Pharmacology

A female client is receiving tetracycline for acne. Which client teaching should the nurse include?

A.Oral contraceptives may not be effective. B.Drinking cranberry juice will promote healing. C.Breast tenderness may occur as a side effect. D.The urine will turn a red-orange color. A

The nurse is preparing to administer a secondary infusion of a dobutamine solution to a client. The nurse notes that the solution is brown in color. Which action should the nurse implement?

A.Verify the prescribed dose with the health care provider. B.Discard the solution and reorder from the pharmacy. C.Dilute the solution with more normal saline until it becomes lighter in color. D.Administer the drug if the solution's reconstitution time is <24 hours. D

When developing a written nursing care plan for a client receiving chemotherapy for treatment of cancer, the nurse writes, "Assess each voiding for hematuria." The administration of which type of chemotherapeutic agent would prompt the nurse to add this intervention?

A.Vincristine B.Bleomycin sulfate C.Chlorambucil D.Cyclophosphamide D

A client with mild parkinsonism is started on oral amantadine. Which statement accurately describes the action of this medication?

A.Viral organisms that provide the underlyling pathophysiology for parkinsonism are eliminated. B.Acetylcholine in the myoneural junction is enhanced. C.Dopamine in the central nervous system is increased. D.Norepinephrine release is reduced within the peripheral system as the final step in dopamine uptake. C

A client receiving a continuous infusion of heparin IV starts to hemorrhage from an arterial access site. Which medication should the nurse anticipate administering to prevent further heparin-induced hemorrhaging?

A.Vitamin K1 B.Protamine sulfate C.Warfarin sodium D.Prothrombin B

A client is ordered 22 mg of gentamicin by IM injection. The drug is available in 20 mg/2 mL. How many milliliters should be administered?

A.1.8 B.2.0 C.2.4 D.2.2 D

A client who is receiving chlorpromazine HCl to control his psychotic behavior also has a prescription for benztropine. When teaching the client and/or significant others about these medications, what should the nurse explain about the use of benztropine in the treatment plan for this client?

A.This medication will reduce the side effect of urinary retention. B.This drug potentiates the effect of chlorpromazine HCl. C.The benztropine is used to control extrapyramidal symptoms. D.The combined effect of these drugs will modify psychotic behavior. C

A client is receiving oral griseofulvin for a persistent tinea corporis infection. Which response by the client indicates an accurate understanding of the drug teaching conducted by the nurse?

A."I might feel some tingling in my fingers." B."This is the worse bacterial infection I've ever had." C."I will need to take the medication for 7 days." D."My urine will probably turn brown due to this drug." A

A client is receiving antiinfective drug therapy for a postoperative infection. Which complaint should alert the nurse to the possibility that the client has contracted a superinfection?

A."My mouth feels sore." B."I have a headache." C."My ears feel plugged up." D."I feel constipated." A

A primigravida at 34 weeks of gestation is admitted to labor and delivery in preterm labor. She is started on a terbutaline sulfate continuous IV infusion via pump. This therapy is ineffective, and the baby is delivered vaginally. For which complication should the nurse monitor in this infant during the first few hours after delivery?

A.Hypokalemia B.Hypermagnesia C.Hypoglycemia D.Hypernatremia C

In addition to nitrate therapy, a client is receiving nifedipine, 10 mg PO every 6 hours. The nurse should plan to observe for which common side effect of this treatment regimen?

A.Hypotension B.Hyperkalemia C.Hypocalcemia D.Seizures A

The nurse is preparing a plan of care for a client receiving the glucocorticoid methylprednisolone. Which nursing diagnosis reflects a problem related to this medication that should be included in the care plan?

A.Ineffective airway clearance B.Risk for infection C.Deficient fluid volume D.Impaired gas exchange B

A client with a dislocated shoulder is being prepared for a closed manual reduction using conscious sedation. Which medication should the nurse explain as a sedative used during the procedure?

A.Inhaled nitrous oxide B.Midazolam IV C.Ketamine IM D.Fentanyl and droperidol IM B

The nurse notes that the hemoglobin level of a client receiving darbepoetin alfa has increased from 6 to 10 g/dL over the first 2 weeks of treatment. Which action should the nurse take?

