Pharmacology Assessment A
A nurse is reinforcing teaching with a female client who has a new prescription for isotretinoin. Which of the following instructions should the nurse include in the teaching? (Select all that apply) A) "You will need to have your liver enzymes monitored after 1 month". The client should have her liver enzymes monitored 1 month after therapy and periodically thereafter because isotretinoin is metabolized in the liver. B) "You can have nosebleeds while taking this medication". Due to the drying effects of isotretinoin, nosebleeds are very common. C) "You should report any thoughts of harming yourself" . Isotretinoin can cause depression, which can lead to suicide. The client or the client's family should report these thoughts to the provider. D) "You will need to have two negative pregnancy tests prior to starting the medication". Due to the potential for severe birth defects, it is important to confirm the client is not pregnant. E) "You will need to take a vitamin A supplement twice daily" is incorrect. Vitamin A enhances the risk of isotretinoin toxicity. The client should avoid taking vitamin A supplements because isotretinoin is a derivative of vitamin A.
A) "You will need to have your liver enzymes monitored after 1 month". The client should have her liver enzymes monitored 1 month after therapy and periodically thereafter because isotretinoin is metabolized in the liver. B) "You can have nosebleeds while taking this medication". Due to the drying effects of isotretinoin, nosebleeds are very common. C) "You should report any thoughts of harming yourself" . Isotretinoin can cause depression, which can lead to suicide. The client or the client's family should report these thoughts to the provider. D) "You will need to have two negative pregnancy tests prior to starting the medication". Due to the potential for severe birth defects, it is important to confirm the client is not pregnant.
A nurse is planning to reinforce teaching regarding newborn immunizations with a client who is 24 hr postpartum. Which of the following information should the nurse plan to include? A) "Your baby will receive the first hepatitis B vaccine before discharge." The newborn should receive the first hepatitis B vaccine at birth, with the next two doses at least 2 months apart. B) "Your baby will receive the rotavirus vaccine if your blood titer is low." The blood titer of a newborn's mother does not determine the need for a rotavirus vaccine. The rotavirus vaccine is administered every 2 months starting at 24 weeks. C) "Your baby will receive the first influenza virus vaccine at the 4-week checkup." Children should receive an annual influenza virus vaccine starting at age 6 months. D) "Your baby will receive the varicella vaccine if you have a history of chickenpox." Children should receive the first of two doses of the varicella vaccine between 12 and 15 months.
A) "Your baby will receive the first hepatitis B vaccine before discharge." The newborn should receive the first hepatitis B vaccine at birth, with the next two doses at least 2 months apart.
A nurse is reinforcing teaching with a client who has seizures and a new prescription for valproic acid. The nurse should instruct the client to report which of the following adverse effects of valproic acid immediately to the provider? A) Abdominal pain The greatest risk to the client is hepatotoxicity and pancreatitis, which can cause abdominal pain. Therefore, the client should notify the provider immediately if experiencing a decrease in appetite, nausea, abdominal pain, or yellowing of the skin. B) Hair loss The client is at risk for hair loss because it is an adverse effect of taking valproic acid. However, another adverse effect is the priority to report to the provider. C) Weight gain The client is at risk for weight gain because it is an adverse effect of taking valproic acid. However, another adverse effect is the priority to report to the provider. D) Ataxia The client is at risk for ataxia because it is an adverse effect of taking valproic acid. However, another adverse effect is the priority to report to the provider.
A) Abdominal pain The greatest risk to the client is hepatotoxicity and pancreatitis, which can cause abdominal pain. Therefore, the client should notify the provider immediately if experiencing a decrease in appetite, nausea, abdominal pain, or yellowing of the skin.
A nurse is collecting data from a client who is receiving digoxin for treatment of heart failure. The nurse should identify which of the following findings as adverse effects of this medication? (Select all that apply) A) Blurred vision. The nurse should identify visual changes such as blurred vision, halos, and a yellow or green tinge to vision as adverse effects of digoxin. B) Nausea. The nurse should identify that nausea and vomiting are adverse effects of digoxin. C) Hyperactivity is incorrect. The nurse should identify that fatigue and weakness are adverse effects of digoxin. D) Increased appetite is incorrect. The nurse should identify that anorexia is an adverse effect of digoxin. E) Dysrhythmia. The nurse should identify that dysrhythmias are an adverse effect of digoxin.
A) Blurred vision. The nurse should identify visual changes such as blurred vision, halos, and a yellow or green tinge to vision as adverse effects of digoxin. B) Nausea. The nurse should identify that nausea and vomiting are adverse effects of digoxin. E) Dysrhythmia. The nurse should identify that dysrhythmias are an adverse effect of digoxin.
A nurse is collecting data from a client who has Parkinson's disease and is taking levodopa/carbidopa. The nurse should identify which of the following findings as an adverse effect of this medication? A) Dark urine The nurse should identify that levodopa/carbidopa can cause a darkening of the client's urine, sweat, and saliva. B) Hypertension The nurse should identify that levodopa/carbidopa can cause orthostatic hypotension. C) Increased salivation The nurse should identify that levodopa/carbidopa can cause dry mouth. D) Bradycardia The nurse should identify that levodopa/carbidopa can cause tachycardia.
A) Dark urine The nurse should identify that levodopa/carbidopa can cause a darkening of the client's urine, sweat, and saliva.
A nurse is caring for a client who has multiple sclerosis and has a new prescription for baclofen. Which of the following findings indicates to the nurse that the medication is having a therapeutic effect? A) Decreased muscle spasticity The nurse should identify that baclofen is an antispasmodic that decreases muscle spasticity in a client who has multiple sclerosis. B) Increased urinary output Urinary frequency is an adverse effect of baclofen rather than a therapeutic effect. C) Increased mental alertness Baclofen is an antispasmodic that can cause CNS adverse effects, such as drowsiness, fatigue, and confusion, and does not produce an increase in the client's mental alertness as a therapeutic effect. D) Decreased heart rate Baclofen is an antispasmodic and does not decrease the client's heart rate as a therapeutic effect.
A) Decreased muscle spasticity The nurse should identify that baclofen is an antispasmodic that decreases muscle spasticity in a client who has multiple sclerosis.
