Pharm Nclex

A nurse is preparing to administer digoxin (Lanoxin) to an adult client. The nurse checks which important item before administering the medication?

Apical pulse rate

A nurse is providing dietary instructions to a client who is taking triamterene (Dyrenium). The nurse instructs the client that it is acceptable to consume which of the following food items daily?

Apple

A nurse notes that the result of the serum theophylline level of a client taking theophylline is 15 mcg/mL. The nurse interprets this result as:

In the middle of the therapeutic range

The nurse is reinforcing medication instructions to a client with breast cancer who is receiving cyclophosphamide (Neosar). The nurse tells the client to:

Increase fluid intake to 2000 to 3000 mL daily.

A client with rheumatoid arthritis has been taking aspirin (acetylsalicylic acid, ASA) more frequently than prescribed because the arthritis has been causing more discomfort than usual. The client complains of joint pain and has an elevated temperature. The nurse is concerned about the possibility of aspirin toxicity and asks the client which question that may confirm this suspicion?

"Do you have any ringing in your ears?"

A nurse is providing instructions to a client with glaucoma receiving acetazolamide (Diamox) daily. Which of the following statements by the client indicates an understanding of the adverse effects related to the medication?

"I need to call the doctor if I notice dark urine and stools."

Metoclopramide (Reglan) four times daily has been prescribed for a client with reflux esophagitis, and the nurse provides instructions to the client regarding administration of the medication. Which statement by the client indicates an understanding of the use of the medication?

"I need to take the medication 30 minutes before meals and at bedtime."

Moxifloxacin (Avelox) is prescribed for a client with a diagnosis of community-acquired pneumonia. The client needs to take the medication for 10 days, and the nurse provides instructions to the client about the medication. Which statement by the client indicates an understanding of the medication instructions?

"I need to wear sunscreen and protective clothing when outdoors."

A nurse is providing instructions to a client with a diagnosis of rheumatoid arthritis (RA) who is receiving aspirin (acetylsalicylic acid, ASA) 5 g orally daily. Which of the following, if stated by the client, would indicate an understanding of the instructions?

"I should notify the health care provider if I get any ringing in my ears."

Which statement indicates that a client with Addison's disease knows how to safely manage a medication regimen that consists of daily doses of glucocorticoids?

"I will need to call my doctor for an increase in medication dose when I'm experiencing a lot of stress."

A nurse is caring for a client with a diagnosis of metastatic breast carcinoma. Tamoxifen citrate 10 mg orally twice daily is prescribed for the client, and the nurse provides instructions to the client regarding the medication. Which statement by the client would indicate an understanding of the medication?

"If I have difficulty seeing, I need to call the health care provider."

A client receives a prescription for methocarbamol (Robaxin), and the nurse reinforces instructions to the client regarding the medication. Which client statement would indicate a need for further instructions?

"If my vision becomes blurred, I don't need to be concerned about it."

Isotretinoin (Accutane) is prescribed for a client to treat severe cystic acne. The nurse tells the client that the length of the usual prescribed course of treatment is:

15 to 20 weeks

A client with recurrent constipation has begun using psyllium (Metamucil). The nurse tells this client that this medication should be taken with:

A full glass of liquid, followed by a second glass of liquid

A client receiving therapy with carbidopa/levodopa (Sinemet) is upset and tells the nurse that his urine has turned a darker color since beginning to take this medication. The client wants to discontinue its use. In formulating a response to the client's concerns, the nurse interprets that this change is:

A harmless side effect of the medication

A client who was started on anticonvulsant therapy with clonazepam (Klonopin) tells the nurse of increasing clumsiness and unsteadiness since starting the medication. The client is visibly upset by these manifestations and asks the nurse what to do. The nurse's response is based on the understanding that these symptoms:

Are severe during initial therapy and decrease or disappear with long-term use

The camp nurse asks the children preparing to swim in the lake if they have applied sunscreen. The nurse reminds the children that chemical sunscreens are most effective when applied:

At least 30 minutes before exposure to the sun

A client who is taking theophylline (Theo-24) reports to the health care clinic as scheduled to have a serum theophylline level drawn. The blood is drawn and the laboratory calls the nurse and reports the results as 10 mcg/mL. The client asks the nurse what this figure means. The nurse accurately responds by stating this level is:

At the low end of the therapeutic range

Saquinavir (Invirase) is prescribed for the client who is human immunodeficiency virus seropositive. The nurse reinforces medication instructions and tells the client to:

Avoid sun exposure.

