Pharm Test 4

Blocking of serotonin and dopamine receptors

A nurse administers metoclopramide [Reglan] to a patient who is having nausea and vomiting postoperatively. The nurse should expect which therapeutic action if the medication is having the desired result?

"While I'm taking these medications, my bowel movements could look black."

A nurse instructs a female patient with peptic ulcer disease who is to start a treatment regimen that includes ranitidine [Zantac] and bismuth subsalicylate [Pepto-Bismol]. Which statement by the patient indicates that the teaching has been effective?

Hypothyroidism

A nurse is caring for a patient with decreased triiodothyronine (T3) and thyroxine (T4) and elevated thyroid-stimulating hormone (TSH) levels. The nurse knows the patient is likely suffering from what?

"While taking this medicine, I may be able to reduce my steroid medication."

A nurse is teaching a patient about montelukast [Singulair]. Which statement by the patient would indicate that the nurse's teaching was effective?

"You may notice an increase in your pain attacks in the first month."

A nurse is teaching a patient with chronic tophaceous gout who is scheduled to start taking allopurinol [Zyloprim]. Which of these statements should the nurse include in the teaching?

H. pylori

A nurse monitors a patient who has peptic ulcer disease and is taking antibacterial medications. If the treatment has been effective, the patient's breath test result should reveal the absence of what?

Muscle twitching and tetany

A nurse monitors the calcium level of a patient who has had a thyroidectomy. The nurse should notice which finding if the patient's calcium level is 7.5 mg/dL?

Blood glucose level of 140 mg/dL

A nurse obtains a health history from a patient who has gout and is taking a glucocorticoid. The nurse should follow up on which finding?

"It would be better to eat five or six small meals a day instead of three larger ones."

A nurse should give which nonmedication instruction to a patient who has peptic ulcers?

apple juice

A nurse should offer which fluid choice to a patient with acute diarrhea?

Renal failure

A nurse should recognize that a patient who takes an angiotensin-converting enzyme (ACE) inhibitor while also taking high-dose aspirin is at risk of developing what complication?

Ibuprofen

A nurse teaches a patient who takes daily low-dose aspirin for protection against myocardial infarction and stroke to avoid also taking which medication?

Decrease in bleeding tendency

A patient has an international normalized ratio [INR] that is elevated to an unsafe level. A nurse administers vitamin K, expecting which therapeutic result?

"I'll take this medication in the morning so as not to interfere with sleep.

A patient has been given instructions about levothyroxine [Synthroid]. Which statement by the patient indicates understanding of these instructions?

"I only have a bowel movement when I take the medicine."

A patient has been taking docusate sodium [Colace] daily for 1 year. Which statement by the patient would indicate a complication associated with use of this drug?

High-dose albuterol [Proventil] via nebulizer treatment

A patient is admitted to the emergency department with acute severe exacerbation of asthma. Which drug should the nurse anticipate will be included in the treatment plan?

Loperamide

A patient is having high-volume output from a new ileostomy. A nurse develops a plan that includes teaching the patient to take which antidiarrheal agent?

Blood glucose control for 24 hours

A patient is scheduled to start taking insulin glargine [Lantus]. On the care plan, a nurse should include which of these outcomes related to the therapeutic effects of the medication?

Nausea and diarrhea

A patient is scheduled to start taking vitamin C. The nurse should teach the patient to observe for which side effect?

Tachycardia

A patient is taking glipizide [Glucotrol] and a beta-adrenergic medication. A nurse is teaching hypoglycemia awareness and should warn the patient about the presence of which symptom?

Caffeine

A patient is taking oral theophylline for maintenance therapy of stable asthma. A nurse instructs the patient to avoid using which substance to prevent a complication?

It promotes the passage of glucose into cells for energy.

A patient newly diagnosed with type 1 diabetes asks a nurse, "How does insulin normally work in my body?" The nurse explains that normal insulin has which action in the body?

Ask whether the patient is using at least 8 ounces of fluid to prepare the psyllium.

A patient reports abdominal bloating and infrequent, small, hard stools after taking psyllium [Metamucil] for 2 weeks. Which is the nurse's priority action?

Potassium

A patient takes glucocorticoids and digoxin [Lanoxin]. It is most important for the nurse to monitor which electrolyte?

Folic Acid

A patient tells the nurse that she is thinking about becoming pregnant. The nurse teaches the patient that which vitamin should be her priority for supplementation before planning a pregnancy?

Neutralized gastric acid

A patient who has gastroesophageal reflux disease (GERD) is taking magnesium hydroxide (milk of magnesia). Which outcome should a nurse expect if the medication is achieving the desired therapeutic effect?

Smooth, intact skin in sun-exposed areas

A patient who has pellagra is taking niacin. Which outcome would be most appropriate for a nurse to establish with the patient?

Administer the drug with an aluminum hydroxide antacid.

A patient who has peptic ulcer disease and is receiving magnesium hydroxide (milk of magnesia) is experiencing an increased number of bowel movements. Which is the nurse's priority action?

Recent heart bypass surgery

A patient who has rheumatoid arthritis is scheduled to start taking celecoxib [Celebrex]. A nurse should recognize which factor from the patient's history as a contraindication to taking this medication?

Refer the patient to a diabetes educator because the result reflects poor glycemic control.

A patient who has type 2 diabetes has a glycated hemoglobin A1c (HbA1c) of 10%. The nurse should make which change to the nursing care plan?

Promotion of insulin secretion

A patient who has type 2 diabetes is taking nateglinide [Starlix]. Which response should a nurse expect the patient to have if the medication is achieving the desired therapeutic effect?

