Pharmacology Final Prep

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A nurse is preparing to administer acetaminophen 650 mg PO every 6 hr PRN for pain. The amount available is acetaminophen liquid 500 mg/5 mL. how many mL should the nurse administer per dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

6.5 ml

A nurse is preparing to administer furosemide 80 mg PO daily. The amount available is furosemide oral solution 10 mg/1 mL. how many mL should the nurse administer? (Round the answer to the nearest whole number. Do not use a trailing zero.)

8 ml

A charge nurse is providing information to a group of nurses on ways to prevent the spread of micro-organisms. What information should the charge nurse include? b. Underlying principles: Describe one related to the concept.

> Controlling the spread of infection to health care professionals and clients in a health care setting.

A charge nurse is providing information to a group of nurses on ways to prevent the spread of micro-organisms. What information should the charge nurse include? c. Nursing interventions: Identify five related to the concept.

> Perform hand hygiene before and after each client contact. > Be aware of invasive procedures that increase the chance of developing an infection. > Encourage the client to maintain up-to-date immunization status. > Teach the client to take all antibiotics prescribed by the provider. > Implement infection control measures: aseptic technique, isolation, proper assignment of rooms. > Evaluate effectiveness of antimicrobial therapy.

6. A charge nurse is providing information to a group of nurses on ways to prevent the spread of micro-organisms. What information should the charge nurse include? a. Related content: Determine one related concept.

> Preventative nursing measures.

3. A nurse is caring for a client who has a prescription for metformin (Glucophage). The nurse should monitor the client for which of the following adverse effects? A. Lactic acidosis B. Hypoglycemia C. Hyperlipidemia D. Respiratory alkalosis

A Lactic acidosis, manifested by extreme drowsiness, hyperventilation, and muscle pain, is a rare but very serious adverse effect caused by metformin.

C. Warfarin

A nurse is taking a history for a client who reports that he is taking aspirin about 4 times a day for a sprained wrist. Which of the following prescribed medications taken by the client is contraindicated with aspirin? A. Digoxin B. Metformin C. Warfarin D. Nitroglycerin

A nurse is caring for a client who is taking propylthiouracil. For which of the following adverse effects of this medication should the nurse monitor?

Bradycardia

A nurse is reinforcing teaching with clients in an outpatient facility about the use of insulin to treat type 1 diabetes mellitus. For which of the following types of insulin should the nurse tell the clients to expect a peak effect 1 to 5 hr after administration? A. Insulin glargine (Lantus) B. NPH insulin (Humulin N) C. Regular insulin (Humulin R) D. Insulin lispro (Humalog)

C Regular insulin has a peak effect around 1 to 5 hr following administration

a nurse is assisting with monitoring a client receiving IV amphotericin B. the nurse should monitor the client for which of the following adverse effects of this medication

Rigors

A nurse is teaching a client who has anemia and a new prescription for a liquid iron supplement. Which of the following information should the nurse include in the teaching? (Select all that apply.)

"Add foods that are high in fiber to your diet." "Rinse your mouth after taking the medication." "Expect stools to be green or black in color." "Add red meat to your diet."

A nurse orientating a newly licensed nurse is reviewing the procedure for taking a telephone prescription. Which of the following statements should the nurse identify as an indication that the newly licensed nurse understands the process?

"Another nurse should listen to the phone call."

A nurse is teaching a client who has angina pectoris and is learning how to treat acute anginal attacks. The clients asks, "What is my next step if I take one tablet, wait 5 minutes, but still have anginal pain?" Which of the following responses should the nurse make?

"Call the emergency response team."

A nurse is providing discharge instructions for a client who has a new prescription for an antihypertensive medication. Which of the following statements should the nurse give?

"Change positions slowly when you move from sitting to standing."

A nurse is preparing a teaching plan for a female client who has bipolar disorder and a new prescription for carbamazepine. Which of the following instructions should the nurse include in the teaching?

"Eliminate grape fruit juice from your diet." "You will need to have a complete blood count and carbamazepine levels drawn periodically." "Notify your provider if you develop a rash." "Avoid driving for the first few days after starting this medication."

A nurse is teaching the family of a child who has cystic fibrosis and a new prescription for acetylcysteine. Which of the following information should the nurse include in the instructions?

"Expect this medication to smell like rotten eggs."

A nurse is teaching a client who has a new prescription for baclofen to treat muscle spasms. Which of the following statements by the client indicates an understanding of the teaching? (Select all that apply.)

"I know the doctor will gradually increase my dose of this medication for a while." "I should increase ber to prevent constipation from this medication." "I won't be able to drink alcohol while I'm taking this medication."

A nurse is teaching a female client who has tobacco use disorder about nicotine replacement therapy. Which of the following statements by the client indicates understanding of the teaching?

"I should avoid eating right before I chew a piece of nicotine gum."

A nurse is completing discharge teaching for a patient who has a new prescription for transdermal patches. Which of the following statements should the nurse identify as an indication that the patient understands the instructions?

"I will apply the patch to an area of skin with no hair."

A nurse is teaching a client who has a new prescription for escitalopram for treatment of generalized anxiety disorder. Which of the following statements by the client indicates understanding of the teaching?

"I will need to discontinue this medication slowly."

A nurse is reviewing a new prescription for terbutaline with a client who has a history of preterm labor. Which of the following client statements indicates understanding of the teaching?

"I will report increasing intensity of contractions to my doctor."

A nurse is evaluating teaching for a client who has rheumatoid arthritis and a new prescription for methotrexate. Which of the following statements by the client indicates understanding of the teaching?

"I'll let the doctor know if I develop sores in my mouth while taking this medication."

A nurse is caring for a client who requests information on the use of feverfew. Which of the following responses should the nurse make?

"It can decrease the frequency of migraine headaches."

A nurse is teaching a client about the use of fluticasone to treat perennial rhinitis. Which of the following statements by the client indicates an understanding of the teaching?

"It can take as long as 3 weeks before the medication takes a maximum effect."

A nurse is teaching a client who has obsessive‐compulsive disorder and has a new prescription for paroxetine. Which of the following instructions should the nurse include?

"It can take several weeks before you feel like the medication is helping."

A nurse is providing teaching for a male client who has schizophrenia and is taking risperidone. Which of the following instructions should the nurse include in the teaching?

"Notify the provider if you develop breast enlargement."

A nurse is providing instructions to a female client who has a new prescription for zolpidem. Which of the following instructions should the nurse include?

"Notify the provider if you plan to become pregnant."

A nurse in a provider's of office is instructing a parent of a toddler how to administer ear drops. Which of the following instructions should the nurse include? (Select all that apply.)

"Place the child on his unaffected side when you are ready to administer the medication." "Warm the medication by gently rolling it between your hands for a few minutes." "Gently shake medication that is in suspension form." "Keep the child on his side for 5 minutes after instillation of the ear drops."

A nurse is providing information about probiotic supplements to a male client. Which of the following information should the nurse include? (Select all that apply.)

"Probiotics are micro‐organisms that are normally found in the GI tract." "Probiotics are used to treat Clostridium difficile." "You can experience bloating while taking probiotic supplements."

A nurse is teaching a client who has angina how to use nitroglycerin transdermal ointment. The nurse should include which of the following instructions?

"Remove the prior dose before applying a new dose."

A nurse is teaching a client who has a new prescription for beclomethasone. Which of the following instructions should the nurse include?

"Rinse your mouth after each use of this medication."

A nurse is providing a client who has peptic ulcer disease with instructions about managing his condition. Which of the following instructions should the nurse include? (Select all that apply.)

"Seek measures to reduce stress." "Avoid smoking."

A nurse is teaching a client who is taking digoxin and has a new prescription for colesevelam. Which of the following instructions should the nurse include in the teaching?

"Take colesevelam with food and at least one glass of water."

The client asked the nurse when is the best time to take levothyroxine. The nurse's best response would be?

"Take it early in the morning, about 30-60 minutes before breakfast."

A nurse is providing instructions to a client who has a prescription for amoxicillin and clarithromycin to treat a peptic ulcer. Which of the following information should the nurse include in the teaching?

"Take these medications with food."

A nurse is teaching a client who has a new prescription for brimonidine ophthalmic drops and wears soft contact lenses. Which of the following instructions should the nurse include in the teaching?

"This medication can absorb into your contacts."

A nurse is providing teaching to a client who has a new prescription for buspirone to treat anxiety. Which of the following information should the nurse include?

"This medication has a low risk for dependency."

A nurse is teaching a client about terbutaline. Which of the following statements by the client indicates understanding of the teaching?

"This medication will stop my contractions."

A nurse is providing instructions to the parent of an adolescent client who has a new prescription for albuterol, PO. Which of the following instructions should the nurse include?

"Tremors are an adverse effect of this medication."

A nurse is reviewing a new prescription for oxcarbazepine with a female client who has partial seizures. Which of the following instructions should the nurse include? (Select all that apply.)

"Use caution if given a prescription for a diuretic medication." "Consider using an alternate form of contraception if you are using oral contraceptives." "Avoid driving until you see how the medication effects you." "Notify your provider if you develop a skin rash."