A nurse has provided discharge instructions to a client being placed on long-term anticoagulant therapy with warfarin sodium (Coumadin). The nurse reminds the client to do which of the following?

Avoid taking products containing acetylsalicylic acid (aspirin).

A 15-year-old child is scheduled to receive a series of the hepatitis B vaccine. The child arrives at the clinic for the first dose. The nurse collects data on the child before administering the vaccine and asks the child about a history of an allergy to:

Baker's yeast

A nurse has a prescription to give a dose of Rho(D) immune globulin (RhoGAM) to a client who has delivered an infant. The nurse understands that this medication will prevent the next infant from experiencing which of the following?

Being affected by Rh incompatibility

A nurse is collecting data from a client about medications being taken, and the client tells the nurse that he is taking herbal supplements for the treatment of varicose veins. The nurse understands that the client is most likely taking which of the following?

Bilberry

Methylergonovine (Methergine) is prescribed for a client with postpartum hemorrhage caused by uterine atony. Before administering the medication, the nurse checks which of the following as the important client parameter?

Blood pressure

A client on the nursing unit has a prescription for dextroamphetamine (Dexedrine) orally daily. The nurse collaborates with the dietitian to limit the amount of which of the following items on the client's dietary trays?

Caffeine

A nurse is caring for a client with Paget's disease who has an elevated serum calcium level of 12.3 mEq/L. The nurse checks to see that which of the following medications is available in the stock medication supply area for possible use to reverse this elevation?

Calcitonin (Calcimar)

A health care provider prescribes auranofin (Ridaura) for a client with rheumatoid arthritis. Which of the following would indicate to the nurse that the client is experiencing toxicity related to the medication?

Complaints of a metallic taste in the mouth

A client is receiving supplemental therapy with folic acid (Folate). The nurse evaluates the effectiveness of this therapy by monitoring the results of which of the following laboratory studies?

Complete blood count

A client with coronary artery disease complains of substernal chest pain. After checking the client's heart rate and blood pressure, a nurse administers nitroglycerin, 0.4 mg, sublingually. After 5 minutes, the client states, "My chest still hurts." Select the appropriate actions that the nurse should take. Select all that apply.

Contact the registered nurse. Assess the client's pain level. Check the client's blood pressure. Administer a second nitroglycerin, 0.4 mg, sublingually.

A nurse is collecting data from a client receiving pioglitazone (Actos) 30 mg orally daily. Which finding indicates that the client is experiencing the expected result of the action of this medication?

Decreased fasting blood glucose and reduced hemoglobin A1C (HbA1c)

A client with acquired immunodeficiency syndrome (AIDS) has an opportunistic respiratory fungal infection and is receiving intravenous amphotericin B. The nurse assisting in caring for the client monitors for which sign that indicates an adverse effect of the medication?

Decreased urine output

Allopurinol (Zyloprim) has been prescribed for the client, and the client asks the nurse about the action of the medication. The nurse responds, knowing that it:

Decreases uric acid production and reduces uric acid concentrations in both the serum and urine

A client has taken his first dose of lisinopril (Zestril) about 2 hours ago and begins to develop fullness in his face and hoarseness. What should be the nurse's first action?

Determine the client's ability to breathe effectively.

A client being seen in the clinic is taking phenytoin (Dilantin). The client's phenytoin blood level is within therapeutic range and the client's seizures are controlled. Which of the following if observed by the nurse on data collection would require health care provider notification and possible discontinuation of the medication?

Diffuse body rash

A client with chronic glaucoma is being started on medication therapy with acetazolamide. The nurse teaches the client that which symptoms that can occur early in use subsides or disappears in time?

Diuresis

A child is hospitalized with Rocky Mountain spotted fever (RMSF). The health record reveals documentation that the child was bitten by a tick 2 weeks ago. The child presents with complaints of headache, fever, and anorexia, and the nurse notes a rash on the palms of the hands and soles of the feet. The nurse reviews the health care provider's prescriptions and anticipates that which of the following will be prescribed?

Doxycycline (Vibramycin)

A client with a history of spinal cord injury is beginning medication therapy with baclofen (Lioresal). The nurse who is providing medication information should caution the client about which side effect of this medication?

Drowsiness

A client with multiple sclerosis is receiving diazepam (Valium), a centrally acting skeletal muscle relaxant. Which of the following would indicate that the client is experiencing a side effect related to this medication?