A.Encourage the client to continue the treatment, because it is effective. B.Advise the client that the dose will need to be increased. C.Assess the client's skin color for continued pallor or cyanosis. D. Notify the health care provider of the change in the client's laboratory values. D

A client who is hypertensive receives a prescription for hydrochlorothiazide. When teaching about the side effects of this drug, which symptoms are most important for the nurse to instruct the client to report?

A.Fatigue and muscle weakness B.Anxiety and heart palpitations C.Abdominal cramping and diarrhea D.Confusion and personality changes A

Dopamine is administered to a client who is hypotensive. Which finding should the nurse identify as a therapeutic response?

A.Gain in weight B.Increase in urine output C.Improved gastric motility D.Decrease in blood pressure B

A client is prescribed a cholinesterase inhibitor, and a family member asks the nurse how this medication works. Which pharmacophysiologic explanation should the nurse use to describe this class of drug?

A.Promotes excretion of neurotoxins. B.Slows nerve cell degeneration. C.Improves nerve impulse transmission. D.Stimulates nerve cell regeneration. C

A client with acute lymphocytic leukemia is to begin chemotherapy today. The health care provider's prescription specifies that ondansetron is to be administered IV 30 minutes prior to the infusion of cisplatin. What is the rationale for administering Zofran prior to the chemotherapy induction?

A.Promotion of diuresis to prevent nephrotoxicity B.Reduction or elimination of nausea and vomiting C.Prevention of a secondary hyperuricemia D.Reduction in the risk of an allergic reaction B

A client with chronic gouty arthritis is talking allopurinol, 100 mg PO daily. Which laboratory serum level should the nurse report to the health care provider to determine the therapeutic outcome?

A.Prothrombin time B.Uric acid level C.White blood cell count D.Creatinine level B

Alteration of which laboratory finding represents the achievement of a therapeutic goal for heparin administration?

A.Prothrombin time (PT) B.Fibrin split products C.Platelet count D.Partial thromboplastin time (PTT) D

Minocycline, 50 mg PO every 8 hours, is prescribed for an adolescent girl diagnosed with acne. The nurse discusses self-care with the client while she is taking the medication. Which teaching points should be included in the discussion? (Select all that apply.)

A.Report vaginal itching or discharge. B.Take the medication at 0800, 1500, and 2200 hours. C.Protect skin from natural and artificial ultraviolet light. D.Avoid driving until response to medication is known. E.Take with an antacid tablet to prevent nausea. F.Use a nonhormonal method of contraception if sexually active. A, C, D, F

A client is experiencing an adverse effect of the gastrointestinal stimulant metoclopramide HCl. Which assessment finding would require immediate intervention by the nurse?

A.Reports dizziness when first getting up. B.Describes an unpleasant metallic taste in the mouth. C.Demonstrates Parkinson-like symptoms, such as cogwheel rigidity. D.Refuses to drive after 6 pm because of an inability to see well at night. C

A client taking linezolid at home for an infected foot ulcer calls the home care nurse to report the onset of watery diarrhea. Which intervention should the nurse implement?

A.Schedule appointments to obtain blood samples for drug peak and trough levels. B.Reassure the client that this is an expected side effect that will resolve in a few days. C.Instruct the client to obtain a stool specimen to be taken to the laboratory for analysis. D.Advise the client to begin taking an over-the-counter antidiarrheal agent. C

The nurse is preparing to administer amphotericin B IV to a client. What laboratory data is most important for the nurse to assess before initiating an IV infusion of this medication?

A.Serum potassium level B.Platelet count C.Serum creatinine level D.Hemoglobin level A

Two hours after taking the first dose of penicillin, a client arrives at the emergency department complaining of feeling ill, exhibiting hives, having difficulty breathing, and experiencing hypotension. These findings are consistent with which client response that requires immediate action?

A.Severe acute anaphylactic response B.Side reaction that should resolve C.Idiosyncratic reaction D.Cumulative drug response A

A 42-year-old client is admitted to the emergency department after taking an overdose of amitriptyline in a suicide attempt. Which drug should the nurse plan to administer to reverse the cardiac and central nervous system effects of amitriptyline?

A.Sodium bicarbonate B.Naloxone C.Phentolamine mesylate D.Atropine sulfate A

During the initial nursing assessment history, a client tells the nurse that he is taking tetracycline hydrochloride for urethritis. The nurse is most concerned if the client reports taking which medication concurrently?