A nurse is caring for a client who has tuberculosis and will begin taking isoniazid. Which of the following actions should the nurse take? A) Determine the client's daily alcohol intake. The nurse should instruct the client to reduce or avoid all use of alcohol because isoniazid can cause liver damage; therefore, it is important for the nurse to determine the client's daily alcohol intake. B) Tell the client to expect red-orange colored urine. Isoniazid does not cause red-orange colored urine. Rifampin is a medication used to treat tuberculosis and causes the client's sweat, urine, saliva, and tears to appear red-orange in color. C) Reinforce teaching on a low-calorie diet. The client is at risk for losing weight; therefore, the nurse should reinforce how the client can maintain his weight with good nutrition. D) Instruct the client to have a yearly tuberculin skin test. A client who has tuberculosis will always have a positive tuberculin skin test. Therefore, there is no reason for the client to have a yearly test.
A) Determine the client's daily alcohol intake. The nurse should instruct the client to reduce or avoid all use of alcohol because isoniazid can cause liver damage; therefore, it is important for the nurse to determine the client's daily alcohol intake.
A nurse is reinforcing teaching with a client who has a new prescription for etanercept to treat rheumatoid arthritis. Which of the following instructions about self-administering this medication should the nurse include? A) Discard any solutions that are cloudy. The client should discard any vials or pre-filled syringes that contain solutions that are discolored, cloudy, or have any sediment in them. B) Attach a 21-gauge needle to the syringe for injection. The client should attach a 27-gauge needle to the syringe for injecting the medication subcutaneously. C) Self-administer the medication on alternate days. The client should self-administer the medication once per week. D) Shake the reconstituted solution well before self-administration. The client should swirl the solution gently before self-administration.
A) Discard any solutions that are cloudy. The client should discard any vials or pre-filled syringes that contain solutions that are discolored, cloudy, or have any sediment in them.
A nurse is collecting data from the parent of a toddler who is about to receive the varicella immunization. The nurse should identify that an anaphylactic reaction to which of the following substances is a contraindication for receiving this immunization? A) Gelatin The nurse should identify that hypersensitivity reactions to either gelatin or neomycin are contraindications for receiving the varicella vaccine because it contains both of these substances. B) Penicillin An anaphylactic reaction to penicillin is not a contraindication to receiving this vaccine. Anaphylactic reactions to specific immunizations or to their components are true contraindications for receiving those vaccines. C) Sulfa A hypersensitivity reaction to sulfa is a contraindication for receiving medications containing sulfonamide. D) Eggs Administering the measles, mumps, and rubella vaccine requires caution with clients who have had hypersensitivity reactions to eggs, gelatin, or neomycin.
A) Gelatin The nurse should identify that hypersensitivity reactions to either gelatin or neomycin are contraindications for receiving the varicella vaccine because it contains both of these substances.
A nurse is reinforcing teaching with a client about the adverse effects of simvastatin. For which of the following adverse effects should the nurse instruct the client to notify the provider? A) Muscle pain The nurse should instruct the client to notify the provider if muscle pain or tenderness develops because this can indicate the client is developing rhabdomyolysis. B) Fine hand tremors Fine hand tremors are not an adverse effect of simvastatin. C) Urinary retention Urinary retention is not an adverse effect of simvastatin. D) Double vision Double vision is not an adverse effect of simvastatin.
A) Muscle pain The nurse should instruct the client to notify the provider if muscle pain or tenderness develops because this can indicate the client is developing rhabdomyolysis.
A nurse is instilling timolol eyedrops for a client who has glaucoma. Which of the following actions should the nurse take after instilling the eyedrops? A) Press the nasolacrimal duct. The nurse should press the client's nasolacrimal duct after instilling the eye drops to prevent the medication from absorbing into systemic circulation. B) Apply pressure to the upper eyelid. The nurse should avoid applying pressure to the client's upper eyelid after instilling the eye drops because it may force the medication out of the conjunctival sac. C) Ask the client to blink her eyes several times. The nurse should avoid asking the client to blink her eyes after instilling the eye drops because it can prevent the medication from entering the conjunctival sac. D) Tell the client to keep her eyes open for at least 15 seconds. The nurse should avoid asking the client to keep her eyes open after instilling the eye drops because it can inhibit distribution of the medication.
A) Press the nasolacrimal duct. The nurse should press the client's nasolacrimal duct after instilling the eye drops to prevent the medication from absorbing into systemic circulation.
A nurse is caring for a client who has a new prescription for sumatriptan. The nurse notes that the client takes fluoxetine. The nurse should notify the provider that the combination of these medications will place the client at risk for which of the following adverse effects? A) Tremors Concurrent use of sumatriptan and fluoxetine can lead to excessive stimulation of serotonin receptors, placing the client at risk for serotonin syndrome. The client can experience tremors, confusion, and hallucinations. B) Renal calculi Concurrent use of sumatriptan and fluoxetine does not lead to the formation of renal calculi. C) Dysphagia Concurrent use of sumatriptan and fluoxetine does not lead to dysphagia. D) Hearing loss Concurrent use of sumatriptan and fluoxetine does not result in hearing loss.
A) Tremors Concurrent use of sumatriptan and fluoxetine can lead to excessive stimulation of serotonin receptors, placing the client at risk for serotonin syndrome. The client can experience tremors, confusion, and hallucinations.
A nurse is reinforcing teaching about benzodiazepine withdrawal with an older adult client who discontinued taking lorazepam after taking it for 3 months. Which of the following instructions should the nurse include? A) "Increase your fiber intake with each meal." The client who is withdrawing from lorazepam does not need to increase dietary fiber because fiber is not associated with withdrawal manifestations. B) "Have someone assist you with ADLs." The client who has lorazepam withdrawal can manifest tremors and dizziness, making ADLs difficult to perform. C) "Watch for increased drowsiness." The client who has lorazepam withdrawal can manifest insomnia. D) "Limit your daily fluid intake to 1,500 milliliters." The client who has lorazepam withdrawal can manifest diaphoresis and should increase fluid intake to prevent dehydration.
B) "Have someone assist you with ADLs." The client who has lorazepam withdrawal can manifest tremors and dizziness, making ADLs difficult to perform.
A nurse is caring for a client who has a prescription for an IM injection of penicillin G benzathine. The client asks why the injection must be given IM instead of through the IV line. Which of the following responses should the nurse make? A) "The medication is more rapidly absorbed when given IM." The nurse should inform the client that this type of penicillin is absorbed slowly for several weeks, maintaining a continuous low blood level. Medications given intravenous are absorbed faster than IM medications. B) "Your medication can't be given IV because it is not water-soluble." The nurse should inform the client this type of penicillin has poor water solubility and is never administered intravenous. C) "You will experience less discomfort with an IM injection." The nurse should inform the client IM injections of this medication can cause discomfort at the injection site. D) "An IM injection allows more precise control of the medication level in your blood." The nurse should inform the client that IV administration of a medication allows more precise control of the medication level in the blood.