Drowsiness

A nurse is caring for a client receiving morphine sulfate subcutaneously for pain. Because morphine sulfate has been prescribed for this client, which nursing action would be included in the plan of care?

Encourage the client to cough and deep breathe.

A nursing student is asked about the medication latanoprost (Xalatan) and how this medication helps glaucoma. The student responds correctly by identifying that the medication's mechanism of action is to:

Facilitate the outflow of aqueous humor.

A client admitted to the hospital gives the nurse a bottle of clomipramine (Anafranil). The nurse notes that the medication has not been taken by the client in 2 months. What behaviors observed in the client would validate noncompliance with this medication?

Frequent handwashing with hot, soapy water

A client diagnosed with hypothyroidism is taking levothyroxine (Synthroid). The client returns to the clinic 1 week after beginning the medication and tells the nurse that the medication has not helped. The appropriate nursing response to the client is based on which of the following?

Full therapeutic effect may take 1 to 3 weeks.

Propantheline bromide (Pro-Banthine) is prescribed for a client with bladder spasms. Which of the following disorders, if noted in the client's record, alerts the nurse to question the prescription for this medication?

Glaucoma

A nurse is reinforcing dietary instructions to a client who has been prescribed cyclosporine (Sandimmune). Which food item would the nurse instruct the client to avoid?

Grapefruit juice

A nurse is caring for a client in preterm labor who is receiving terbutaline sulfate to stop uterine activity. During this medication therapy, the nurse implements nursing interventions to monitor which specific body organs that can be affected by this medication?

Heart and lungs

The client has been taking omeprazole (Prilosec) for 4 weeks. The ambulatory care nurse evaluates that the client is receiving optimal intended effect of the medication if the client reports the absence of which symptom?

Heartburn

A client taking an aldosterone antagonist known as eplerenone (Inspra) for hypertension asks about side effects of this medication. The nurse tells the client that which of the following is a side effect?

Hyperkalemia

A client is seen in the clinic for complaints of thirst, frequent urination, and headaches. Following diagnostic studies, diabetes insipidus is diagnosed. Desmopressin acetate (DDAVP) is prescribed for the client. The nurse provides instructions to the client and tells the client that the medication is prescribed to:

Increase water reabsorption.

A client who has begun taking fosinopril (Monopril) is very distressed, telling the nurse that he cannot taste food normally since beginning the medication 2 weeks ago. The nurse provides the best support to the client by:

Informing the client that impaired taste is expected and generally disappears in 2 to 3 months

A nurse is providing medication instruction to a client who has been prescribed simvastatin (Zocor). The nurse explains the action of the medication to the client based on the fact that simvastatin:

Inhibits hepatic synthesis of cholesterol

A client who is prescribed metronidazole (Flagyl) calls the clinic nurse to report dark discoloration of the urine. The nurse interprets that the client's report warrants which nursing action at this time?

Instruct the client to increase oral fluid intake.

A nurse is providing instructions to a client regarding the administration of lypressin. The nurse instructs the client that the medication will be taken by which of the following routes?

Intranasal

A nurse instructs a client with diabetes mellitus about blood glucose monitoring and monitoring for signs of hypoglycemia. The nurse informs the client that hypoglycemia is a blood glucose level of:

Less than 50 mg/dL

Dantrolene (Dantrium) is prescribed for a client with a spinal cord injury for discomfort resulting from spasticity. The nurse tells the client about the importance of follow-up and the need for which blood study?

Liver function studies

A nurse is reinforcing discharge instructions to a client receiving sulfisoxazole. Which of the following would be included in the plan of care for instructions?

Maintain a high fluid intake.

A client with human immunodeficiency virus (HIV) who is taking an oral solution of ritonavir (Norvir) complains about the taste of the solution. The nurse tells the client to:

Mix the oral solution with chocolate milk.

A nurse is preparing to administer ribavirin (Virazole) to a child with respiratory syncytial virus (RSV). The pharmacy dispenses the medication as a powder. The nurse helps prepare to administer the medication by:

Mixing the medication as prescribed and administering by inhalation

A nurse is assisting in preparing to administer acetylcysteine (Mucomyst) to a client with an overdose of acetaminophen (Tylenol). The nurse prepares to administer the medication by:

Mixing the medication in a flavored ice drink and allowing the client to drink the medication through a straw

A nurse is providing instructions to a client beginning medication therapy with divalproex sodium (Depakote ER) for the treatment of absence seizures. The nurse instructs the client that which of the following is the most frequent side effect of this medication?