A.Sucralfate B.Hydrochlorothiazide C.Acetaminophen D.Phenytoin A

The health care provider prescribes oral contraceptives for a client who wants to prevent pregnancy. Which information is the most important for the nurse to provide to this client?

A.Take one pill at the same time every day until all the pills are gone. B.Use condoms and foam instead of the pill while on any antibiotics. C.Limit sexual intercourse for at least one cycle after starting the pill. D.Use another contraceptive if two or more pills are missed in one cycle. A

A client with angina pectoris is instructed to take sublingual nitroglycerin tablets PRN for chest pain. Which instruction should the nurse include in the client's teaching plan?

A.Take one tablet every 3 minutes, up to five tablets. B.Take one tablet at the onset of angina and stop activity. C.Replace nitroglycerin tablets yearly to maintain freshness. D.Allow 30 minutes for a tablet to provide relief from angina. B

A client who is HIV-positive is receiving combination therapy with the antiviral medication zidovudine. Which instruction should the nurse include in this client's teaching plan?

A.Take the drug as prescribed to cure HIV infections. B.Use the drug to reduce the risk of transmitting HIV to sexual contacts. C.Return to the clinic every 2 weeks for blood counts. D.Report to the health care provider immediately if dizziness is experienced. C

A 67-year-old client is discharged from the hospital with a prescription for digoxin, 0.25 mg daily. Which instruction should the nurse include in this client's discharge teaching plan?

A.Take the medication in the morning before rising. B.Take and record radial pulse rate daily. C.Expect some vision changes caused by the medication. D.Increase intake of foods rich in vitamin K. B

A client who is experiencing an acute attack of gouty arthritis is prescribed colchicine USP, 1 mg PO daily. Which information is most important for the nurse to provide the client?

A.Take the medication with meals. B.Limit fluid intake until the attack subsides. C.Stop the medication when the pain resolves. D.Report any vomiting to the clinic. D

The health care provider prescribes the H2 antagonist famotidine, 20 mg PO in the morning and at bedtime. Which statement regarding the action of H2 antagonists offers the correct rationale for administering the medication at bedtime?

A.Gastric acid secreted at night is buffered, preventing pepsin formation. B.Hydrochloric acid secreted during the night is blocked. C.The drug relaxes stomach muscles at night to reduce acid. D.Ingestion of the medication at night offers a sedative effect, promoting sleep. B

A psychiatric client is discharged from the hospital with a prescription for haloperidol. Which instruction should the nurse include in the discharge teaching plan for this client?

A.Take with antacids to reduce gastrointestinal irritation. B.Use sunglasses and sunscreen when outdoors. C.Eat foods low in fiber and salt. D.Count the pulse before each dose. B

A mother brings her 18-month-old child to the community health center because the child has had "bad diarrhea" for the last 3 days. She states, "I bought some of this liquid at the pharmacy and gave my daughter a half-ounce." The nurse sees that the bottle contains loperamide. Which intervention is most important for the nurse to implement initially?

A.Tell the mother never to give this drug to her toddler. B.Ask if any other siblings have experienced diarrhea. C.Take the child's oral and tympanic temperatures. D.Ask the mother when the child last voided. D

An older client who had a colon resection yesterday is receiving a constant dose of hydromorphone via a patient-controlled analgesia (PCA) pump. Which assessment finding is most significant and requires that the nurse intervene?

A.The client is drowsy and complains of pruritus. B.Pupils are 3 mm; PERRLA. C.The area around the sutures is reddened and swollen. D.Respirations decrease to 10 breaths/min D

When providing client teaching about the administration of methylphenidate (Ritalin) to a parent of a child diagnosed with ADHD, which instruction should the nurse include in the teaching plan?

A.The doses should be given exactly 12 hours apart to sustain a therapeutic serum level. B.Doses should be scheduled at midmorning and midafternoon to achieve optimal benefit. C.Give the medication only on school days and when the child appears to be anxious. D.Offer the child the medication with breakfast and after the child eats lunch. D

Methenamine mandelate is prescribed for a client with a urinary tract infection and renal calculi. Which finding indicates to the nurse that the medication is effective?