B) "Your medication can't be given IV because it is not water-soluble." The nurse should inform the client this type of penicillin has poor water solubility and is never administered intravenous.
A client comes to an urgent care clinic and announces with great enthusiasm, "I am an expert at all things medical as they apply to me, and I require zolpidem." The client's pupils are dilated, along with an elevated heart rate and blood pressure level. The nurse should suspect intoxication with which of the following substances? A) Alcohol The client who has alcohol intoxication typically has slurred speech, drowsiness, impaired judgment, irritability, and decreased blood pressure. B) Cocaine The client who has cocaine intoxication typically has tachycardia, elevated blood pressure, dilated pupils, and displays delusions. This client's behavior and physiological data indicate cocaine intoxication. C) Barbiturates The client who has barbiturate toxicity typically has respiratory depression, constricted pupils, drowsiness, impaired judgment, irritability, and decreased blood pressure. D) Heroin The client who has heroin toxicity typically has slurred speech, drowsiness, constricted pupils, and decreased blood pressure.
B) Cocaine The client who has cocaine intoxication typically has tachycardia, elevated blood pressure, dilated pupils, and displays delusions. This client's behavior and physiological data indicate cocaine intoxication.
A nurse is reviewing medication prescriptions for a group of clients. The nurse should recognize that which of the following prescriptions can result in a medication administration error? A) Penicillin G benzathine 1.2 million units IM daily The nurse should recognize that this prescription is written correctly and should not result in a medication administration error. B) Furosemide 10.0 mg PO daily The nurse should avoid using a trailing zero following a whole number. This prescription can result in a medication error because the nurse can mistake the dosage as 100 mg instead of 10 mg because the decimal point is not always recognized. C) Albuterol 2.5 mg 2 inhalations every 6 hr as needed for shortness of breath The nurse should recognize that this prescription is written correctly and should not result in a medication administration error. D) Insulin glargine 15 units subcutaneous daily at bedtime The nurse should recognize that this prescription is written correctly and should not result in a medication administration error.
B) Furosemide 10.0 mg PO daily The nurse should avoid using a trailing zero following a whole number. This prescription can result in a medication error because the nurse can mistake the dosage as 100 mg instead of 10 mg because the decimal point is not always recognized.
A nurse is collecting data from the parent of an 11 yr old child who has previously received all the immunizations in accordance with the CDC Recommended Immunization Schedule. Which of the following immunizations should the nurse plan to administer to this child at this age? A) Hepatitis A (HepA) Having received all previous immunizations according to the CDC Schedule, the child should have received the HepA immunization series between the ages of 12 and 24 months of age. B) Human papilloma virus (HPV) This is a voluntary immunization that the CDC's Advisory Committee on Immunization Practices recommends for children between the ages of 11 and 12 years of age. This immunization is intended to prevent development of human papilloma virus. Certain strains of this virus can lead to genital warts and cancers. C) Varicella (VAR) Having received all previous immunizations according to the CDC Schedule, the child should have received the varicella A immunization series between the ages of 12 months and 6 years of age. D) Inactivated poliovirus (IPV) Having received all previous immunizations according to the CDC Schedule, the child should have received the IPV immunization series between the ages of 2 months and 6 years of age.
B) Human papilloma virus (HPV) This is a voluntary immunization that the CDC's Advisory Committee on Immunization Practices recommends for children between the ages of 11 and 12 years of age. This immunization is intended to prevent development of human papilloma virus. Certain strains of this virus can lead to genital warts and cancers.
A nurse is caring for a client who has a history of psychosis and is taking chlorpromazine. Which of the following actions should the nurse take to counteract the adverse effects of this medication? A) Suggest that the client apply antiperspirant more frequently. Chlorpromazine has the adverse effect of reduced perspiration. Tricyclic antidepressants, rather than antipsychotics, can cause excessive sweating. B) Inform the client to apply sunblock before going outside. The nurse should inform the client to apply sunblock, which will counteract the adverse effects of photosensitivity. Chlorpromazine increases skin's sensitivity to ultraviolet light causing temporary pigmentation changes and increases the risk of sunburn. C) Give the client a list of over-the-counter antidiarrheal medications. The anticholinergic properties of antipsychotic drugs cause constipation, not diarrhea. D) Recommend that the client take the medication on an empty stomach. The client should take chlorpromazine with food or fluid to minimize gastrointestinal distress.
B) Inform the client to apply sunblock before going outside. The nurse should inform the client to apply sunblock, which will counteract the adverse effects of photosensitivity. Chlorpromazine increases skin's sensitivity to ultraviolet light causing temporary pigmentation changes and increases the risk of sunburn.
A nurse is caring for a client who has a prescription for a hydromorphone 2 mg immediate release tablet by mouth. The nurse administers a 4 mg immediate release tablet by mistake. Which of the following actions should the nurse take first? A) Document the facts about the error in the medication administration record. The nurse should document only factual information about the error in the medication administration record so that other members of the health care team can continue to monitor the client for adverse effects. However, there is another action the nurse should take first. B) Obtain the client's vital signs and level of consciousness. The first action the nurse should take when using the nursing process is to collect data from the client, such as vital signs and level of consciousness. After a medication error, the first thing the nurse should do is evaluate the client for adverse effects. A double dose of hydromorphone increases the client's risk for oversedation and respiratory depression. C) Prepare an incident report. The nurse should prepare an incident report to document the medication error, the client's condition, and actions taken by the nurse. However, there is another action the nurse should take first. D) Report the error to the provider and charge nurse. The nurse should inform the provider and the charge nurse of the medication error to ensure the continued safety of the client. The provider might prescribe a reversal agent for the excess dose of opioids. However, there is another action the nurse should take first.
B) Obtain the client's vital signs and level of consciousness. The first action the nurse should take when using the nursing process is to collect data from the client, such as vital signs and level of consciousness. After a medication error, the first thing the nurse should do is evaluate the client for adverse effects. A double dose of hydromorphone increases the client's risk for oversedation and respiratory depression.