Nausea and vomiting

The client with ovarian cancer is being treated with vincristine (Oncovin). The nurse monitors the client, knowing that which of the following indicates a side effect specific to this medication?

Numbness and tingling in the fingers and toes

The client with small cell lung cancer is being treated with etoposide (VePesid). The nurse who is assisting in caring for the client during its administration understands that which side effect is specifically associated with this medication?

Orthostatic hypotension

The nurse is reviewing the history and physical examination of a client who will be receiving asparaginase (Elspar), an antineoplastic agent. The nurse consults with the registered nurse regarding the administration of the medication if which of the following is documented in the client's history?

Pancreatitis

A client with lung cancer is receiving a high dose of methotrexate (Rheumatrex). Leucovorin (citrovorum factor, folic acid) is also prescribed. The nurse who is assisting in planning care for the client understands that the purpose of administering the leucovorin is to:

Preserve normal cells.

A nurse in the emergency department is preparing to instill fluorescein into the eye of a client with the complaint of eye pain. The nurse understands the rationale for the use of this medication is to:

Provide visualization of injury to the cornea.

A nurse prepares to administer sodium polystyrene sulfonate (Kayexalate) to a client. Before administering the medication, the nurse reviews the action of the medication and understands that it:

Releases sodium ions in exchange for primarily potassium ions

Colcrys (colchicine) is prescribed for a client with a diagnosis of gout. The nurse reviews the client's medical history in the health record, knowing that the medication would be contraindicated in which disorder?

Renal failure

A licensed practical nurse (LPN) is assisting in the care of a pregnant teenaged client with preeclampsia receiving magnesium sulfate. The LPN plans to notify the registered nurse immediately if which sign of magnesium toxicity is noted?

Respiratory rate of 10 breaths per minute

A nurse is admitting a client to the hospital for the treatment of dehydration. The client reports nausea, vomiting, diarrhea, and cramping for the past week. The nurse asks the client about medications he is taking. The client denies taking prescription medications but states he has been taking some herbs given to him by his cousin. The nurse alerts the health care provider when the client states he has been taking:

Senna

Trimethoprim-sulfamethoxazole (TMP-SMZ) is prescribed for a client. A nurse should instruct the client to report which symptom if it developed during the course of this medication therapy?

Sore throat

Isosorbide mononitrate (Imdur) is prescribed for a client with angina pectoris. The client tells the nurse that the medication is causing a chronic headache. The nurse appropriately suggests that the client:

Take the medication with food.

A client with acquired immunodeficiency syndrome (AIDS) has a low T4 count. The nurse initiates prophylactic treatment as prescribed with aerosolized pentamidine isethionate (NebuPent) and monitors for which expected outcome?

The client has a respiratory rate and depth within normal limits for activity level.

A client taking fexofenadine (Allegra) is scheduled for allergy skin testing and tells the nurse in the health care provider's office that a dose was taken this morning. The nurse determines that:

The client should reschedule the appointment.

Salicylic acid is prescribed for a client with a diagnosis of psoriasis. The nurse monitors the client, knowing that which of the following would indicate the presence of systemic toxicity from this medication?

Tinnitus

A nurse is assisting with caring for a client with cancer who is receiving cisplatin. Select the adverse effects that the nurse monitors for that are associated with this medication. Select all that apply.

Tinnitus Ototoxicity Nephrotoxicity Hypomagnesemia

A nurse is caring for a client after thyroidectomy and notes that calcium gluconate is prescribed for the client. The nurse determines that this medication has been prescribed to:

Treat hypocalcemic tetany.

A nurse reinforces medication instructions to a client who is taking levothyroxine (Synthroid). The nurse instructs the client to notify the health care provider (HCP) if which of the following occurs?

Tremors

A client is receiving meperidine hydrochloride (Demerol) for pain. Which of the following are side effects of this medication. Select all that apply.

Tremors Drowsiness Hypotension

A client who is taking hydrochlorothiazide (HydroDIURIL, HCTZ) has been started on triamterene (Dyrenium) as well. The client asks the nurse why both medications are required. The nurse formulates a response, based on the understanding that:

Triamterene is a potassium-sparing diuretic, whereas hydrochlorothiazide is a potassium-losing diuretic.

A client is receiving a daily dose of oral fluphenazine. The nurse would teach the client to do which of the following to minimize common side effects of this medication?

Use hard, sour candy or sugarless gum.