A.The frequency of urinary tract infections decreases. B.The urine changes color and pain is diminished. C.The dipstick test changes from +1 to trace. D.The daily urinary output increases by 10%. A

A client who has chronic back pain is on long-term pain medication management and asks the nurse why his pain relief therapy is not as effective as it was 2 months ago. How should the nurse respond?

A.The phenomenon occurs when opiates are used for more than 6 months to relieve pain. B.Withdrawal occurs if the drug is not tapered slowly while being discontinued. C.Pharmacodynamic tolerance requires increased drug levels to achieve the same effect. D.A consistent dosage with around-the-clock administration is the most effective. C

A male client asks the nurse why condoms should not be lubricated with the spermicide nonoxynol-9. Which response is best for the nurse to provide?

A.The risk of female infertility and spontaneous abortion is linked with nonoxynol-9. B.Partners can develop intermittent interstitial cystitis if the spermicide is used after the expiration date. C.The spermicide decreases the amount of vaginal and penile sensitivity for up to 8 to 12 hours. D.Nonoxynol-9 provides no protection from STDs and has been linked to the transmission of HIV. D

The nurse plans to draw blood samples for the determination of peak and trough levels of gentamicin sulfate in a client receiving IV doses of this medication. When should the nurse plan to obtain the peak level?

A.Thirty minutes after the dose is administered B.Immediately before giving the next dose C.When the next electrolyte levels are drawn D.Sixty minutes after the dose is administered A

A client being treated for an acute myocardial infarction is to receive the tissue plasminogen activator alteplase. The nurse would be correct in providing which explanation to the client regarding the purpose of this drug?

A.This drug is a nitrate that promotes vasodilation of the coronary arteries. B.This drug is a clot buster that dissolves clots within a coronary artery. C.This drug is a blood thinner that will help prevent the formation of a new clot. D.This drug is a volume expander that improves myocardial perfusion by increasing output. B

A client receives a prescription for theophylline PO to be initiated in the morning after the dose of theophylline IV is complete. The nurse determines that a theophylline level drawn yesterday was 22 mcg/mL. Based on this information, which action should the nurse implement?

A.Hold the theophylline dose and notify the health care provider. B.Start the client on a half-dose of theophylline PO. C.The theophylline dose can be initiated as planned. D.The client is not ready to be weaned from the IV to the PO route. A

In developing a nursing care plan for a 9-month-old infant with cystic fibrosis, the nurse writes a nursing diagnosis of alteration in nutrition: less than body requirements, related to inadequate digestion of nutrients. Which intervention would best meet this child's needs?

A.Give aluminum hydroxide and magnesium hydroxide after meals. B.Give pancrelipase capsule mixed with applesauce before each meal. C.Administer cholestyramine resin before each meal and at bedtime. D.Administer omeprazole for gastroesophageal reflux. B

The nurse is scheduling a client's antibiotic peak and trough levels with the laboratory personnel. What is the best schedule for drawing the trough level?

A.Give the dose of medication, and call the laboratory to draw the trough STAT. B.Arrange for the laboratory to draw the trough 1 hour after the dose is given. C.Instruct the laboratory to draw the trough immediately before the next scheduled dose. D.Give the first dose of medication after the laboratory reports that the trough has been drawn. C

A client who is HIV-positive is receiving epoetin alfa for the management of anemia secondary to zidovudine (AZT) therapy. Which laboratory finding is most important for the nurse to report to the health care provider?

A.Hematocrit (HCT) of 58% B.Hemoglobin of 10.8 g/dL C.White blood cell count of 5000 mm3 D.Serum potassium level of 5 mEq/L A

A client receives pancuronium, a long-acting, nondepolarizing neuromuscular blocker, during surgical anesthesia. Which client situation should alert the nurse to evaluate the client for a prolonged muscle relaxation response to this medication?

A.Hepatitis B.Heart failure C.Renal insufficiency D.History of emphysema C

Which question should the nurse ask a client prior to the initiation of treatment with IV infusions of gentamicin sulfate?

A."Are you having difficulty hearing?" B.Have you ever been diagnosed with cancer?" C."Do you have any type of diabetes mellitus?" D."Have you ever had anemia?" A

A client is taking famotidine. Which client statement should the nurse further assess because it may indicate that the client is experiencing a side effect of this drug?