A nurse is collecting data from a client who is postoperative and taking morphine for pain. Which of the following findings is the priority for the nurse to report to the provider? A) Constipation The nurse should monitor and treat the client for constipation; however, there is another finding that is the priority for the nurse to report. B) Oxygen saturation 87% When using the airway, breathing, circulation approach to client care, the nurse determines that the priority finding is an oxygen saturation of 87%, which is a manifestation of respiratory depression and should be reported to the provider. C) Vomiting The nurse should monitor and treat the client for vomiting; however, there is another finding that is the priority for the nurse to report. D) Urinary output 25 mL over 1 hr The nurse should monitor and treat the client for urinary retention; however, there is another finding that is the priority for the nurse to report.
B) Oxygen saturation 87% When using the airway, breathing, circulation approach to client care, the nurse determines that the priority finding is an oxygen saturation of 87%, which is a manifestation of respiratory depression and should be reported to the provider.
A nurse is collecting data from a female client who has been taking propylthiouracil (PTU) for 2 months to treat Graves' disease. Which of the following findings should the nurse recognize as an indication that the medication is effective? A) Weight loss MY ANSWER The nurse should identify that weight loss is a manifestation of hyperthyroidism, which indicates the medication is not effective. B) Pulse 82/min Tachycardia is a manifestation of hyperthyroidism. The nurse should identify that a pulse of 82/min is within the expected reference range of 60 to 100/min, indicating that the medication is effective. C) Respiratory rate 22/min The nurse should identify that tachypnea is a manifestation of hyperthyroidism, which indicates the medication is not effective. D) Decreased menstrual flow The nurse should identify that amenorrhea is a manifestation of hyperthyroidism, which indicates the medication is not effective.
B) Pulse 82/min Tachycardia is a manifestation of hyperthyroidism. The nurse should identify that a pulse of 82/min is within the expected reference range of 60 to 100/min, indicating that the medication is effective.
A nurse is reinforcing teaching with a client who has hypertension and a new prescription for spironolactone. Which of the following instructions should the nurse include in the teaching? A) Increase foods high in zinc. The nurse should instruct the client that spironolactone does not affect the client's zinc level. B) Restrict foods high in potassium. The nurse should instruct the client that spironolactone is a potassium-sparing diuretic, which can cause hyperkalemia. Therefore, the client should restrict foods that are high in potassium and salt substitutes that contain potassium. C) Restrict foods high in vitamin K. The nurse should instruct the client that spironolactone does not affect the client's vitamin K level. D) Increase foods high in magnesium. The nurse should instruct the client that spironolactone does not affect the client's magnesium level.
B) Restrict foods high in potassium. The nurse should instruct the client that spironolactone is a potassium-sparing diuretic, which can cause hyperkalemia. Therefore, the client should restrict foods that are high in potassium and salt substitutes that contain potassium.
A nurse is reinforcing teaching with a client who has a new prescription for omeprazole oral capsule. Which of the following instructions should the nurse include? A) Take the medication at bedtime. The client should take omeprazole in the morning, prior to the first meal of the day, to increase the absorption of the medication. B) Swallow the medication whole. The nurse should instruct the client to swallow the capsules or tablets whole and not chew or crush them. Omeprazole, a proton pump inhibitor, blocks the secretion of gastric acid. It is available in delayed-release capsules and over the counter in delayed-release tablets, as well as suspensions and powders. C) Take the medication with food. Food can reduce the absorption of omeprazole, a proton pump inhibitor. Therefore, the client should avoid taking the medication with food. D) Avoid antacids when taking this medication. Antacids do not alter the effectiveness of omeprazole. Therefore, the client does not need to avoid antacids when taking this medication.
B) Swallow the medication whole. The nurse should instruct the client to swallow the capsules or tablets whole and not chew or crush them. Omeprazole, a proton pump inhibitor, blocks the secretion of gastric acid. It is available in delayed-release capsules and over the counter in delayed-release tablets, as well as suspensions and powders.
A nurse is reinforcing teaching with the parent of a preschooler who has otitis media. The child has had a low-grade fever and irritability for 2 days. Which of the following instructions should the nurse include in the teaching? A) "Administer amoxicillin twice a day for 3 days." The nurse should instruct the parent to administer the full course of antibiotics, which is expected to be 5 to 7 days for mild to moderate infection and 10 days for severe infection. B) "Apply cold packs every 4 hours for relief of pain." The nurse should instruct the parent to apply heat to the ear while the child lies on the affected side to reduce discomfort. This position promotes drainage of exudate. C) "Give acetaminophen as needed for discomfort and fever." The nurse should instruct the parent to administer analgesics, such as acetaminophen or ibuprofen, to decrease discomfort and fever related to otitis media. D) "Return to the office in 72 hours for a follow-up appointment." The nurse should instruct the parent to return for a follow-up appointment when the antibiotic therapy has been completed. This allows for determining the effectiveness of the treatment and identification of complications.
C) "Give acetaminophen as needed for discomfort and fever." The nurse should instruct the parent to administer analgesics, such as acetaminophen or ibuprofen, to decrease discomfort and fever related to otitis media.
A nurse is reinforcing teaching with a client who has HIV and a new prescription for zidovudine. Which of the following client statements should indicate to the nurse an understanding of the teaching? A) "I can have unprotected sex after 6 months of taking this medication." The client should continue to use protection during sexual activity even if the plasma HIV RNA is undetectable after taking zidovudine. B) "I can expect to have constipation while taking this medication." Zidovudine can cause GI disturbances, such as diarrhea, abdominal pain, nausea, and vomiting. C) "I will be sure to have my blood tested for anemia." Zidovudine can cause severe anemia and neutropenia. The client should have blood tests performed before treatment begins and have continued monitoring during the course of treatment. D) "My fingers might feel numb after I start therapy." Numbness and tingling are not adverse effects of zidovudine. The client's nail beds might have changes to pigmentation while taking this medication.
C) "I will be sure to have my blood tested for anemia." Zidovudine can cause severe anemia and neutropenia. The client should have blood tests performed before treatment begins and have continued monitoring during the course of treatment.
A nurse is reinforcing teaching with a client about the use of sublingual nitroglycerin for chest pain. Which of the following statements by the client indicates an understanding of the teaching? A) "I will store my nitroglycerin tablets in my car glove box when traveling." The nurse should instruct the client to store nitroglycerin at room temperature, not in the extreme heat or cold inside a car's glove box. B) "I will take a nitroglycerin tablet 60 minutes prior to exercise." The nurse should instruct the client to take a nitroglycerin tablet prophylactically 5 to 10 min prior to exercise because sublingual nitroglycerin has an onset of 1 to 3 min with a duration of up to 60 min. C) "I will call 911 if my chest pain is not relieved within 5 minutes of taking nitroglycerin." The nurse should instruct the client to call 911 if chest pain is not relieved within 5 min after taking nitroglycerin. Chest pain not relieved by nitroglycerin can be an indication that the client is having a myocardial infarction. The client should continue to take two more nitroglycerin tablets every 5 min for continued chest pain, while waiting for emergency response to arrive. D) "If I get a headache after taking a nitroglycerin tablet, I should report it to my doctor immediately." The nurse should instruct the client that headaches are a common adverse effect of nitroglycerin and to use a mild analgesic to relieve the headache.