"After taking the medication, sit or stand for 30 minutes."

A patient who is postmenopausal is scheduled to begin taking alendronate [Fosamax] to prevent osteoporosis. Which instruction should the nurse give the patient?

It should be administered by inhalation 15 minutes before anticipated exertion.

A patient who takes cromolyn for exercise-induced bronchospasm should follow which approach for maximum therapeutic effectiveness?

Check the patient's capillary blood sugar.

A patient who took NPH insulin at 0800 reports feeling weak and tremulous at 1700. Which action should the nurse take?

"I'll tell my doctor if I have fatigue, hair loss, or cold intolerance."

A patient with Graves' disease is treated with iodine-131 therapy. Which statement by the patient would indicate understanding of the treatment's effects?

The patient will need higher doses of glucocorticoids following a trauma.

A patient with a chronic illness is on daily glucocorticoids. He is brought to the hospital following a severe motor vehicle accident. He is wearing a medical alert bracelet stating his home medications. Noting that the patient takes glucocorticoids daily, the nurse knows which of the following to be true?

"Use a spacer with the inhaler and rinse your mouth after each dose administration."

A patient with asthma is scheduled to start taking a glucocorticoid medication with a metered-dose inhaler (MDI). The nurse should give the patient which instruction about correct use of the inhaler?

Reduced ammonia level

A patient with hepatic encephalopathy receives lactulose. The nurse expects which therapeutic outcome if the medication is having the desired effect?

Polyethylene glycol-electrolyte solution [GoLYTELY]

A patient with renal impairment requires bowel cleansing before a diagnostic procedure. The nurse prepares to administer which laxative?

Just before bedtime

A postoperative patient is scheduled to start taking a daily oral dose of bisacodyl [Dulcolax]. When does the nurse administer the medication?

"Inject this insulin with your first bite of food, because it is very fast acting."

A teaching plan for a patient who is taking lispro [Humalog] should include which instruction by the nurse?

Suppression of T lymphocytes

A transplant recipient is receiving cyclosporine [Sandimmune]. Which response should a nurse expect if the medication is having the desired effect?

Ciprofloxacin

An adult patient in a physician's office reports severe diarrhea after returning from a trip to Mexico. Which medication might be prescribed for this patient?

Creatinine (Cr) level of 2.1 mg/dL

Before administering metformin [Glucophage], the nurse should notify the prescriber about which laboratory value?

impaired night vision

In assessing a patient with a vitamin A deficiency, the nurse should determine whether the patient has which manifestation?

Hematemesis (GI ulcerations and bleeding)

The nurse assesses a patient who takes ibuprofen [Advil] on a regular basis. Which finding does the nurse know is an adverse effect of ibuprofen [Advil] therapy?

Increases or supplements dosage of glucocorticoid at times of stress

The nurse is developing a plan to minimize the risk of adrenal insufficiency for a patient who is receiving long-term glucocorticoid therapy. Which outcome should be included?

Note the contraindication and clarify the order with the healthcare provider.

The nurse is screening a patient before administering a live virus vaccine. The patient is currently taking a glucocorticoid medication. Which action should the nurse take?

In the morning, after breakfast

The nurse prepares to administer a bisacodyl suppository to a patient who has not had a bowel movement in several days. When should the nurse administer the PRN medication?

Complaints of muscle pain and weakness

The nurse should be concerned about which finding in a patient on long-term, low-dose colchicine therapy to prevent gout?

Systemic fungal infection

The nurse should question an order for glucocorticoids in the treatment of a patient with what?

Naproxen achieves more predicable pain relief with fewer side effects.

The nurse teaches a patient with gout that naproxen [Naprosyn] is an agent of first choice for treatment over colchicine. The nurse should use which rationale for the teaching?

Thyroid stimulating hormone (TSH)

The patient reports that she had to switch pharmacies to save money. She noticed that her "thyroid pill" looks different. The nurse anticipates that the healthcare provider will order what?

On a continuing, daily basis

To achieve therapeutic effectiveness, a nurse teaches a patient with chronic asthma to use an inhaled glucocorticoid medication according to which schedule?

Increase in bone resorption of calcium

To normalize a low serum calcium level, the body releases parathyroid hormone (PTH); this results in which therapeutic effect?

Whenever needed (PRN) as a quick-relief agent

Using a stepwise approach to managing asthma, a nurse teaches a patient who is at step 1 to use albuterol MDI [Proventil] at which of these times?

Ensure that meals are at bedside so that administration with food reduces gastric irritation.

When administering prednisone to a patient, the nurse will do what?

Hold the vitamin and consult the prescriber.

Which action should a nurse take when preparing to administer vitamin D to a patient diagnosed with hyperparathyroidism?

Chronic alcohol abuse

Which factor in a patient's history is most likely related to the development of thiamine (vitamin B1) deficiency?

Excessive bruising

Which finding in a patient taking levothyroxine [Synthroid] and warfarin [Coumadin] would require follow-up by a nurse?

"The drug can cause your bowel movements to be black."

Which instruction should the nurse give a patient who is to take bismuth subsalicylate for eradication of H. pylori?

"Draw up the clear regular insulin first, followed by the cloudy NPH insulin."

Which instruction should the nurse provide when teaching a patient to mix regular insulin and NPH insulin in the same syringe?

Tachycardia

Which manifestations should a nurse investigate first when monitoring a patient who is taking levothyroxine [Synthroid]?

Supplements additional doses at times of stress

Which outcome should a nurse establish as a priority for a patient taking an oral glucocorticoid for long-term treatment of asthma?