A."I have heartburn whenever I lie down." B."I am never hungry. I've lost weight in the past 2 weeks." C."I have a funny metallic taste in my mouth." D."I seem to be having difficulty thinking clearly." D

Which instructions should the nurse provide to an adolescent female client who is initiating treatment with isotretinoin for acne vulgaris? (Select all that apply.)

A."Notify the health care provider immediately if you think you are pregnant." B."If your acne gets worse, stop the medication and call the health care provider." C."Take a daily multiple vitamin to prevent deficiencies and promote dermal healing." D."Dermabrasion for deep acne scars should be postponed for 1 month after therapy is stopped." E."If you begin crying more than usual and feel sad, stop the drug and call the health care provider." F."Before, during, and after therapy, two effective forms of birth control must be used at the same time." A, E, F

The nurse is preparing a teaching plan for a client who has received a new prescription for levothyroxine sodium. Which instruction should be included?

A."Take this medication with a high-protein snack at bedtime." B."You may change at any time to a less expensive generic brand." C."Take your pulse daily, and if it exceeds 100 beats/min, contact the health care provider." D."Return to the clinic weekly for serum blood glucose testing." C

A lidocaine IV infusion at 4 mg/min via infusion pump is prescribed for a client having premature ventricular contractions (PVCs). The available premixed infusion contains 2 mg/mL of D5W. How many milliliters per hour should the nurse program the pump to deliver to this client?

A.20 B.24 C.60 D.120 D

Dopamine, 5 mcg/kg/min, is prescribed for a client who weighs 105 kg. The nurse mixes 400 mg of dopamine in 250 mL D5W for IV administration via an infusion pump. What is the hourly rate that the nurse should set on the pump?

A.5 mL/hr B.10 mL/hr C.15 mL/hr D.20 mL/hr D

The nurse is administering the early morning dose of insulin aspart, 5 units subcutaneously, to a client with diabetes mellitus type 1. The client's fingerstick serum glucose level is 140 mg/dL. Considering the onset of insulin aspart, when should the nurse ensure that the client's breakfast be given?

A.5 minutes after subcutaneous administration B.30 minutes after subcutaneous administration C.1 to 2 hours after administration D.At any time because of a flat peak of action A

Prior to administering a scheduled dose of digoxin, the nurse reviews the client's current serum digoxin level, which is 1.3 ng/dL. Which action should the nurse implement?

A.Administer Digibind to counteract the toxicity. B.Withhold the drug and notify the health care provider immediately. C.Withhold the dose and notify the health care provider during rounds that the dose was held. D.Give the dose of digoxin if the client's heart rate is within a safe range. D

A 3-year-old boy is admitted to the emergency department after ingesting an unknown amount of phenobarbital elixir prescribed for his brother's seizure disorder. Which nursing intervention should the nurse implement first?

A.Administer syrup of ipecac. B.Take the child's vital signs. C.Draw a blood specimen for a phenobarbital level. D.Teach the mother safe medication storage practices. B

Methylphenidate is prescribed for daily administration to a 10-year-old child with attention-deficit/hyperactivity disorder (ADHD). In preparing a teaching plan for the parents of this child newly diagnosed with ADHD, which instruction is most important for the nurse to provide to the parents?

A.Administer the medication in the morning before the child goes to school. B.Plan to implement periodic interruptions in the administration of the drug. C.Attempt to be consistent when setting limits on inappropriate behavior. D.Seek professional counseling if the child's behavior continues to be disruptive. A

A female client who has started long-term corticosteroid therapy tells the nurse that she is careful to take her daily dose at bedtime with a snack of crackers and milk. Which is the best response by the nurse?

A.Advise the client to take the medication in the morning, rather than at bedtime. B.Teach the client that dairy products should not be taken with her medication. C.Tell the client that absorption is improved when taken on an empty stomach. D.Affirm that the client has a safe and effective routine for taking the medication. A

The health care provider prescribes ipratropium for a client. An allergic reaction to which other medication would cause the nurse to question the prescription for?

A.Albuterol B.Theophylline C.Metaproterenol D.Atropine sulfate D

Which class of antineoplastic chemotherapy agents resembles the essential elements required for DNA and RNA synthesis and inhibits enzymes necessary for cellular function and replication?