C) "I will call 911 if my chest pain is not relieved within 5 minutes of taking nitroglycerin." The nurse should instruct the client to call 911 if chest pain is not relieved within 5 min after taking nitroglycerin. Chest pain not relieved by nitroglycerin can be an indication that the client is having a myocardial infarction. The client should continue to take two more nitroglycerin tablets every 5 min for continued chest pain, while waiting for emergency response to arrive.
A nurse is reinforcing teaching with a client who has a new prescription for ethinyl estradiol/norethindrone, an oral contraceptive. Which of the following client statements should indicate to the nurse an understanding of the teaching? A) "I should expect my menstrual flow to increase." The nurse should reinforce with the client that the volume of her menstrual flow will decrease, as well as the number of days of menses. B) "I should monitor my blood pressure for hypotension while on this medication." The client should monitor her blood pressure for hypertension because the medication causes increased secretion of aldosterone and angiotensin. C) "I will take the medication at the same time each day." The client should take this medication at the same time each day to maintain a consistent level to reduce fertility and the chance of pregnancy. D) "This type of medication is the most effective because it only contains estrogen." The nurse should reinforce to the client that ethinyl estradiol/norethindrone is a combination oral contraceptive with each tablet containing both estrogen and progestin.
C) "I will take the medication at the same time each day." The client should take this medication at the same time each day to maintain a consistent level to reduce fertility and the chance of pregnancy.
A nurse is reinforcing teaching with a client who has a new prescription for propranolol. Which of the following information should the nurse include in the teaching? A) "If you miss a dose, double the next scheduled dose." The nurse should instruct the client to take a missed dose as soon as he notices and prior to 4 hr before the next dose is scheduled. B) "Discontinue this medication if lightheadedness occurs." The nurse should instruct the client that lightheadedness and dizziness are adverse effects of this medication, and the client should avoid driving or other hazardous activities until the effects of the medication are known. The nurse should instruct the client to avoid abrupt discontinuation of the medication as this can cause life-threatening arrhythmias. C) "If your pulse rate is less than 50 beats per minute, notify your provider." The nurse should instruct the client to check his pulse before taking the medication and to withhold the medication if his pulse is less than 50/min. The client should also notify his provider. Bradycardia is a common adverse effect of beta blockers. D) "This medication can cause heat intolerance." The nurse should instruct the client that beta blockers, such as propranolol, can cause cold intolerance.
C) "If your pulse rate is less than 50 beats per minute, notify your provider." The nurse should instruct the client to check his pulse before taking the medication and to withhold the medication if his pulse is less than 50/min. The client should also notify his provider. Bradycardia is a common adverse effect of beta blockers.
A nurse is reinforcing teaching with a client following placement of a cast for a fractured ankle. The client is to take oxycodone for pain management. The nurse should instruct the client that which of the following over-the-counter medications is contraindicated while taking oxycodone? A) Docusate sodium Use of oxycodone can result in constipation. The client can take a stool softener, such as docusate sodium, to manage this adverse effect. B) Ranitidine There are no known interactions between oxycodone and ranitidine and no indication for the client to avoid the use of ranitidine while taking oxycodone. C) Diphenhydramine Both diphenhydramine, an antihistamine, and oxycodone, an opioid analgesic, can cause CNS depression. Therefore, when a client uses the two medications together, the client is at increased risk for sedation, respiratory depression, and injury. D) Ibuprofen Clients who have a musculoskeletal injury will benefit from using ibuprofen, an NSAID, in conjunction with an opioid analgesic.
C) Diphenhydramine Both diphenhydramine, an antihistamine, and oxycodone, an opioid analgesic, can cause CNS depression. Therefore, when a client uses the two medications together, the client is at increased risk for sedation, respiratory depression, and injury.
A nurse is reviewing the laboratory results of a client who takes insulin for the management of diabetes mellitus. Which of the following findings should indicate to the nurse the medication is effective? A) Fasting blood glucose 260 mg/dL The expected reference range for a fasting blood glucose level is 70 to 110 mg/dL. The nurse should identify that a client who has a fasting blood glucose level of 260 mg/dL is hyperglycemic and does not indicate effective management of diabetes mellitus. B) HbA1c 9.2% The expected reference range for HbA1c is 5.5% to 7%. The nurse should identify that a client who has an HbA1c of 9.2% has poor diabetic control and does not indicate effective management of diabetes mellitus. C) Fasting blood glucose 100 mg/dL The expected reference range for a fasting blood glucose level is 70 to 110 mg/dL. The nurse should identify that a client who has a fasting blood glucose level of 100 mg/dL is effectively managing diabetes mellitus. D) HbA1c 3% The expected reference range for HbA1c is 5.5% to 7%. The nurse should identify that a client who has an HbA1c of 3% might have anemia, chronic blood loss, or chronic renal failure, which can result in low HbA1c results.
C) Fasting blood glucose 100 mg/dL The expected reference range for a fasting blood glucose level is 70 to 110 mg/dL. The nurse should identify that a client who has a fasting blood glucose level of 100 mg/dL is effectively managing diabetes mellitus.
A nurse is caring for a client who has chronic kidney disease and has been receiving epoetin alfa for 2 weeks. Which of the following findings should indicate to the nurse that the client's medication is having the desired therapeutic effect? A) Albumin is within the expected reference range. Epoetin alfa does not affect the client's albumin level. B) Urine output increases to 60 mL/hr. Epoetin alfa does not affect the client's urine output. C) Hemoglobin rises 0.5 g/dL. Initial therapeutic effects, such as hemoglobin rising 0.5 g/dL, can occur within the first 2 weeks of therapy. The client's hemoglobin should reach target levels (10 to 11 g/dL) in 2 to 3 months. D) Blood urea nitrogen level is within the expected reference range. Epoetin alfa does not affect the client's BUN level.
C) Hemoglobin rises 0.5 g/dL. Initial therapeutic effects, such as hemoglobin rising 0.5 g/dL, can occur within the first 2 weeks of therapy. The client's hemoglobin should reach target levels (10 to 11 g/dL) in 2 to 3 months.