A nurse is providing discharge teaching to a client who has a new prescription for fluoxetine for posttraumatic stress disorder. Which of the following statements should the nurse include in the teaching?

"You may have a decreased desire for intimacy while taking this medication."

A nurse is providing discharge teaching to a client who has a new prescription for clozapine. Which of the following statements should the nurse include in the teaching?

"You should have your white blood cell count monitored every week."

A nurse is preparing to administer heparin 15,000 units subcutaneously every 12 hr. The amount available is heparin injection 20,000 units/mL. how many mL should the nurse administer per dose? (Round the answer to the nearest tenth. Do not use a trailing zero.)

0.8 ml

the nurse is monitoring the administration of Gentamicin by IV infusion at 0900 the medication will take 1 hour to infuse which of the following times should the nurse plan to obtain a blood sample for a peak serum level of Gentamicin

1030

A nurse is preparing to administer dextrose 5% in water (D5W) 750 mL IV to infuse over 6 hr. The nurse should set the IV pump to deliver how many mL/hr? (Round the answer to the nearest whole number. Do not use a trailing zero.)

125 ml/hr

A nurse is preparing to administer haloperidol 2 mg PO every 12 hr. The amount available is haloperidol 1 mg/tablet. how many tablets should the nurse administer? (Round the answer to the nearest whole number. Do not use a trailing zero.)

2 tablets

A nurse is preparing to administer clindamycin 200 mg by intermittent IV bolus. The amount available is clindamycin injection 200 mg in 100 mL 0.9% sodium chloride (0.9% NaCl) to infuse over 30 min. The nurse should set the IV pump to deliver how many mL/hr? (Round the answer to the nearest whole number. Do not use a trailing zero.)

200 ml/hr

A nurse is preparing to administer vancomycin 1 g by intermittent IV bolus. Available is vancomycin 1 g in 100 mL of dextrose 5% in water (D5W) to infuse over 45 min. The drop factor of the manual IV tubing is 10 gtt/mL. The nurse should adjust the manual IV infusion to deliver how many gtt/min? (Round the answer to the nearest whole number. Do not use a trailing zero.)

22 gtt/min

A nurse is caring for a client who has preeclampsia and is receiving magnesium sulfate IV continuous infusion. Which of the following findings should the nurse report to the provider?

24 mL/hr urinary output

A nurse is evaluating a group of clients at a health fair to identify the need for folic acid therapy. Which of the following clients require folic acid therapy? (Select all that apply.)

24‐year‐old female who has no health problems 55-year‐old female who has alcohol use disorder

A nurse is preparing to administer amoxicillin 20 mg/kg/day PO to divide equally every 12 hr to a preschooler who weighs 44 lb. The amount available is amoxicillin suspension 250 mg/5 mL. how many mL should the nurse administer per dose? (Round the answer to the nearest whole number. Do not use a trailing zero.)

4 ml

While doing hourly rounding, the nurse notices that the patient is diaphoretic, heart rate of 110 beats/minute, has some shakiness and is complaining of headache. The nurse checks the patient's blood sugar and it's 56 mg/dL. Which of the following can the nurse administer safely?

4 oz Orange Juice

C. Celecoxib doesn't cause GI adverse effects as frequently as aspirin and ibuprofen

A 67 year old patient with a history of gastric ulcer is to begin a regimen of celecoxib, a COX-2 inhibitor for osteoarthritis. She asks you " Why do I have to have a prescription for this? Can't I take something over the counter like aspirin or ibuprofen?" What will your best reply be? A. either aspirin or ibuprofen can be substituted if the patient prefers B. aspirin and ibuprofen don't relieve arthritis pain C. Celecoxib doesn't cause GI adverse effects as frequently as aspirin and ibuprofen D. Celecoxib is prescription strength aspirin

C. return for laboratory tests every 6 months

A 70 year old patient is prescribed aspirin for treatment of arthritis. Patient teaching should include: A. take aspirin on an empty stomach B. store aspirin in the bathroom medicine chest C. return for laboratory tests every 6 months D. crush the extended release tablets for easier swallowing

A nurse is caring for four clients who have peptic ulcer disease. The nurse should recognize misoprostol is contraindicated for which of the following clients?

A client who is pregnant

A nurse in a clinic is caring for a group of clients. The nurse should contact the provider about a potential contraindication to a medication for which of the following clients? (Select all that apply.)

A client who takes prednisone and has a possible fungal infection A client who has chronic liver disease and is taking hydrocodone A client who has a prosthetic heart valve, takes warfarin, and reports a suspected pregnancy

D. respiratory depression

A nurse in an emergency department is performing an admission assessment for a client who has aspirin toxicity. Which of the following findings should the nurse expect? A. Body temperature 35 degrees C (95 degrees F) B. Lung crackles C. Cool, dry skin D. Respiratory Depression

A. acetylcysteine

A nurse is admitting a toddler to the hospital after an acetaminophen overdose. Which of the following medications should the nurse anticipate administering to this client? A. acetylcysteine B Misoprostol C. Naltrexone D. Pefilgrastin

A. Dizziness D. Tinnitus E. Headache

A nurse is assessing a client who has salicylism. Which of the following findings should the nurse expect? Select all that apply: A. Dizziness B. Diarrhea C. Jaundice D. Tinnitus E. Headache

a

A nurse is caring for a client who receives a local anesthetic of lidocaine during the repair of a skin laceration. For which of the following adverse reactions should the nurse monitor the client? a. Seizures b. Tachycardia c. Hypertension d. Fever

a

A nurse is planning care for a client who is to receive tetracaine prior to a bronchoscopy. Which of the following actions should the nurse include in the plan of care? a. Keep the client NPO until pharyngeal response returns. b. Monitor the insertion site for a hematoma. c. Palpate the bladder for detect urinary retention. d. Maintain a client on bed rest for 12 hr following the procedure.

A. urinary retention

A nurse is preparing to administer an opioid agonist to a client who has acute pain. Which of the following complications should the nurse monitor? A. urinary retention B. tachypnea C. hypertension D. Irritating cough

c d e

A nurse is providing teaching to a client who has migraine headaches and a new prescription for ergotamine. For which of the following adverse effects should the nurse instruct the client to stop taking the medication and notify the provider? (Select all that apply.) a. Nausea b. Visual disturbances c. Positive home pregnancy test d. Numbness and tingling in fingers e. Muscle pain

b c d

A nurse is providing teaching to a client who is experiencing migraine headaches. Which of the following instructions should the nurse provide? (Select all that apply.) a. Take ergotamine as a prophylaxis to prevent a migraine headache. b. Identify and avoid trigger factors. c. Lie down in a dark quiet room at the onset of the migraine. d. Avoid foods that contain tyramine. e. Avoid exercise that can increase heart rate.

d

A nurse is reviewing a health history of a client who has migraine headaches and is to begin prophylaxis therapy with propanolol. Which of the following findings in the client history should the nurse report to the provider? a. The client had a prior myocardial infarction. b. The client takes warfarin for atrial fibrillation. c. The client takes an SSRI for depression. d. An ECG indicates a first-degree heart block.

B. Diazepam due to its CNS effects

A nurse is reviewing the medication administration record for a client who is receiving a transdermal fentanyl for severe pain. Which of the following medication should the nurse expect to cause an adverse effect when administered concurrently with fentanyl? A. Ampicillin B. Diazepam C. Furosemide D. Prednisone

A. Increases risk for MI

A nurse is teaching a client about a new prescription for celecoxib (celebrex). Which of the following information should the nurse include in the teaching? A. increases risk for MI B. Decreases risk for stroke C. Increases platelet aggregation

B. administer acetylcysteine

A patient is brought to the emergency room after having attempted suicide by swallowing half a bottle of acetaminophen. The nurse would expect to: A. draw blood work for platelet count B. administer acetylcysteine C. administer acetylsalicylic acid D. send the patient for an abdominal CT scan

A 12-month old child just received her first measles , mumps, and rubella (MMR) vaccine. For which of the following possible reactions to this vaccine should the nurse teach the parents to monitor? (Select all that apply) A. Rash B. Redness and discomfort at injection site C. Bruising on multiple areas of the body D. Fainting E. Inconsolable crying

A, B, C

A nurse is caring for a client who takes oral morphine and carbamazepine (Tegretol) for cancer pain. Which of the following effects may occur when both medications are administered to this client? (Select all that apply) A. Dosage of the opioid is reduced B. Adverse effects of the opioid are reduced C. Analgesic effects are increased D. CNS stimulation is enhanced E. Opioid tolerance is increased

A, B, C

A nurse is administering RV, DTaP, Hib, PCV, and IPV vaccinations to a 4-month old infant in an outpatient facility. Which of the following actions should the nurse plan to take? (Select All That Apply) A. Administer any oral vaccine before giving injectable vaccine B. Administer subcutaneous injections in the anterolateral thigh C. Administer IM injections in the deltoid muscle D. Administer infant pacifier during vaccine injections E. Teach parents to administer aspirin prior to the vaccination to prevent inflammation

A, B, E

2. A nurse is caring for a client who takes several antiretroviral medications, including the NRTI zidovudine, to treat HIV infection. The nurse should monitor for which of the following adverse effects of zidovudine? (Select all that apply.) A. Fatigue B. Blurred vision C. Ataxia D. Hyperventilation E. Vomiting

A. CORRECT: Fatigue is a manifestation of anemia, an adverse effect of zidovudine. Neutropenia can also occur, causing a high risk for infection. D. CORRECT: Hyperventilation is a finding that can occur if the client develops lactic acidosis, a serious adverse effect of zidovudine. E. CORRECT: Vomiting and other GI effects are adverse effects of zidovudine.