A.Alkylating agents B.Antimetabolites C.Antitumor antibiotics D.Plant alkaloids B

A client with HIV who was recently diagnosed with tuberculosis (TB) asks the nurse, "Why do I need to take all of these medications for TB?" What information should the nurse provide?

A.Antiretroviral medications decrease the efficacy of the TB drugs. B.Multiple drugs prevent the development of resistant organisms. C.Duration of the medication regimen is shortened. D.Potential adverse drug reactions are minimized. B

The nurse is preparing to apply a surface anesthetic agent for a client. Which action should the nurse implement to reduce the risk of systemic absorption?

A.Apply the anesthetic to mucous membranes. B.Limit the area of application to inflamed areas. C.Avoid abraded skin areas when applying the anesthetic. D.Spread the topical agent over a large surface area. C

To evaluate whether the administration of an antihypertensive medication has caused a therapeutic effect, which action should the nurse implement?

A.Ask the client about the onset of any dizziness since taking the medication. B.Measure the client's blood pressure while the client is lying, sitting, and then standing. C.Compare the client's blood pressure before and after the client takes the medication. D.Interview the client about any past or recent history of high blood pressure. C

Which nursing intervention has the highest priority during IV administration of mechlorethamine HCl and actinomycin?

A.Assess for extravasation at the IV site during infusion. B.Premedicate with antiemetics 30 to 60 minutes before infusion. C.Monitor cardiac rate and rhythm during the IV infusion. D.Check the granulocyte count daily for the presence of neutropenia. A

A client with Tourette syndrome takes haloperidol to control tics and vocalizations. The client has become increasingly drowsy over the past 2 days and reports becoming dizzy when changing from a supine to sitting position. Which action should the nurse take?

A.Assess for poor skin turgor, sunken eyeballs, and concentrated urine output. B.Recognize that a sedative effect is expected and continue monitoring the client. C.Have the caregiver hold the next two doses of the medication to reduce the drug toxicity. D.Determine whether the client's urine is pink or reddish brown, and report findings to the health care provider. A

The health care provider has prescribed a low-molecular-weight heparin, enoxaparin prefilled syringe, 30 mg/0.3 mL IV every 12 hours, for a client following hip replacement. Prior to administering the first dose, which intervention is most important for the nurse to implement?

A.Assess the client's IV site for signs of inflammation. B.Evaluate the client's degree of mobility. C.Instruct the client regarding medication side effects. D.Contact the health care provider to clarify the prescription. D

The nurse is preparing to administer the disease-modifying antirheumatic drug (DMARD) methotrexate to a client diagnosed with rheumatoid arthritis. Which intervention is most important to implement prior to administering this medication?

A.Assess the client's liver function test results. B.Monitor the client's intake and output. C.Have another nurse check the prescription. D.Assess the client's oral mucosa. C

Which medication is useful in treating digoxin toxicity?

A.Atropine sulfate B.Isoproterenol C.Xylocaine D.Digoxin immune Fab D

A female client with trichomoniasis (Trichomonas vaginalis) receives a prescription for metronidazole. Which instruction is most important for the nurse to include in this client's teaching plan?

A.Avoid alcohol consumption. B.Complete the medication regimen. C.Use a barrier contraceptive method. D.Treat partner(s) concurrently. A

The nurse is providing discharge instructions to a client who has received a prescription for an antibiotic that is hepatotoxic. Which information should the nurse include in the instructions?

A.Avoid ingesting any alcohol or acetaminophen. B.Schedule a follow-up visit for a liver biopsy in 1 month. C.Activities that are strenuous should be avoided. D.Notify the health care provider of any increase in appetite. A

Which response best supports the observations that the nurse identifies in a client who is experiencing a placebo effect?

A.Beneficial response or cure for disease B.Behavioral or psychotropic responses C.Malingering or drug-seeking behaviors D.Psychological response to inert medication D

A client who has trouble swallowing pills intermittently has been prescribed venlafaxine (XR) for depression. The medication comes in capsule form. What should the nurse include in the discharge teaching plan for this client?