A nurse is collecting data from a client who is asking about taking celecoxib for treatment of joint pain. The nurse should identify that which of the following findings is a contraindication to receiving celecoxib? A) Hyperglycemia Celecoxib is not contraindicated for a client who has hyperglycemia. B) Allergy to penicillin Celecoxib can cause hypersensitivity reactions in clients who are allergic to sulfonamides or salicylates rather than penicillin. C) History of myocardial infarction Celecoxib increases the risk of myocardial infarction caused by increased vasoconstriction and unimpeded platelet aggregation. It is contraindicated for a client who has a history of myocardial infarction or heart disease. D) Peptic ulcer disease Celecoxib should be used with caution for clients who have peptic ulcer disease; however, it is not contraindicated.
C) History of myocardial infarction Celecoxib increases the risk of myocardial infarction caused by increased vasoconstriction and unimpeded platelet aggregation. It is contraindicated for a client who has a history of myocardial infarction or heart disease.
A nurse is caring for a client who has a new prescription for eplerenone to treat hypertension. The nurse should monitor for which of the following adverse effects of this medication? A) Hematuria The nurse should identify that eplerenone can cause vaginal bleeding, not blood in the urine. B) Hypernatremia The nurse should identify that eplerenone can cause decreased sodium levels, not increased sodium levels. C) Hyperkalemia The nurse should identify that eplerenone can place the client at risk for increased potassium levels because eplerenone can cause potassium retention. D) Constipation The nurse should identify that eplerenone can cause diarrhea, not constipation.
C) Hyperkalemia The nurse should identify that eplerenone can place the client at risk for increased potassium levels because eplerenone can cause potassium retention.
A nurse is assisting with the care of a client who has a methicillin-resistant Staphylococcus aureus (MRSA) infection and is receiving vancomycin via IV infusion. Which of the following changes in the client's condition should the nurse identify as the priority finding to report to the provider? A) Nausea Although the nurse should report nausea for a client who is receiving vancomycin therapy, there is another finding that is the nurse's priority to report. B) Back pain Although the nurse should report back pain for a client who is receiving vancomycin therapy, there is another finding that is the nurse's priority to report. C) Hypotension When using the urgent vs. nonurgent approach to client care, the nurse determines that the priority finding to report to the provider is hypotension. If the client's vancomycin infusion is too rapid, it can cause red man syndrome, which is a group of adverse effects that includes tachycardia, hypotension, flushing, and urticaria. D) Chills Although the nurse should report chills for a client who is receiving vancomycin therapy, there is another finding that is the nurse's priority to report.
C) Hypotension When using the urgent vs. nonurgent approach to client care, the nurse determines that the priority finding to report to the provider is hypotension. If the client's vancomycin infusion is too rapid, it can cause red man syndrome, which is a group of adverse effects that includes tachycardia, hypotension, flushing, and urticaria.
A nurse is monitoring a client who is receiving a transfusion of packed RBCs. The client's temperature increases to 39.1 C (102.4 F). Which of the following actions should the nurse take first? A) Obtain a urine specimen. The nurse should obtain a urine specimen to determine the extent of the reaction; however, this is not the first action the nurse should take. B) Administer diphenhydramine. The nurse might need to administer an antihistamine, such as diphenhydramine, as an emergency medication; however, this is not the first action the nurse should take. C) Stop the transfusion. The greatest risk to this client is injury from an elevated temperature; therefore, the first action the nurse should take is to stop the transfusion. D) Notify the charge nurse. The nurse should notify the charge nurse of a possible transfusion reaction because it is an emergent situation; however, this is not the first action the nurse should take.
C) Stop the transfusion. The greatest risk to this client is injury from an elevated temperature; therefore, the first action the nurse should take is to stop the transfusion.
A nurse is reinforcing teaching with a client who has Helicobacter pylori and a new prescription for tetracycline. Which of the following instructions should the nurse include in the teaching? A) "Expect your urine to turn orange." Tetracycline does not cause changes in urine color. However, it can affect kidney function tests, such as BUN and creatinine. B) "Take the medication with 240 milliliters (8 ounces) milk." The client should avoid taking tetracycline with foods high in calcium, such as milk. This decreases the absorption of the medication. C) "Watch for excessive bleeding when brushing your teeth." Tetracycline does not cause bleeding complications. However, it can cause fungal infections, such as candidiasis. D) "Avoid prolonged exposure to sunlight." The nurse should instruct the client to avoid prolonged exposure to sunlight while taking tetracycline. This medication causes photosensitivity and increased severity of sunburn.
D) "Avoid prolonged exposure to sunlight." The nurse should instruct the client to avoid prolonged exposure to sunlight while taking tetracycline. This medication causes photosensitivity and increased severity of sunburn.
A nurse is reinforcing teaching with a client who has a prescription for alendronate. Which of the following client responses indicates to the nurse an understanding of the teaching? A) "I will take the medication with my breakfast." The client should take alendronate upon arising and at least 30 minutes before eating or drinking liquids other than water. B) "I will take the medication with 1 tablespoon of an antacid." The client should avoid taking alendronate with antacids containing calcium because they can decrease absorption of alendronate. C) "I will lie down for 30 minutes after taking the medication." The client should sit upright for 30 min after taking the medication because alendronate can cause erosion of the esophagus. D) "I will take the medication with 8 ounces of water." The client should take alendronate on an empty stomach with 240 mL (8 oz) of water to ensure it does not lodge in the esophagus, which can result in esophageal ulcerations.
D) "I will take the medication with 8 ounces of water." The client should take alendronate on an empty stomach with 240 mL (8 oz) of water to ensure it does not lodge in the esophagus, which can result in esophageal ulcerations.
A nurse is preparing to administer a PRN medication to a group of clients. Which of the following clients should the nurse administer medication to first? A) A client who has GERD and requests an antacid Requesting an antacid is nonurgent because heartburn is an expected finding for a client who has GERD. Therefore, there is another client the nurse should administer medication to first. B) A client who reports constipation for 3 days and requests a stool softener The client who reports constipation and requests a stool softener is nonurgent. Therefore, there is another client the nurse should administer medication to first. C) A client who has mild generalized anxiety disorder and requests an antianxiety medication Requesting an antianxiety medication is nonurgent for a client who has mild generalized anxiety disorder. Therefore, there is another client the nurse should administer medication to first. D) A client who is attending postoperative physical therapy and requests pain medication When using the urgent vs nonurgent approach to client care, the nurse should determine the first client to medicate is the client who is postoperative and going to physical therapy. The client can experience pain during and after therapy.