A nurse is planning care for a client who has brain cancer and experiences headache causedby cerebral edema. Which of the following adjuvant medications may be indicated for this client? A. Dexamethasone (Decadron) B. Methylphenidate (Ritalin) C. Hydroxyzine (Vistaril) D. Amitriptyline (Elavil)

A. Dexamethasone, a glucocorticoid, decreases inflammation and swelling. It is used to reduce cerebral edema and relieve pressure from the tumor

A nurse is teaching a client who is taking sucralfate PO for peptic ulcer disease has a new prescription for phenytoin to control seizures. Which of the following instructions should the nurse include?

Allow a 2‐hr interval between these medications.

A nurse is providing instructions to a client who has a new prescription for albuterol and beclomethasone inhalers for the control of asthma. Which of the following instructions should the nurse include in the teaching?

Administer the albuterol inhaler prior to using the beclomethasone inhaler.

6. A nurse in an acute care facility is reinforcing teaching with a client who has type 2 diabetes mellitus and is taking exenatide (Byetta) along with an oral antidiabetic agent. What should the nurse inform the client about this medication? A. Therapeutic Use B. Adverse Effects (2) C. Nursing Interventions: Describe two laboratory tests the nurse should monitor. D. Client Teaching

A. Therapeutic Use ● Exenatide is prescribed along with an oral antidiabetic medication, such as metformin or a sulfonylurea medication, for clients who have type 2 diabetes mellitus to improve diabetes control. Exenatide improves insulin secretion by the pancreas, decreases secretion of glucagon, and slows gastric emptying. B. Adverse Effects ● GI effects, such as nausea and vomiting ● Pancreatitis manifested by acute abdominal pain and possibly severe vomiting ● Hypoglycemia, especially when taken concurrently with a sulfonylurea medication, such as glipizide C. Nursing Interventions ● The nurse should monitor daily blood glucose testing by the client, periodic HbA1c tests, and periodic kidney function testing. Exenatide should be used cautiously in clients who have any renal impairment. D. Client Teaching ● Instruct the client how to inject exenatide subcutaneously. ● Instruct the client to take exenatide within 60 min before the morning and evening meal but not following the meal. ● Advise the client to withhold exenatide and notify the provider for severe abdominal pain. ● Instruct the client how to recognize and treat hypoglycemia. ● Instruct the client that exenatide should not be given within 1 hr of oral antibiotics, acetaminophen, or an oral contraceptive due to its ability to slow gastric emptying.

A nurse is preparing to administer an opioid agonist to a client who has acute pain. Which of the following complications should the nurse monitor? A.Urinary retention B.Tachypnea C. hypertension D.Irritating cough

A.Urinary retention

A nurse is completing a nursing history for a client who takes simvastatin. The nurse should identify which of the following disorders as a contraindication to adding ezetimibe to the client's medications?

Active hepatitis C

A nurse is providing instruction to a client who has a new prescription for calcitonin-salmon for postmenopausal osteoporosis. Which of the following instructions should the nurse include in the teaching?

Alternate nostrils each time calcitonin-salmon is inhaled.

A nurse is teaching a school‐age child and his parents about a new prescription for lisdexamfetamine. Which of the following information should the nurse include in the teaching? (Select all that apply.)

An adverse effect of this medication is CNS stimulation Monitor blood pressure while taking this medication This medication raises the levels of dopamine in the brain

A nurse is caring for a client who is taking oral oxycodone The client states he is also taking ibuprofen in three recommended doses daily. The nurse should identify that an interaction between these two medications will cause which of the following findings?

An increase in the expected therapeutic effect of both medications

5. A charge nurse is teaching a group of nurses about the importance of prophylactic antimicrobial therapy. Which of the following information should the charge nurse include in teaching? (select all that apply) a. Administer prophylactic antimicrobial therapy to the client who suspects exposure to a sexually transmitted infection. b. Administer prophylactic antimicrobial therapy to the client who is having orthopedic surgery. c. Instruct a client about the need for prophylactic antimicrobial therapy before dental work if he has a prosthetic heart valve. d. Consult the provider for prophylactic antimicrobial therapy if the client has recurrent urinary tract infections. e. Instruct a client to obtain prophylactic antimicrobial therapy immediately when he has an upper respiratory infection.

Answer is A (A client who suspects exposure to sexually transmitted infection should be treated with prophylactic antimicrobial therapy to prevent an infection) B (A client who is having orthopedic surgery should be treated with prophylactic antimicrobial therapy to prevent an infection) C (A client who is having dental work and has a prosthetic heart valve should receive prophylactic antimicrobial therapy to prevent an infection) D (A client who has recurrent urinary tract infections should be treated with prophylactic antimicrobial therapy to prevent an infection)

3. A nurse is providing teaching to a client who has a new prescription for nitrofurantoin. Which of the following information should the nurse include in the teaching? (select all that apply) a. Observe for bruising on the skin b. Take the medication with milk or meals c. Expect brownish discoloration of urine d. Crush the medication if difficult to swallow e. Expect headaches and drowsiness

Answer is A (Bruising may indicate a blood dyscrasia, and the client should notify the provider if this occurs) B (Taking the medication with milk or meals will decrease GI discomfort related to nausea, vomiting, anorexia, and diarrhea) C (A brownish discoloration of urine is a common adverse effect when taking nitrofurantoin)

1. A nurse is reviewing a client's medication history and notes an allergy to sulfonamides. Which of the following medications are contraindicated due to this allergy? (select all that apply) a. Hydrochlorothiazide b. Metorprolol c. Acetaminophen d. Tolbutamide e. Furosemide

Answer is A (Hydrochlorothiazide is contraindicated with sulfonamides, which can lead to hypersensitivity, including Stevens-Johnson syndrome) D (Tolbutamide is a sulfonamide-type hypoglycemic medication and is contraindicated with sulfonamides, which can lead to hypersensitivity including Steven-Johnson syndrome) E (Furosemide is a sulfonamide-type diuretic medication and is contraindicated with sulfonamides, which can lead to hypersensitivity including Steven-Johnson syndrome)

4. A nurse is teaching about ciprofloxacin to a female client who has a severe urinary tract infection. Which of the following information about adverse reactions should the nurse include in the teaching? (Select all that apply) a. Observe for pain and swelling of the Achilles tendon b. Monitor for a vaginal yeast infection c. Check for excessive nighttime perspiration d. Inspect the mouth for cottage cheese-like lesions e. Take medication with a dairy product

Answer is A (Pain and swelling of the Achilles tendon indicate an adverse effect of ciprofloxacin and should be reported to the provider) B (A vaginal yeast infection is an overgrowth of Candida albicans, which commonly occurs when taking ciprofloxacin) D (Cottage-cheese like lesions in the mouth indicates an overgrowth of Candida albicans, a common adverse effect when taking ciprofloxacin)

4. A nurse is caring for a client who has subacute bacterial endocarditis and is being treated with several antibiotics, including IM streptomycin. For which of the following adverse effects of streptomycin should the nurse monitor for this client? a. Extremity paresthesias b. Urinary retention c. Severe constipation d. Complex partial seizures

Answer is A (Paresthesias of the hands and feet may occur in clients taking streptomycin. Stretomycin has many other severe adverse effects, and is usually used to treat infections either in combination with other antibiotics or to treat severe infections where other antibiotics failed)

5. A nurse is caring for a client who is being prepared for extensive colorectal surgery. Which of the following oral antibiotics should the nurse expect to be prescribed for this client in order to suppress normal flora in the GI tract? a. Amikacin b. Gentamicin c. Neomycin d. Erythromycin

Answer is C (Neomycin, an aminoglycoside antibiotic, is administered orally prior to GI surgery in order to rid the bowel of normal flora)

3. A charge nurse is preparing information for the unit nurses on the effectiveness of antimicrobial therapy for clients who have bacterial infections. Which of the following client conditions should the charge nurse include in the information? (select all that apply) a. A client who has meningitis b. A client who has a pacemaker c. A client who has endocarditis d. A client who has pneumonia e. A client who has pyelonephritis

Answer is A (The client who has meningitis may have difficulty responding to antimicrobial therapy because of the blood-brain barrier) B (The client who has a pacemaker may have difficulty responding to antimicrobial therapy because of colonization of micro-organisms around the pacemaker and the inability of phagocytic cells to destroy the micro-organisms) C (The client who has endocarditis may have difficulty responding to antimicrobial therapy because the antibiotic may be unable to penetrate the vegetative thrombus that develops on the injured endocardium)

