiving 15 units of Novolin R insulin and 20 units of Novolin N insulin at 7 am each day. At what time should the nurse anticipate a hypoglycemic reaction from the Novolin N to occur?

In the afternoon

A nurse concludes that a client has a hypoglycemic reaction to insulin. Which clinical findings support this conclusion? Select all that apply.

Irritability Heart palpitations

A nurse prepares to administer metformin (Glucophage XR) to an older adult who has asked that it be crushed because it is difficult to swallow. The nurse explains that this drug cannot be crushed because of what reason?

It is released slowly.

A client with arthritis, "Can I take Tylenol instead of aspirin? Aspirin irritates my stomach." The nurse explains what about acetaminophen (Tylenol)?

It lacks an anti-inflammatory action

A client is taking furosemide (Lasix) and digoxin (Lanoxin) for heart failure. Why does the nurse advise the client to drink a glass of orange juice every day?

Maintaining potassium levels

A school-aged child with a seizure disorder has been taking carbamazepine (Tegretol) for 3 years. What nursing intervention is most important at this time?

Monitoring the child's complete blood cell counts

Carbidopa-levodopa is prescribed for a client with Parkinson disease. The nurse assesses for which adverse responses that are associated with this medication? Select all that apply.

Nausea Emotional changes

An 8-year-old child is being given insulin glargine (Lantus) before breakfast. What is the most appropriate information for the nurse to give the parents concerning a bedtime snack?

Offer a snack to prevent hypoglycemia during the night.

A male client who is receiving prolonged steroid therapy complains of always being thirsty and urinating frequently. What is the nurse's best initial action?

Perform a finger stick to test the client's blood glucose level.

A school-aged child is receiving 45 units of intermediate-acting insulin at 7:00 AM and 7:00 PM. What will the nurse tell the parents regarding a bedtime snack?

Provide a bedtime snack to prevent hypoglycemia during the night.

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 does the nurse conclude that the client probably is experiencing?

Salicylate toxicity

A client who recently started receiving oral corticosteroids for a severe allergic reaction is instructed that the dosage will be reduced gradually until all medication is stopped at the end of two weeks. What reason does the nurse provide for this gradual reduction in dosage?

Slow reduction of the drug will prevent a physiologic crisis because the adrenal glands are suppressed.

A client is experiencing diplopia, ptosis, and mild dysphagia. Myasthenia gravis is diagnosed and an anticholinergic medication is prescribed. The nurse is planning care with the client and spouse. What direction is the priority?

Take the medication according to a specific schedule

A client who has a habit of smoking is on estrogen therapy. What condition is the client at risk of developing?

Thrombosis

Several hours after administering insulin, the nurse is assessing a client for an adverse response to the insulin. Which client responses are indicative of a hypoglycemic reaction? Select all that apply.

Tremors Confusion Diaphoresis

A client has been taking levothyroxine (Synthroid) for hypothyroidism for three weeks. The nurse suspects that a decrease in dosage is needed when the client exhibits which clinical manifestations? Select all that apply.

Tremors Heat intolerance

A nurse is monitoring a child for toxicity precipitated by digoxin. For what sign of digoxin toxicity will the nurse assess the child?

Vomiting

A client who has a long leg cast for a fractured bone is to be discharged from the emergency department. When discussing pain management, the nurse should advise the client to take the prescribed as needed oxycodone and acetaminophen when?

When the discomfort begins