D) A client who is attending postoperative physical therapy and requests pain medication When using the urgent vs nonurgent approach to client care, the nurse should determine the first client to medicate is the client who is postoperative and going to physical therapy. The client can experience pain during and after therapy.
A nurse is preparing to administer diphenhydramine 50 mg PO at 2200 to a client who has difficulty swallowing pills and capsules. Available is diphenhydramine 12.5 mg/5 mL PO. Which of the following nusing actions requires the completion of an incident report? A) Giving the medication at 2140 Administering the medication at 2140 is within the appropriate time frame. B) Administering the medication with grapefruit juice Although grapefruit juice can alter the action of a number of medications, it does not affect diphenhydramine. C) Giving the medication when the client's apical pulse is 58/min The nurse can administer diphenhydramine if the client's heart rate is below 60/min because this medication can increase the heart rate. D) Administering 25 mL of the syrup This dose is higher than the client should receive. The correct dosage is 20 mL. Administering an incorrect amount of medication to a client requires completion of an incident report.
D) Administering 25 mL of the syrup This dose is higher than the client should receive. The correct dosage is 20 mL. Administering an incorrect amount of medication to a client requires completion of an incident report.
A nurse is contributing to the plan of care for a client who has schizophrenia and a new prescription for clozapine. The nurse should include in the plan to monitor the client for which of the following adverse effects of this medication? A) Hypoglycemia The nurse should monitor the client for hyperglycemia, rather than hypoglycemia. B) Iron-deficiency anemia The nurse should monitor the client for hyperlipidemia, rather than iron-deficiency anemia. C) Serotonin syndrome The nurse should monitor the client for tardive dyskinesia, rather than serotonin syndrome. D) Agranulocytosis The nurse should monitor the client's WBC count and notify the provider for a value below the expected reference range of 5,000 to 10,000 mm3.
D) Agranulocytosis The nurse should monitor the client's WBC count and notify the provider for a value below the expected reference range of 5,000 to 10,000 mm3.
A nurse is caring for a client who has hyperthyroidism and has been taking methimazole. Which of the following laboratory findings should indicate to the nurse that the medication has had a therapeutic effect? A) Decreased blood glucose level The nurse should identify that methimazole does not affect the client's blood glucose level. Therefore, this finding does not indicate a therapeutic effect. B) Increased Hgb The nurse should identify that methimazole does not affect the client's Hgb level. Therefore, this finding does not indicate a therapeutic effect. C) Increased platelets The nurse should identify that methimazole can cause decreased platelets as an adverse effect. Therefore, this finding does not indicate a therapeutic effect. D) Decreased T4 The nurse should identify that methimazole inhibits the synthesis of thyroid hormone, reducing levels to provide a euthyroid state. Therefore, a decreased level of T4 is an indication of a therapeutic effect.
D) Decreased T4 The nurse should identify that methimazole inhibits the synthesis of thyroid hormone, reducing levels to provide a euthyroid state. Therefore, a decreased level of T4 is an indication of a therapeutic effect.
A nurse is monitoring a client who is receiving repaglinide for type 2 diabetes mellitus. Which of the following laboratory tests should the nurse plan to review to obtain information about the long-term therapeutic effect of this medication? A) Fasting blood glucose level The fasting blood glucose level indicates the client's current status, not the long-term therapeutic effect of repaglinide. B) 1-hr oral glucose tolerance test The 1-hr oral glucose tolerance test evaluates the client's response to a carbohydrate challenge. The client can undergo this test to determine if they have gestational diabetes. C) Urinary ketones The presence of urinary ketones indicates diabetic ketoacidosis, not the long-term therapeutic effect of repaglinide. D) Glycosylated HbA1c The client's HbA1c value measures the average of blood glucose levels over the past 2 to 3 months. Therefore, the nurse should review this laboratory test to obtain information about the long-term therapeutic effect of repaglinide.
D) Glycosylated HbA1c The client's HbA1c value measures the average of blood glucose levels over the past 2 to 3 months. Therefore, the nurse should review this laboratory test to obtain information about the long-term therapeutic effect of repaglinide.
A nurse is collecting data from a client who is taking ferrous sulfate orally. Which of the following findings reported by the client should indicate to the nurse that the medication is having a therapeutic effect? A) Passage of a soft, formed stool daily Passing a soft, formed stool is not an indication the medication is having a therapeutic effect. Ferrous sulfate can cause constipation. B) Decreased number of viral illnesses A decreased number of viral illnesses is not an indication the ferrous sulfate is having a therapeutic effect. C) Improved ability to fall asleep An improved ability to fall asleep is not an indication the ferrous sulfate is having a therapeutic effect. D) Increased tolerance to exercise The client who takes ferrous sulfate, which is used to treat iron-deficiency anemia, can have fatigue and shortness of breath due to a low hemoglobin level. An increased tolerance to exercise is an indication the ferrous sulfate is having a therapeutic effect. Increased tolerance to exercise occurs when the hemoglobin level increases, allowing more oxygen to be carried to the vital organs and tissue.
D) Increased tolerance to exercise The client who takes ferrous sulfate, which is used to treat iron-deficiency anemia, can have fatigue and shortness of breath due to a low hemoglobin level. An increased tolerance to exercise is an indication the ferrous sulfate is having a therapeutic effect. Increased tolerance to exercise occurs when the hemoglobin level increases, allowing more oxygen to be carried to the vital organs and tissue.
A nurse is reviewing the history of a client who is to start taking cefotetan to treat a bacterial infection. Which of the following information from the client's medical record should the nurse report to the provider before the client begins receiving this medication? A) Hearing impairment Hearing loss is a contraindication for some types of antibiotics, such as aminoglycosides, due to their ototoxic effects. B) Milk-protein allergy Cefditoren, a cephalosporin, can cause an allergic reaction in clients who have milk-protein hypersensitivity. C) Tendon pain Clients who have tendon pain should use fluoroquinolone antibiotics with caution due to the possible adverse effect of tendon rupture. D) Penicillin allergy Cefotetan is a cephalosporin, an antibiotic structurally similar to penicillins. The client who has a severe allergy to penicillin can develop cross-reactivity and have an allergic reaction to cephalosporins.
D) Penicillin allergy Cefotetan is a cephalosporin, an antibiotic structurally similar to penicillins. The client who has a severe allergy to penicillin can develop cross-reactivity and have an allergic reaction to cephalosporins.