A.Capsule contents can be sprinkled on pudding or applesauce. B.Chew the medication thoroughly to enhance absorption. C.Take the medication with a large glass of water or juice. D.Contact the health care provider for another form of medication. D

A client with viral influenza is receiving vitamin C, 1000 mg PO daily, and acetaminophen elixir, 650 mg PO every 4 hours PRN. The nurse calls the health care provider to report that the client has developed diarrhea. Which change in prescriptions should the nurse anticipate?

A.Change the acetaminophen to ibuprofen. B.Change the elixir to an injectable route. C.Decrease the dose of vitamin C. D.Begin treatment with an antibiotic. C

A 19-year-old male client who has sustained a severe head injury is intubated and placed on assisted mechanical ventilation. To facilitate optimal ventilation and prevent the client from "fighting" the ventilator, the health care provider administers pancuronium bromide IV, with adjunctive opioid analgesia. What medication should be immediately accessible for a potential complication with this drug?

A.Dantrolene sodium B.Neostigmine bromide C.Succinylcholine bromide D.Epinephrine B

Following the administration of sublingual nitroglycerin, which assessment finding indicates that the medication was effective?

A.Decrease in level of chest pain B.Clear bilateral breath sounds C.Increase in blood pressure D.Increase in urinary output A

The nurse is preparing a child for transport to the operating room for an emergency appendectomy. The anesthesiologist prescribes atropine sulfate, IM STAT. What is the primary purpose for administering this drug to the child at this time?

A.Decrease the oral secretions. B.Reduce the child's anxiety. C.Potentiate the opioid effects. D.Prevent possible peritonitis. A

A client is receiving pyridostigmine bromide to control the symptoms of myasthenia gravis. Which client behavior would indicate that the drug therapy is effective?

A.Decreased oral secretions B.Clear speech C.Diminished hand tremors D.Increased ptosis B

Which intervention is most important for a nurse to implement prior to administering atropine PO?

A.Determine the presence of 5 to 35 bowel sounds/min. B.Provide oral care prior to administration. C.Verify that the client's tendon reflexes are 2+. D.Have the client rate his or her pain on a 0 to10 scale. A

A client experiencing dysrhythmias is given quinidine, 300 mg PO every 6 hours. The nurse plans to observe this client for which common side effect associated with the use of this medication?

A.Diarrhea B.Hypothermia C.Seizures D.Dysphagia A

A 2-month-old infant is scheduled to receive the first DPT immunization. What is the preferred injection site to administer this immunization?

A.Dorsal gluteal B.Vastus lateralis C.Ventral gluteal D.Deltoid B

During administration of theophylline, the nurse should monitor for signs of toxicity. Which symptom would cause the nurse to suspect theophylline toxicity?

A.Dry mouth B.Urinary retention C.Restlessness D.Sedation C

A chemotherapeutic regimen with doxorubicin HCl is being planned for a client recently diagnosed with cancer. What diagnostic test results should the nurse review prior to initiating this treatment?

A.Electrocardiogram (ECG) B.Arterial blood gases (ABGs) C.Serum cholesterol level D.Pelvic ultrasound A

A client with metastatic cancer who has been receiving fentanyl for several weeks reports to the nurse that the medication is not effectively controlling the pain. Which intervention should the nurse initiate?

A.Instruct the client about the indications of opioid dependence. B.Monitor the client for symptoms of opioid withdrawal. C.Notify the health care provider of the need to increase the dose. D.Administer naloxone per PRN protocol for reversal. C

A female client is receiving tamoxifen following surgery for breast cancer. She reports the onset of hot flashes to the nurse. Which intervention should the nurse implement?

A.Instruct the client that hot flashes are a side effect that often occurs with the use of this medication. B.Encourage the client to verbalize her feelings and fears about the recurrence of her breast cancer. C.Help the client schedule an appointment for evaluation of the need to increase the dose of medication. D.Notify the health care provider that the client needs immediate evaluation for medication toxicity. A

When caring for a client on digoxin therapy, the nurse knows to be alert for digoxin toxicity. Which finding would predispose this client to developing digoxin toxicity?

A.Low serum sodium level B.High serum sodium level C.Low serum potassium level D.High serum potassium level C

A pediatric client is discharged home with multiple prescriptions for medications. Which information should the nurse provide that is most helpful to the parents when managing the medication regimens?