4. A nurse is caring for a group of clients who are receiving antimicrobial therapy. Which of the following clients should the nurse plan to monitor for manifestations of antibiotic toxicity? a. Adolescent client who has a sinus infection b. Older adult client who has prostatitis c. New mother who has mastitis d. Middle adult client who has a urinary tract infection

Answer is B (An older adult client who has prostatitis and is receiving antibiotics is at risk for toxicity because of the age-related reduction in drug metabolism and excretion)

5. A nurse is planning to administer ciprofloxacin IV to a client who has cystitis. Which of the following is an appropriate action by the nurse? a. Administer a concentrated solution b. Infuse medication over 60 minutes c. Piggyback the solution onto existing IV medication tubing d. Choose a small peripheral vein for administration

Answer is B (Ciprofloxacin should be administered IV over 60 minutes to minimize irritation of the vein)

1. A nurse is providing teaching to a client prescribed tetracycline to treat a GI infection caused by Helicobacter pylori. Which of the following statements by the client indicates understanding of the teaching? a. "I will take this medication with a full glass of milk." b. "I will let my doctor know if I start having diarrhea." c. "I can stop taking this medication when I feel completely well." d. "I can take this medication just before bedtime."

Answer is B (Diarrhea can indicate that the client is developing a suprainfection, which can be very serious and needs to notify the provider right away)

3. A nurse is caring for a client who is starting a course of gentamicin IV for a serious respiratory infection. For which of the following adverse effects should the nurse monitor? (select all that apply) a. Drowsiness b. Hematuria c. Muscle weakness d. Difficulty swallowing e. Vertigo

Answer is B (Hematuria is an indication of acute kidney toxicity by gentamicin) C (Muscle weakness and respiratory depress may occur in clients taking gentamicin as a result of neuromuscular blockade) E (Vertigo, ataxia, and hearing loss are signs of otoxicity that can occur in clients taking gentamicin)

5. A nurse is teaching a client who has active tuberculosis about his treatment regimen. The client asks why he must take four different medications. Which of the following replies by the nurse is appropriate? "Taking multiple antituberculosis medications a. decreases the chance for a severe allergic reaction to any of the medications." b. reduces the chance that the TB bacteria will become resistant to the medications." c. minimizes the chance of adverse effects caused by any of the medications." d. lessens the chance that you will have a positive tuberculin test indefinitely."

Answer is B (If the client took only one medication to treat active tuberculosis, resistance to the medication would occur quickly. Taking three or four different medications decreases the possibility of resistance)

1. A nurse is caring for a client who has diabetes mellitus and pulmonary tuberculosis and has a new prescription for isoniazid (INH). Which of the following supplements should the nurse expect to administer to prevent an adverse effect of INH? a. Ascorbic acid b. Pyridoxine c. Folic acid d. Cyanocobalamin

Answer is B (Pyridoxine (vitamin B6) is frequently prescribed along with INH to prevent peripheral neuropathy for clients who have increased risk factors such as diabetes mellitus or alcohol use disorder)

2. A nurse is administering gentamicin by IV infusion at 09:00. The gentamicin will take 1 hour to infuse. When should the nurse plan for a peak serum level of gentamicin to be drawn? a. 10:00 b. 10:30 c. 11:00 d. 11:30

Answer is B (The peak serum level should be drawn at 10:30, 30 minutes after the IV infusion is complete. The trough level should be drawn just before the infusion is started.)

1. A nurse is implementing a plan of care for a client who has an infected wound of the arm. Which of the following actions should the nurse perform first? a. Administer antibiotic medication b. Obtain a culture of the wound c. Review WBC laboratory findings d. Apply a dressing to the wound

Answer is B (When using the urgent vs. nonurgent approach to care, the nurse's priority action is to obtain a culture of the wound before initiating antibiotic therapy.)

2. A nurse is reviewing a client's laboratory findings to identify the antibiotic that may be prescribed by the provider to treat the client's urinary tract infection. Which of the following tests of the client's urine would provide this information? a. Gram stain b. Culture c. Sensitivity d. Specific gravity

Answer is C (A sensitivity test identifies the most effective antibiotic to be used to treat a specific micro-organism)

4. A nurse is teaching a client who is beginning a course of metronidazole to treat an infection. For which of the following adverse effects should the nurse teach the client to stop taking metronidazole and notify the provider? a. Metallic taste b. Nausea c. Ataxia d. Dark-colored urine

Answer is C (Ataxia, tremors, paresthesias of the extremities, and seizures are manifestations of CNS toxicity. The client should stop taking the medication and notify the provider if any of these effects occur)

3. A nurse is administering IV amphotericin B to a client who has a systemic fungal infection. The nurse should monitor which of the following laboratory values? (select all that apply) a. Blood glucose b. Serum amylase c. Serum potassium d. Hematocrit e. Serum creatinine

Answer is C (Hypokalemia is a serious adverse effect of amphotericin B. The nurse should monitor serum potassium values for hypokalemia) D (Amphotericin B can cause bone marrow suppression. Hematocrit and platelet count should be monitored periodically. E (Amphotericin B can cause nephrotoxicity. Kidney function (with sodium creatinine, BUN, creatinine clearance) should be monitored)

2. A nurse is planning discharge teaching for a female client who has a new prescription for sulfamethoxazole-trimethoprim. Which of the following information should the nurse include in the teaching? a. May take if pregnant b. Drink 1 liter of water each day c. Take the medication on an empty stomach d. Discontinue medication when symptoms subside

Answer is C (The nurse should instruct the client to take the sulfamethoxazole-trimethoprim on an empty stomach with a full glass of water for maximum absorption of the medication)

A nurse assessing a client's IV catheter insertion site notes a hematoma. Which of the following actions should the nurse take? (Select all that apply.)

Apply warm compress to the insertion site Elevate the client's arm

A nurse is preparing to administer eye drops to a patient. Which of the following actions should the nurse take (SATA)?

Ask the patient to look at the ceiling Drop the medication into the center of the patient's conjunctival sac Instruct the patient to close her eye gently after instillation

A nurse is assessing a client who has chronic neutropenia and who has been receiving filgrastim. Which of the following actions should the nurse take to assess for an adverse effect of filgrastim?

Assess for bone pain

A nursing is planning care for a client who is receiving furosemide IV for peripheral edema. Which of the following interventions should the nurse include in the plan of care? (Select all that apply.)

Assess for tinnitus. Monitor serum potassium levels. Elevate the head of bed slowly before ambulation. Recommend eating a banana daily.

A nurse is preparing to administer propranolol to a client who has a dysrhythmia. Which of the following actions should the nurse plan to take?

Assist the client when she sits up or stands after taking this medication.

A nurse is reviewing the health record of a client who asks about using propranolol to treat hypertension. The nurse should recognize which of the following conditions is a contraindication for taking propranolol?

Asthma

A nurse manager is reviewing the facility's policies for IV therapy with the members of his team. The nurse manager should remind the team that which of the following techniques helps minimize the risk of catheter embolism?

Avoiding reinserting the needle into an IV catheter

2. A nurse is reinforcing teaching with a client who has type 2 diabetes mellitus and is starting repaglinide (Prandin). Which of the following statements made by the client indicates understanding of the administration of this medication? A. "I'll take this medicine with my meals." B. "I'll take this medicine 30 minutes before I eat." C. "I'll take this medicine just before I go to bed." D. "I'll take this medicine as soon as I wake up in the morning."

B Repaglinide causes a rapid, short-lived release of insulin. The client should take this medication within 30 min before each meal so that insulin is available when food is digested.

A nurse is caring for a client who has cancer and is taking a glucocorticoid as an adjuvant for pain control. The nurse should plan to perform which of the following interventions? (Select all that apply) A. Monitor for urinary retention B. Monitor serum glucose C. Monitor serum potassium level D. Monitor for gastric bleeding E. Monitor for respiratory depression

B, C, D B. Monitoring serum glucose, especially in clients who have DM, is important because glucocorticoids raise the glucose level C. May cause hypokalemia D. Irritate the gastric mucosa and put the client at risk for a peptic ulcer

A nurse is caring for several clients who came to the clinic for a seasonal influenza vaccination. Which of the following clients could receive the vaccine via nasal spray rather than injection? A. A 1-year old with no health problems B. A 17-year old who has a hypersensitivity to penicillin C. A 25-year old who is pregnant D. A 52-year old who takes a multivitamin supplement

B. A 17-year old who has a hypersensitivity to penicillin

4. A nurse is caring for a client who has a new prescription for enfuvirtide to treat HIV infection. The nurse should monitor the client for which of the adverse reactions of this medication? (Select all that apply.) A. Bleeding B. Pneumonia C. Cerebral edema D. Localized erythema E. Hypotension

B. CORRECT: Bacterial pneumonia with fever, cough, and difficulty breathing are manifestations of an adverse reaction to enfuvirtide. The nurse should assess breath sounds regularly. D. CORRECT: Enfuvirtide is administered subcutaneously. Injection‑site reactions, such as pain, redness, itching, and bruising, are common. E. CORRECT: A systemic allergic reaction can occur when taking enfuvirtide. Manifestations of hypersensitivity include rash, hypotension, fever, and chills.