A nurse is reviewing the medical record of a client who has a new prescription for cephalexin to treat pneumonia. Which of the following data should the nurse report to the provider before the client receives this medication? A) Neomycin sensitivity The nurse should identify that a neomycin sensitivity is a contraindication to receiving the measles, mumps, and rubella (MMR) immunization. However, it is not a contraindication to receiving cephalexin. B) Egg allergy The nurse should identify that a previous anaphylactic reaction to eggs requires a risk evaluation before receiving the influenza immunization. However, it is not a contraindication to receiving cephalexin. C) Alcohol sensitivity The nurse should identify that alcohol intolerance or sensitivity is a contraindication to receiving sirolimus. However, it is not a contraindication to receiving cephalexin. D) Penicillin allergy The nurse should identify that cephalexin is a cephalosporin, a classification of antibiotics whose structure is similar to that of penicillin. Although it is rare, a life-threatening cross-reactivity can develop in clients who are allergic to penicillin and take a cephalosporin. The nurse should notify the provider.
D) Penicillin allergy The nurse should identify that cephalexin is a cephalosporin, a classification of antibiotics whose structure is similar to that of penicillin. Although it is rare, a life-threatening cross-reactivity can develop in clients who are allergic to penicillin and take a cephalosporin. The nurse should notify the provider.
A nurse is caring for a client who is receiving 0.9% sodium chloride 1,000 mL to infuse over 8 hr. The drop factor on the manual IV tubing is 15 gtt/mL. The nurse should ensure that the manual infusion is set to deliver how many gtt/min? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)
Step 1: What is the unit of measurement the nurse should calculate? gtt/min Step 2: What is the quantity of the drop factor that is available ? 15 gtt/mL Step 3: What is the volume the nurse should infuse? 1,000 mL Step 4: What is the total infusion time? 8 hr Step 5: Should the nurse convert the units of measurement? Yes (hr does not equal min) 1 hr/min = 8 hr/ 60 min X = 480 min Step 6: Set up an equation and solve for X. Volume (mL)/Time (min) x drop factor (gtt/mL) = X 1,000 mL/480 min x 15 gtt/mL = X gtt/min X = 31.25 Step 7: Round if necessary. 31.25 = 31 gtt/min Step 8: Reassess to determine whether the amount to administer makes sense. If the prescription reads 0.9% sodium chloride 1,000 mL IV to infuse over 8 hr, the drop factor on the manual IV tubing is 15 gtt/mL, it makes sense to administer 31 gtt/min. The nurse should set the manual IV infusion to deliver 0.9% sodium chloride 1,000 mL IV at 31 gtt /min over 8 hr.
At 0800 hr a nurse initiates a 1,000 mL intravenous (IV) infusion on a client, which is running at 125 mL/hr. It is now 1300 hr. How much fluid is left in the IV bag?
Step 1: What is the unit of measurement the nurse should calculate? mL Step 2: What is the total volume to be infused? Total volume = 1,000 mL Step 3: What is the rate of infusion? Rate = 125 mL/hr Step 4: What is the total infusion time so far? Time = 5 hr Step 5: Should the nurse convert the units of measurement? No Step 6: Set up an equation and solve for X. Rate (mL/hr) x Time (hr) = Volume infused (X mL) 125 mL/hr x 5 hr = X mL Volume infused = 625 mL Total volume (mL) - Volume infused (mL) = Volume remaining (mL) 1,000 mL - 625 mL = 375 mL Volume remaining = 375 mL Step 7: Round if necessary. No Step 8: Reassess to determine whether the amount remaining makes sense. If the rate of the IV infusion is 125 mL/hr, with a total volume of 1,000 mL, it makes sense that after 5 hr there are 375 mL remaining to infuse.
A nurse is reinforcing teaching about comfort measures with the parent of a 10 yr old child who has a viral infection. The nurse should plan to tell the parent that aspirin is contraindicated because of the risk for which of the following conditions? A) Juvenile idiopathic arthritis There is no association between taking aspirin for a viral illness in childhood and developing juvenile idiopathic arthritis. B) Reye's syndrome Aspirin is contraindicated for children and adolescents who have a viral illness because it is associated with the development of Reye's syndrome. There is a risk for children and adolescents to develop Reye's syndrome if they take aspirin following a viral illness. C) Glomerulonephritis There is no association between taking aspirin for a viral illness in childhood and developing glomerulonephritis. D) Iron-deficiency anemia There is no association between taking aspirin for a viral illness in childhood and developing iron-deficiency anemia.
B) Reye's syndrome Aspirin is contraindicated for children and adolescents who have a viral illness because it is associated with the development of Reye's syndrome. There is a risk for children and adolescents to develop Reye's syndrome if they take aspirin following a viral illness.
A nurse is reinforcing teaching with a client who has bipolar disorder and a new prescription for lithium. Which of the following instructions should the nurse include in the teaching? A) Take the medication on an empty stomach. The client should take lithium with meals or milk to reduce gastrointestinal upset. B) Monitor for signs of hyperthyroidism. The nurse should instruct the client that hypothyroidism can occur when taking lithium. C) Watch for signs of urinary retention. The nurse should instruct the client that polyuria can occur when taking lithium. D) Maintain a consistent sodium intake. The client should maintain a consistent sodium intake while taking lithium. Decreased serum sodium levels cause lithium excretion to decline, which can lead to toxicity.
D) Maintain a consistent sodium intake. The client should maintain a consistent sodium intake while taking lithium. Decreased serum sodium levels cause lithium excretion to decline, which can lead to toxicity.
A nurse is planning to administer metoprolol to a client who has heart failure and a heart rate of 48/min. Which of the following actions should the nurse take? A) Ambulate the client before administering the medication. A client who has a heart rate of 50/min or below can become hypotensive. Therefore, ambulating can increase the client's risk of falling. However, the nurse should not administer this medication because of the client's bradycardia. B) Give the medication when the client has an empty stomach. The nurse should administer the medication to the client with meals or immediately after meals. This medication can mask manifestations of hypoglycemia if the client has diabetes. C) Administer one-half of the client's prescribed dose. The nurse should notify the provider of the client's heart rate to determine when to administer the next dose or if a decrease in the dosage is needed. D) Withhold the client's medication. The nurse should withhold the metoprolol when the client's heart rate is 50/min or less and notify the provider.
D) Withhold the client's medication. The nurse should withhold the metoprolol when the client's heart rate is 50/min or less and notify the provider.