A.Maintain a drug administration record. B.Fill all prescriptions at one pharmacy. C.Allow one person to give the medications. D.Give all medications in small volumes. A

Which instruction should the nurse include in the teaching plan for a client who is receiving phenytoin for seizure control?

A.Maintain consistent sodium intake. B.Use sunscreen when outdoors. C.Return for monthly urinalysis. D.Brush and floss teeth daily. D

A client is being discharged with a prescription for sulfasalazine to treat ulcerative colitis. Which instruction should the nurse provide to this client prior to discharge?

A.Maintain good oral hygiene. B.Take the medication 30 minutes before a meal. C.Discontinue use of the drug gradually. D.Drink at least eight glasses of fluid a day. D

A client is receiving acyclovir sodium IV for a severe herpes simplex infection. Which intervention should the nurse implement during this drug therapy?

A.Maintain respiratory isolation precautions. B.Increase daily fluids to 2000 to 4000 mL/day. C.Administer with meals to decrease gastric irritation. D.Assess for signs of severe liver dysfunction. B

When providing nursing care for a client receiving pyridostigmine bromide for myasthenia gravis, which nursing intervention has the highest priority?

A.Monitor the client frequently for urinary retention. B.Assess respiratory status and breath sounds often. C.Monitor blood pressure each shift to screen for hypertension. D.Administer most medications after meals to decrease gastrointestinal irritation. B

The nurse is assessing a stuporous client in the emergency department who is suspected of overdosing with opioids. Which agent should the nurse prepare to administer if the client becomes comatose?

A.Naloxone hydrochloride B.Atropine sulfate C.Vitamin K D.Flumazenil A

The health care provider prescribes carbamazepine for a child whose tonic-clonic seizures have been poorly controlled. The nurse informs the mother that the child must have blood tests every week. The mother asks why so many blood tests are necessary. Which complication is assessed through frequent laboratory testing that the nurse should explain to this mother?

A.Nephrotoxicity B.Ototoxicity C.Myelosuppression D.Hepatotoxicity C

A 4-year-old child is receiving chemotherapy for acute lymphocytic leukemia. Which laboratory result should the nurse examine to assess the child's risk for infection?

A.Neutrophil count B.Platelet count C.Reticulocyte count D.Lymphocyte count A

An older client is receiving a water-soluble drug that is more than the average dose for a young adult. Which action should the nurse implement first?

A.Obtain a prescription for lower medication dosages. B.Determine the drug's serum levels for toxicity. C.Start IV fluids to decrease the serum drug levels. D.Hold the next dosage and notify the health care provider. B

A client with metastatic cancer reports severe continuous pain. Which route of administration should the nurse use to provide the most effective continuous analgesia?

A.Oral B.Intravenous C.Transdermal D.Intramuscular C

The health care provider prescribes cisplatin to be administered in 5% dextrose and 0.45% normal saline with mannitol added. Which assessment parameters would be most helpful to the nurse in evaluating the effectiveness of the therapy?

A.Oral temperature B.Blood cultures C.Urine output D.Liver enzyme levels C

A 45-year-old female client is receiving alprazolam for anxiety. Which client behavior would indicate that the drug is effective?

A.Personal hygiene is maintained by the client for the first time in a week. B.The client has an average resting heart rate of 120 beats/min. C.The staff observes the client sitting in the day room reading a book. D.The nurse records that the client lost 2 lb of body weight in the past week. C

A child with cystic fibrosis is receiving ticarcillin disodium for Pseudomonas pneumonia. For which adverse effect should the nurse assess and report promptly to the health care provider?

A.Petechiae B.Tinnitus C.Oliguria D.Hypertension A

A 6-year-old child is admitted to the emergency department with status epilepticus. His parents report that his seizure disorder has been managed with phenytoin, 50 mg PO bid, for the past year. Which drug should the nurse plan to administer in the emergency department?

A.Phenytoin B.Diazepam C.Phenobarbital D.Carbamazepine B

In administering the antiinfective agent chloramphenicol IV to a client with bacterial meningitis, the nurse observes the client closely for signs of bone marrow depression. Which laboratory data would be most important for the nurse to monitor?

A.Platelet count B.Blood urea nitrogen level C.Culture and sensitivity D.Serum calcium level A