2. A nurse in an outpatient facility is preparing to administer nafcillin (Unipen) IM to an adult client who has an infection. Which of the following actions should the nurse plan to take? (Select all that apply.) A. Select a 25-gauge, ½-inch needle for the injection. B. Administer the medication deeply into the ventrogluteal muscle. C. Ask the client about allergy to penicillin before administering the medication. D. Monitor the client for 30 min following the injection. E. Tell the client to expect a temporary rash to occur following the injection.

B. CORRECT: It is important to administer nafcillin IM into a deep muscle mass, such as the ventrogluteal site. C. CORRECT: It is important to ask the client about allergy to penicillin or other antibiotics before administering nafcillin. In general, a documented allergy to another penicillin or to a cephalosporin is a contraindication for administering nafcillin. D. CORRECT: When administering a parenteral penicillin or other antibiotic, it is important to monitor the client for 30 min for an allergic reaction.

A nurse is reviewing the medication administration record for a client who is receiving transdermal fentanyl for severe pain. Which of the following medications should the nurse expect to cause an adverse effect when administered concurrently with fentanyl? A.Ampicillin B.Diazepam C.Furosemide D.Prednisone

B.Diazepam

A nurse is preparing to administer pamidronate (Aredia) to a client who has bone pain caused by cancer. Which of the following precautions should the nurse take when administering pamidronate? A. Inspect skin for redness and irritation when changing the client's intradermal patch B. Assess IV site for thrombophlebitis frequently during administration C. Instruct the client to sit upright or stand for 30 minutes following oral administration D. Watch for manifestations of analphylaxis for 20 minutes after IM administration

B. This medication is irritating to veins

1. A nurse is caring for a client in an acute care setting who was admitted with a cerebral spinal fluid (CSF) infection caused by a highly gram-negative bacteria. Which of the following cephalosporin IV antibiotics should the nurse expect to be effective in treating this infection? A. Cefaclor (Ceclor) B. Cefazolin (Ancef) C. Cefepime (Maxipime) D. Cephalexin (Keflex)

C. CORRECT Rationale: Cefepime, a fourth-generation cephalosporin, is more likely to be effective against this infection than the other medications, which are from the first or second generation. Medications from each progressive generation of cephalosporin are more effective against gram-negative bacteria, more resistant to being destroyed by beta-lactamase, and more able to penetrate the CSF.

3. A nurse is preparing to administer cefotaxime (Claforan) IV to a client who has a severe infection and has been receiving cefotaxime for the past week. Which of the following findings indicates a potentially serious adverse reaction to this medication and should be reported to the provider? A. Diaphoresis B. Epistaxis C. Diarrhea D. Alopecia

C. CORRECT: Diarrhea is caused by cefotaxime and other cephalosporins and should be reported to the provider. Severe diarrhea may indicate the client has developed antibiotic-associated pseudomembranous colitis, which could be life-threatening.

4. A nurse is taking a medication history for a hospitalized client who is to receive imipenem-cilastatin IV to treat an infection. Which of the following medications taken by the client places the client at risk for medication interaction? A. Regular insulin (Humulin R) B. Furosemide (Lasix) C. Valproic acid (Depakote) D. Ferrous sulfate (Feosol)

C. CORRECT: Imipenem-cilastatin decreases blood levels of valproic acid, an anti seizure medication, putting the client at risk for increased seizure activity. Combination of these two medications should be avoided. If they must be taken concurrently, the nurse should monitor the client for seizures.

1. A nurse is teaching a client who has a new prescription for combination oral NRTIs (abacavir, lamivudine, and zidovudine) for treatment of HIV. Which of the following statements should the nurse include? A. "These medications work by blocking HIV entry into cells." B. "These medications work by weakening the cell wall of the HIV virus." C. "These medications work by inhibiting enzymes to prevent HIV replication." D. "These medications work by preventing protein synthesis within the HIV cell."

C. CORRECT: The NRTI antiretroviral medications this client takes work by inhibiting the enzyme reverse transcriptase and preventing HIV replication.

5. A nurse is administering IV acyclovir to a client who has varicella. Which of the following actions should the nurse take? A. Administer a stool softener. B. Decrease fluid intake following infusion. C. Infuse acyclovir over 1 hr. D. Monitor for a for hypotension

C. CORRECT: The nurse should administer IV acyclovir slowly, over at least 1 hr, to prevent nephrotoxicity.

6. A nurse is teaching a client who is beginning highly active antiretroviral therapy (HAART) for HIV infection about ways to prevent medication resistance. Which of the following information should the nurse teach the client about resistance? A. Taking low dosages of antiretroviral medication minimizes resistance. B. Taking one antiretroviral medication at a time minimizes resistance. C. Taking medication at the same times daily without missing doses minimizes resistance. D. Changing the medication regimen when adverse effects occur minimizes resistance.

C. CORRECT: The nurse should emphasize the importance of taking each dose of medication exactly as prescribed. Missing even a few doses of antiretroviral medication can promote medication resistance, which can cause treatment failure.

A nurse is caring for a client who has end‑stage cancer and is receiving morphine. The client's daughter asks why the provider prescribed methylnaltrexone. Which of the following responses should the nurse make? A."The medication will increase your mother's respirations." B."The medication will prevent dependence on the morphine." C."The medication will relieve your mother's constipation." D."The medication works with the morphine to increase pain relief."

C."The medication will relieve your mother's constipation."

A nurse is planning to administer morphine IV to a client who is postoperative. Which of the following actions should the nurse take? A. monitor for seizures and confusion with repeated doses. B.Protect the client's skin from the severe diarrhea that occurs with morphine. C.Withhold this medication if respiratory rate is less than 12/min. D.Give morphine intermittent via IV bolus over 30 seconds or less.

C.Withhold this medication if respiratory rate is less than 12/min.

A nurse is caring for a client who is taking for somatropin to stimulate growth. The nurse should plan to monitor the client's urine for which of the following?

Calcium

A nurse is caring for a young adult client whose serum calcium us 8.8 mg/dL. Which of the following medications should the nurse anticipate administering to the client?

Calcium carbonate.

A nurse is caring for a client who received IV verapamil to treat supraventricular tachycardia (SVT). The client's pulse rate is now 98/min and his blood pressure is 74/44 mg hg. The nurse should anticipate a prescription for which of the following IV medications?

Calcium gluconate

A nurse is reviewing a client's health record and notes that the client experiences permanent extrapyramidal effects caused by a previous medication. The nurse should recognize that the medication affected which of the following systems in the client?

Central nervous

A nurse is providing teaching to a client who has a new prescription for amitriptyline for treatment of depression. Which of the following should the nurse include in the teaching? (Select all that apply.)

Change positions slowly to minimize dizziness Chew sugarless gum to prevent dry mouth

A nurse is teaching a client who has schizophrenia strategies to cope with anticholinergic effects of fluphenazine. Which of the following should the nurse suggest to the client to minimize anticholinergic effects?

Chew sugarless gum to moisten the mouth

A nurse is assessing a client who takes lithium carbonate for the treatment of bipolar disorder. The nurse should recognize which of the following findings as a possible indication of toxicity to this medication?

Coarse tremors

A nurse is monitoring a client who takes aspirin 81 mg PO daily. The nurse should identify which of the following manifestations as adverse effects of daily aspirin therapy? (Select all that apply.)

Coffee‐ground emesis Tinnitus Nausea

A nurse is caring for a client who takes paroxetine to treat posttraumatic stress disorder and reports that he grinds his teeth during the night. The nurse should identify which of the following interventions to manage bruxism? (Select all that apply.)

Concurrent administration of buspirone Use of a mouth guard Changing to a different class of antidepressant medication

A nurse is teaching a client who has a new prescription for digoxin to treat heart failure. Which of the following instructions should the nurse include in the teaching?

Contact provider if heart rate is less than 60/min.

A nurse is caring for a client who has depression and a new prescription for venlafaxine. For which of the following adverse effects should the nurse monitor this client? (Select all that apply)

Cough Dizziness Decreased libido

5. A nurse in an outpatient facility is caring for a client who has been taking acarbose (Precose) for type 2 diabetes mellitus. Which of the following laboratory tests should the nurse plan to monitor? A. WBC B. Serum potassium C. Platelet count D. Liver function tests

D Acarbose can cause liver toxicity when taken long-term. Liver function tests should be monitored periodically while the client takes this medication.

4. A nurse is reinforcing teaching with a client who has a prescription for pramlintide (Symlin) for type 1 diabetes mellitus. Which of the following should the nurse reinforce in the teaching? (Select all that apply.) A. "Take oral medications 1 hr before injection." B. "Use upper arms as preferred injection sites." C. "Mix pramlintide with breakfast dose of insulin." D. "Inject pramlintide just before a meal." E. "Discard open vials after 28 days."