A nurse has given medication instructions to a client beginning anticonvulsant therapy with carbamazepine (Tegretol). The nurse determines that the client understands the use of the medication if the client knows to:

Use sunscreen when outsides.

The client has a new prescription for metoclopramide (Reglan). On review of the chart, the nurse identifies that this medication can be safely administered with which condition?

Vomiting following cancer chemotherapy

A client with osteoarthritis is receiving diclofenac sodium (Voltaren). The licensed practical nurse (LPN) reviewing the client's medication prescription sheet would plan to verify the prescription with the registered nurse (RN) if which of the following other medications were listed?

Warfarin (Coumadin)

A nurse notes that a client in a long-term care facility is receiving a daily dose of furosemide (Lasix). The nurse writes in the care plan to monitor which of the following parameters on a daily basis?

Weight

Warfarin sodium (Coumadin) has been prescribed for a client, and a nurse teaches the client and family about the medication. Which statement by the client indicates that further teaching is necessary?

"I will not take any over-the-counter medications except aspirin."

Nifedipine (Procardia) has been prescribed for a client with Raynaud's disease, and the nurse reinforces medication instructions with the client about the medication. Which statement by the client indicates a need for further instructions?

"Nausea and drowsiness is expected, and if it occurs I don't really need to worry about it."

A client reports to the clinic for followup after a 1-month treatment with acebutolol (Sectral). The nurse determines that a therapeutic effect of the medication has occurred if which of the following is noted?

A blood pressure of 130/84 mm Hg

A client has been receiving nitrofurantoin sodium (Macrodantin). The nurse determines that the therapy is effective if which of the following is noted?

Absence of dysuria

The client has a PRN prescription for loperamide hydrochloride (Imodium). The nurse understands that this medication is used for which condition?

An episode of diarrhea

Prednisone is prescribed for a client with diabetes mellitus who is taking NPH insulin daily. Which of the following prescriptions would the nurse anticipate during therapy with the prednisone?

An increased amount of daily NPH insulin

Carbidopa-levodopa (Sinemet) is prescribed for a client with Parkinson's disease, and the nurse monitors the client for adverse reactions to the medication. Which of the following indicates that the client is experiencing an adverse reaction?

Impaired voluntary movements

A client with multiple sclerosis is receiving diazepam (Valium), and the home care nurse provides instructions to the client regarding the side effects of the medication. The nurse tells the client that which of the following is a side effect of this medication?

Incoordination

A client is diagnosed with an acute myocardial infarction and is receiving tissue plasminogen activator, alteplase (Activase, tPA). Which action is a priority nursing intervention?

Monitor for signs of bleeding.

A client with cancer is receiving daunorubicin (Cerubidine) intravenously. The nurse assigned to assist in caring for the client monitors for which commonly expected side effect?

Nausea and vomiting

A nurse is reinforcing instructions for a client regarding intranasal desmopressin acetate (DDAVP). The nurse tells the client that which of the following is a side effect of the medication?

Runny nose

The client with acquired immunodeficiency syndrome and Pneumocystis jiroveci infection has been receiving pentamidine isethionate (Pentam 300). The client develops a temperature of 101° F. The nurse does further monitoring of the client, knowing that this sign would most likely indicate:

The result of another infection caused by leukopenic effects of the medication.

A nurse is reading the laboratory results for a client being treated with carbamazepine (Tegretol) for prophylaxis of complex-partial seizures. The nurse interprets that which of the following values is consistent with an adverse reaction to this medication?

White blood cell count 3200/mm3

Ketoconazole (Nizoral) is prescribed for an assigned client. The nurse prepares to administer the medication:

With food

Nalidixic acid (NegGram) is prescribed for the client with a urinary tract infection. Reviewing the client's record, the nurse notes that the client is taking warfarin (Coumadin) on a daily basis. Which of the following prescriptions would the nurse anticipate because the client is taking this oral anticoagulant?

A reduction in the anticoagulation dosage

A nurse employed in the emergency department receives a telephone call from the emergency alert system informing the department that a child who ingested a bottle of acetaminophen (Tylenol) is en route to the emergency department. The nurse prepares the room for the arrival of the child and checks the medication supply to determine whether which medication that is the antidote is available?

Acetylcysteine (Mucomyst)

Dantrolene sodium (Dantrium) is prescribed for a client experiencing flexor spasms, and the client asks the nurse about the action of the medication. The nurse responds, knowing that the therapeutic action of this medication is which of the following?

Acts directly on the skeletal muscle to relieve spasticity