D, E -Pramlintide delays oral medication absorption, so oral medications should be taken 1 to 2 hr after pramlintide injection. -Pramlintide can cause hypoglycemia, especially when the client also takes insulin, so it is important to eat a meal after injecting this medication. -Unused medication in the open pramlintide vial should be discarded after 28 days.

A nurse is caring for a group of clients who are not protected against varicella. Which of the following clients should receive a varicella vaccination at this time? A. A 24-year old woman in the third trimester of pregnancy B. A 3-year old child who has Wilms' tumor and is receiving chemotherapy C. A 2-month old infant who has no health problems D. A 32-year old man who has essential hypertension

D. A 32-year old man who has essential hypertension

3. A nurse is caring for a client who is taking ritonavir, a protease inhibitor, to treat HIV infection. The nurse should monitor for which of the following adverse effects of this medication? A. Increased TSH level B. Decreased ALT level C. Hypoglycemia D. Hyperlipidemia

D. CORRECT: Hyperlipidemia with increased cholesterol and triglyceride levels can occur as an adverse effect of ritonavir.

A nurse is administering amitiptyline (Elavil) to a client who has pain caused by a malignant tumor. Which of the following is an adverse effect of amitriptyline that should be monitored by the nurse? A. Decreased appetite B. Explosive diarrhea C. Decreased pulse rate D. Orthostatic hypotension

D. Instruct the client to move slowly from lying down to sitting after taking this medication.

A nurse is caring for a client who has a prescription for bethanechol to treat urinary retention. The nurse should recognize that which of the following findings is a manifestation of muscarinic stimulation?

Excessive perspiration

A nurse is teaching a group of parents about immunizations. Which of the following vaccines should the nurse tall the parents is administered to children younger than 1 year of age and not to older children or adults? A. Pneumococcal vaccine B. Meningococcal vaccine C. Varicella vaccine D. Rotavirus vaccine

D. Rotavirus vaccine

A nurse is preparing to initiate IV therapy for an older adult client. Which of the following actions should the nurse plan to take?

Distend the veins by using a blood pressure cuff

A nurse is preparing to administer butorphanol to a client who has a history of substance use disorder. The nurse should identify which of the following information as true regarding butorphanol? A.Butorphanol has a greater risk for abuse than morphine. B.Butorphanol causes a higher incidence of respiratory depression than morphine. C.Butorphanol cannot be reversed with an opioid antagonist. D.Butorphanol can cause abstinence syndrome in opioid‑dependent clients

D.Butorphanol can cause abstinence syndrome in opioid‑dependent clients

A nurse in the operating room is caring for a client who received a dose of succinylcholine. During the operation, the client suddenly develops rigidity, and his body temperature begins to rise. The nurse should anticipate a prescription for which of the following medications?

Dantrolene

A nurse is providing teaching for a client who is withdrawing from alcohol and has a new prescription for propranolol. Which of the following information should the nurse to include in the teaching?

Decreases cravings

A nurse is providing teaching to a female client who is taking testosterone to treat advanced breast cancer. The nurse should tell the client that which of the following are adverse effects of this medication? (Select all that apply.)

Deepening voice Weight gain Facial hair

A nurse in an acute care facility is caring for a client who is receiving IV nitroprusside for hypertensive crisis. The nurse should monitor the client for which of the following adverse reactions to this medication?

Delirium

a nurse is collecting data from a client who has been receiving cefotaxime IV for the past week. which of the following findings indicates a potentially serious adverse reaction to the medication that the nurse should report to the provider

Diarrhea

A nurse is taking a medication history from a client who has angina and is to begin taking ranolazine. The nurse should report which of the following medications in the client's history that can interact with ranolazine? (Select all that apply.)

Digoxin Simvastatin Verapamil

A nurse is caring for a client who received prochlorperazine 4 hr ago. The client reports spasms of his face. The nurse should anticipate a prescription for which of the following medications?

Diphenhydramine

A nurse is preparing to administer filgrastim for the first time to a client who has just undergone a bone marrow transplant. Which of the following interventions is appropriate?

Discard vial after removing one dose of the medication.

A nurse is preparing to perform a follow‐up assessment on a client who takes chlorpromazine for the treatment of schizophrenia. The nurse should expect to find the greatest improvement in which of the following manifestations? (Select all that apply.)

Disorganized speech Bizarre behavior Hallucinations

A nurse is providing teaching to a client who has a new prescription for clonidine to assist with maintenance of abstinence from opioids. The nurse should instruct the client to monitor for which of the following adverse effects?

Dry mouth

A nurse is teaching a client who has a new prescription for diphenhydramine for allergic rhinitis. The nurse should instruct the client to monitor for which of the following adverse reactions of this medication? (Select all that apply.)

Dry mouth Drowsiness Urinary hesitation

A nurse is caring for a client who has a new diagnosis of fibromyalgia. Which of the following medications should the nurse anticipate being prescribed for this client?

Duloxetine

A nurse is caring for a client who has increased intracranial pressure and is receiving mannitol. Which of the following findings should the nurse report to the provider?

Dyspnea

A nurse is assessing a client's IV infusion site. Which of the following findings should the nurse identify as an indication of phlebitis? (Select all that apply.)

Erythema Pain

6. A nurse in an outpatient facility is teaching a client about the oral erythromycin she is starting every 6 hours to treat pneumonia. What should the nurse teach the client about this medication? a. Therapeutic use: Describe the therapeutic use for erythromycin in this client.

Erythromycin inhibits protein synthesis in the cells of susceptible micro-organisms, usually gram-positive bacteria. Erythromycin can be either bacteriostatic or bactericidal, depending on the organism and on the medication dosage. It is sometimes used to treat infections in clients who are allergic to penicillin.

A nurse is preparing to administer a medication to a client who has absence seizures. The nurse should anticipate administering which of the following medications to the client? (Select all that apply.)

Ethosuximide Valproic acid Lamotrigine

A nurse is providing teaching to a client who has a new prescription for digoxin. The nurse should instruct the client to monitor and report which of the following adverse effects that is a manifestation digoxin toxicity? (Select all that apply.)

Fatigue Anorexia Diplopia

A nurse is caring for a client who has been taking sertraline for the past 2 days. Which of the following assessment findings should alert the nurse to the possibility that the client is developing serotonin syndrome?

Fever

A nurse is caring for a client who is receiving moderate sedation with diazepam IV. The client is oversedated. Which of the following medications should the nurse anticipate administering to this client?

Flumazenil

A nurse is reviewing a new prescription for ondansetron 4 mg PO PRN for nausea and vomiting for a patient who has hyperemesis gravidarum. The nurse should clarify which of the following parts of the prescription with the provider?

Frequency

A nurse is caring for a hospitalized client who has an activated partial thromboplastin time (aPTT) greater than 1.5 times the expected reference range. Which of the following blood products should the nurse prepare to transfuse?

Fresh frozen plasma

A nurse is teaching a client who has a new prescription for ramelteon. The nurse should instruct the client to avoid which of the following foods while taking this medication?

Fried chicken

A nurse is assessing a client during transfusion of a unit of whole blood. The client develops a cough, shortness of breath, elevated blood pressure, and distended neck veins. The nurse should anticipate a prescription for which of the following medications?

Furosemide

Which of the following insulin could not be mixed with other insulin?

Glargine

A nurse is reviewing the health care record of a client who reports urinary incontinence and asks about a prescription for oxybutynin. The nurse should recognize that oxybutynin is contraindicated in the presence of which of the following conditions?

Glaucoma

A nurse is providing information to a client who has early Parkinson's disease and a new prescription for pramipexole. The nurse should instruct the client to monitor for which of the following adverse effects of this medication?

Hallucinations

A nurse is assessing a client who takes desmopressin for diabetes insipidus. For which of the following adverse effects should the nurse monitor?

Headache

A nurse is planning to administer ondansetron IV for an older adult client who has a history of diabetes mellitus and cardiac myopathy and is receiving chemotherapy for cancer. For which of the following adverse effects of ondansetron should the nurse monitor? (Select all that apply.)

Headache Diarrhea Prolonged QT interval

A nurse is planning to administer IV alteplase to a client who is demonstrating manifestations of a massive pulmonary embolism. Which of the following interventions should the nurse plan to take?

Hold direct pressure on puncture sites for up to 30 min.

A nurse is providing teaching to a client who is taking raloxifene to prevent postmenopausal osteoporosis. The nurse should advise the client that which of the following are adverse effects of this medication?

Hot flashes. Swelling or redness in calf. Shortness of breath.

During emergency situation, which type of insulin can be given intravenously?

Humulin R

A nurse is planning to administer a first dose of captopril to a client who has hypertension. Which of the following medications can intensify first dose hypotension? (Select all that apply.)

Hydrochlorothiazide Clonidine Aliskiren

A nurse is caring for a client who has a new prescription for niacin to reduce cholesterol. The nurse should monitor for which of the following findings as an adverse effect of niacin? (Select all that apply.)

Hyperglycemia Flushing of the skin Jaundice

A nurse is monitoring a client who is receiving epoetin alfa for adverse effects. The nurse should identify which of the following findings as an adverse effect of this medication? (Select all that apply)

Hypertension Headache

A nurse is planning caring for a client who is has a new prescription for torsemide. The nurse should plan to monitor for which of the following adverse reactions of this medications? (Select all that apply.)

Hypokalemia Hypotension Ototoxicity Ventricular dysrhythmias

A nurse is providing teaching to a client who will start alfuzosin for treatment of benign prostatic hyperplasia. The nurse should instruct the client that which of the following is an adverse effect of this medication?

Hypotension

a nurse is reinforcing teaching with a client about taking tetracycline to treat a GI infection due to helicobacter pylori. which of the following statement indicate understanding

I will let my doctor know if I have started. having diarrhea

A nurse working in an emergency department is caring for a client who has benzodiazepine toxicity due to an overdose. Which of the following actions is the nurse's priority?

Identify the client's level of orientation

5. A nurse is preparing to administer ceftriaxone (Rocephin) 0.5 g IM to a client in a long-term care facility. Available is ceftriaxone diluted to 350 mg/mL. How many mL should the nurse administer? (Round the answer to the nearest tenth.)

If there is 350 mg/mL and the prescribed amount is 0.5 g (500 mg), it makes sense to give 1.4 mL. The nurse should administer ceftriaxone injection 1.4 mL IM.

C. cough suppressant

In addition to pain relief, codeine is also frequently used as? A. decongestant B. laxative C. cough suppressant D. sedative

A nurse in a provider's of office is reviewing the medical record of a client who is pregnant and is at her first prenatal visit. Which of the following immunizations may the nurse administer safely to this client?

Inactivated influenza vaccine

A nurse is providing instructions to a client who has been experiencing insomnia and has a new prescription for temazepam. The nurse should inform the client that which of the following manifestations are adverse effects of temazepam? (Select all that apply.)

Incoordination Sleep driving Amnesia

A nurse is teaching a client who has a new prescription for verapamil to control hypertension. Which of the following instructions should the nurse include?

Increase the amount of dietary fiber in the diet.

A nurse is administering a dopamine infusion at a low dose to a client who has severe heart failure. Which of the following findings is an expected effect of this medication?

Increased myocardial contractility

A nurse is preparing to administer medications to a 4‐month‐old infant. Which of the following pharmacokinetic principles should the nurse consider when administering medications to this client? (Select all that apply.)

Infants have immature liver function Infants blood-brain barrier is poorly developed Infants have an increased ability to absorb topical medications

A nurse is preparing to administer potassium chloride IV to a client who has hypokalemia. Which of the following actions should the nurse take? (Select all that apply.)

Infuse medication through a large‐bore needle. Implement cardiac monitoring. Administer the infusion using an IV pump.

A nurse is planning to administer subcutaneous enoxaparin 40 mg using a prefilled syringe of enoxaparin 40 mg/0.4 mL to an adult client following hip arthroplasty. Which of the following actions should the nurse plan to take?

Insert the needle completely into the client's tissue.

A client who has a urinary tract infection is to receive phenazopyridine. What therapeutic uses and nursing considerations should the nurse review? c. Nursing interventions/client education: Include three teaching points.

Instruct client that urine will turn orange/red in color. Urine may stain clothing. Take the medication with or after meals to prevent mild GI discomfort. Frequently prescribed in addition to an antibiotic.

A nurse is caring for a client who has angina and asks about obtaining a prescription for sildenafil to treat erectile dysfunction. Which of the following medications is contraindicated with sildenafil?

Isosorbide

A nurse is collecting data from a client who is taking gemfibrozil. Which of the following assessment findings should the nurse identify as an adverse reaction to the medication?

Jaundice

A nurse is caring for a client who has increased liver enzymes and is taking herbal supplements. Which of the following herbal supplements should the nurse report to the provider?

Kava

A nurse is caring for a client who has a new prescription for lithium carbonate. When teaching the client about ways to prevent lithium toxicity, the nurse should advise the client to do which of the following?

Limit aerobic activity in hot weather

A nurse is caring for a client in an outpatient facility who has been taking acarbose for type 2 diabetes mellitus. Which of the following laboratory tests should the nurse plan to monitor?

Liver Function Tests

A nurse is teaching the parents of a school‐age child about transdermal methylphenidate. Which of the following instructions should the nurse include?

Liver damage

A staff educator is reviewing medication dosages and factors that influence medication metabolism with a group of nurses at an in-service presentation. Which of the following factors should the educator include as a reason to administer lower medication dosages (SATA)?

Liver failure Concurrent use of medication the same pathway metabolizes

A charge nurse is planning a staff education session to discuss medications used during the care of a client experiencing alcohol withdrawal. Which of the following medications should the charge nurse include in the discussion? (Select all that apply.)

Lorazepam Diazepam

A nurse is preparing a patient's medications. Which of the following actions should the nurse take in following legal practice guidelines (SATA)?

Maintain skill competency Monitor for adverse effects Safeguard medications

A nurse is caring for a client who has diabetes and is experiencing nausea due to gastroparesis. The nurse should anticipate a prescription for which of the following medications?

Metoclopramide

A nurse is caring for a client who is prescribed isosorbide mononitrate for chronic stable angina and develops re ex tachycardia. Which of the following medications should the nurse expect to administer?

Metoprolol

A nurse in an outpatient facility is teaching a client about the oral erythromycin she is starting every 6 hours to treat pneumonia. What should the nurse teach the client about this medication? c. Diagnostic tests: Describe two diagnostic tests to monitor for clients taking erythromycin.

Monitor liver function tests for clients who take erythromycin over a period of several weeks. If the client is concurrently taking warfarin or digoxin with erythromycin, carefully monitor PT/INR or digoxin levels. Monitor WBC for effectiveness of erythromycin treatment (decrease to normal levels).

A nurse is preparing to administer belimumab for a client who has systemic lupus erythematosus. Which of the following actions should the nurse plan to take?

Monitor the client for hypersensitivity reactions.

A. head injury

Morphine administration is contraindicated in which of the following disorders? A. head injury B. hepatic insufficiency C. renal impairment D. All of the above

C. inhibiting the release of substance P

Morphine has many actions, including? A. decreasing A-delta fibers B. increasing C fibers C. inhibiting release of substance P D. inhibiting release of acetylcysteine

A nurse is caring for a client who states she has been taking phenylephrine nasal drops for the past 10 days for sinusitis. The nurse should assess the client for which of the following adverse effects of this medication?

Nasal congestion

A nurse is instructing a client who has a new prescription for timolol how to insert eye drops. The nurse should instruct the client to press on which of the following areas to prevent systemic absorption of the medication?

Nasolacrimal duct

A nurse is providing teaching for a client who has gout and a new prescription for allopurinol. For which of the following adverse effects should the client be taught to monitor? (Select all that apply.)

Nausea Rash Increased gout pain

A nurse is assessing a male client who recently began taking haloperidol. Which of the following findings is the highest priority to report to the provider?

Neck spasms

A nurse in the post‐anesthesia recovery unit is caring for a client who received a nondepolarizing neuromuscular blocking agent and has muscle weakness. The nurse should anticipate a prescription for which of the following medications?

Neostigmine

A nurse is caring for a client who has a new prescription for captopril for hypertension. The nurse should monitor the client for which of the following adverse effects of this medication?

Neutropenia

When mixing insulin, which insulin should the nurse draw first?

Novolin R (regular insulin), then NPH

A nurse reviewing a patient's medical record notes a new prescription for verifying the trough level of the patient's medication. Which of the following actions should the nurse take?

Obtain a blood specimen immediately prior to administering the next dose of medication

A nurse in an acute mental health facility is caring for a client who is experiencing withdrawal from opioid use and has a new prescription for clonidine. Which of the following actions should the nurse identify as the priority?

Obtain baseline vital signs

A nurse is preparing to transfuse a unit of packed red blood cells (PRBCs) for a client who has severe anemia. Which of the following interventions will prevent an acute hemolytic reaction?

Obtain help from another nurse to con rm the correct client and blood product.

A nurse is caring for a client who is in labor and receiving IV opioid analgesics. Which of the following actions should the nurse take?

Offer oral hygiene every 2 hr.

A nurse is caring for a client who has atrial fibrillation and a new prescription for dabigatran to prevent development of thrombosis. Which of the following medications is prescribed concurrently to treat an adverse effect of dabigatran?

Omeprazole

A provider prescribes phenobarbital for a patient who has a seizure disorder. The medication has a long half-life of 4 days. How many times per day should the nurse expect to administer this medication?

One

A nurse is caring for a client who has a new prescription for phenelzine for the treatment of depression. Which of the following indicates that the client has developed an adverse effect of this medication?

Orthostatic hypotension

D. all of the above

Patient teaching for acetaminophen therapy should include to? A. take only the recommended dose B. read the labels of OTC medications to avoid overdose C. seek medical care immediately for accidental overdose D. do all of the above

A. unusual bruising

Patients receiving ibuprofen on a regular basis should be told to contact the physician or the nurse practitioner immediately if they note: A. unusual bruising B. slow heartbeat C. upset stomach D. slight dizziness

A nurse is reviewing laboratory findings and notes that a client's plasma lithium level is 2.1 mEq/L. Which of the following is an appropriate action by the nurse?

Perform immediate gastric lavage

6. A client who has a urinary tract infection is to receive phenazopyridine. What therapeutic uses and nursing considerations should the nurse review? a. Expected pharmacological action

Phenazopyridine is an azo dye, which acts as a local anesthetic on the mucosa of the urinary tract. It is not an antibiotic)

A nurse in the post‐anesthesia care unit is caring for a client who is experiencing malignant hyperthermia. Which of the following actions should the nurse take? (Select all that apply.)

Place a cooling blanket on the client. Administer oxygen at 100%. Administer iced 0.9% sodium chloride. Monitor core body temperature.

A nurse is caring for a client who is receiving daily doses of oprelvekin. Which of the following laboratory values should the nurse monitor to determine effectiveness of this medication?

Platelet count

A nurse in a provider's of office is monitoring serum electrolytes for four older adult clients who take digoxin. Which of the following electrolyte values increases a client's risk for digoxin toxicity?

Potassium 3.4 mEq/L

A nurse is assessing a client who is taking amiodarone to treat atrial fibrillation. Which of the following findings is a manifestation of amiodarone toxicity?

Productive cough

A nurse is caring for a hospitalized client who is receiving IV heparin for a deep‐vein thrombosis. The client begins vomiting blood. After the heparin has been stopped, which of the following medications should the nurse prepare to administer?

Protamine

A nurse on a medical‐surgical unit administers a hypnotic medication to an older adult client at 2100. The next morning, the client is drowsy and wants to sleep instead of eating breakfast. Which of the following factors should the nurse identify as a possible reason for the client's drowsiness?

Reduced hepatic function

A nurse is teaching clients in an outpatient facility about the use of insulin to treat type 1 diabetes mellitus. For which of the following types of insulin should the nurse tell the clients to expect a peak effect 1 to 5 hr after administration?

Regular Insulin

A client who has a urinary tract infection is to receive phenazopyridine. What therapeutic uses and nursing considerations should the nurse review? b. Therapeutic uses: Describe four.

Relieves manifestations of burning, urgency, pain, and frequency upon urination.

A nurse is teaching a client who has a new prescription for nitroglycerin transdermal patch for angina pectoris. Which of the following instructions should the nurse include?

Remove the patch each evening.

A nurse is assessing a client who is taking digoxin to treat heart failure. Which of the following findings is a manifestation of digoxin toxicity?

Report of anorexia

A nurse reviewing a patient's health record notes a new prescription for lisinopril 10 mg PO once every day. The nurse should identify this as which of the following types of prescription?

Routine

A nurse is caring for a client who is admitted to undergo a surgical procedure. Which of the following preexisting conditions can be a contraindication for the use of ketamine as an intravenous anesthetic?

Schizophrenia

A nurse is teaching a client who has a new prescription for dextromethorphan to suppress a cough. The nurse should instruct the client to monitor for which of the following adverse effects of this medication?

Sedation

A nurse is monitoring a client who is receiving spironolactone. Which of the following findings should the nurse report to the provider?

Serum potassium 5.2 mEq/L

A nurse in an emergency unit is reviewing the medical record of a client who is being evaluated for angle‐closure glaucoma. Which of the following findings are indicative of this condition?

Severe pain around eyes

A nurse is caring for a client who has a new prescription for calcitonin-salmon for osteoporosis. Which of the following tests should the nurse tell the client to expect before beginning this medication?

Skin test for allergy to the medication.

A nurse is providing instructions about the use of laxatives to a client who has heart failure. The nurse should tell the client he should avoid which of the following laxatives?

Sodium phosphate

A nurse is providing teaching for a client who has a new prescription for metformin. Which of the following adverse effects of metformin should the nurse instruct the client to report to the provider?

Somnolence

A nurse is transfusing a unit of packed red blood cells (PRBCs) for a client who has anemia due to chemotherapy. The client reports a sudden headache and chills. The client's temperature is 2° F higher than her baseline. In addition to notifying the provider, which of the following actions should the nurse take? (Select all that apply.)

Stop the transfusion. Remove the blood bag and tubing from the IV catheter. Obtain a urine specimen.

A nurse is teaching the parents of a child who has a new prescription for desipramine. The nurse should instruct the parents that which of the following adverse effects is the priority to report to the provider?

Suicidal thoughts

A nurse is providing information to a client who has a new prescription for hydrochlorothiazide. Which of the following information should the nurse include?

Take the medication with food.

A nurse is providing teaching to a client who is starting simvastatin. Which of the following information should the nurse include in the teaching?

Take this medication in the evening.

A nurse is teaching a client who has osteoporosis and a new prescription for alendronate. Which of the following instructions should the nurse provide?

Take this medication in the morning before eating. Drink an 8 oz glass of water with each tablet. Avoid laying down after taking this medication.

A nurse is teaching a client who has a new prescription for levodopa/ carbidopa for Parkinson's disease. Which of the following instructions should the nurse include?

Take this medication with food

A nurse in an outpatient facility is teaching a client about the oral erythromycin she is starting every 6 hours to treat pneumonia. What should the nurse teach the client about this medication? d. Nursing interventions: Describe two nursing actions for clients taking erythromycin.

Teach clients to take erythromycin on an empty stomach, 1 hour before or 2 hours after meals with a full glass of water. Some forms of erythromycin may be taken with meals if GI distress occurs, so check the prescribing reference before teaching the client. Teach the client about adverse effects to watch for, and to call the provider for severe GI distress, manifestations of liver toxicity, and ototoxicity. Advise client that the medication should be taken as prescribed and not stopped if the client is feeling better.

A nurse is caring for an older adult client in a long‑term care facility who has hypothyroidism and a new prescription for levothyroxine. Which of the following dosage schedules should the nurse expect for this client?

The client will start on a low dose, which will be gradually increased.

A nurse in an outpatient facility is teaching a client about the oral erythromycin she is starting every 6 hours to treat pneumonia. What should the nurse teach the client about this medication? b. Adverse effects: Identify two adverse effects the client should watch for.

The most common adverse effects of erythromycin are GI effects, including abdominal pain, nausea/vomiting, and diarrhea. Hepatotoxicity with abdominal pain, anorexia, fatigue, and possibly jaundice can occur after 1 to 2 weeks of erythromycin therapy. Erythromycin can cause a prolonged QT interval on ECG, which can lead to potentially fatal tachydysrhythmias. Ototoxicity can occur if erythromycin is given in high doses, especially for prolonged periods.

C. respiratory system

The most hazardous adverse effects to the use of Morphine occur to the? A. integumentary system B. cardiovascular system C. respiratory system D. gastrointestinal system

C. Withhold this medication if respiratory rate is less than 12/min

The nurse is planning to administer morphine IV to a client who is postoperative. Which of the following actions should the nurse take? A. Monitor for seizures and confusion with repeated doses B. Protect the client's skin from the sever diarrhea that occurs with morphine C. Withhold this medication if respiratory rate is less than 12/min D. Give morphine intermittent via bolus over 30 seconds or less

C. to read combination OTC drug labels carefully to determine if acetaminophen is also part of that product

The nurse should teach a patient taking acetaminophen A. to take the drug when there is inflammation of the tissues B. that one formulation of the drug can be used for all ages in the family C.. to read combination OTC drug labels carefully to determine if acetaminophen is also part of that product D. that acetaminophen is too dangerous to use OTC

A nurse is caring for a client who has a new prescription for adalimumab for rheumatoid arthritis. Based on the route of administration of adalimumab, which of the following should the nurse plan to monitor?

The subcutaneous site for redness following injection

A nurse is explaining the mechanism of action of combination oral contraceptives to a group of clients. The nurse should tell the clients that which of the following actions occur with the use of combination oral contraceptives? (Select all that apply.)

Thickening the cervical mucus Altering the endometrial lining Inhibiting ovulation

A nurse is teaching a client who has a new prescription for omeprazole for management of heartburn. Which of the following information should the nurse include in the teaching?

This medication decreases the production of gastric acid.

A nurse is caring for a client who has a new prescription for valproic acid. The nurse should instruct the client that while taking this medication he will need to have which of the following laboratory tests completed periodically? (Select all that apply.)

Thrombocyte count Amylase Liver functions tests

A nurse is reviewing the health care record of a client who is asking about conjugated equine estrogens. The nurse should inform the client this medication is contraindicated in which of the following conditions?

Thrombophlebitis

A nurse is teaching a client about preventing otitis externa. Which of the following instructions should the nurse include?

Tip the head to the side to remove water from the ears after showering

A nurse is caring for a client who has a new prescription for oxytocin to stimulate uterine contractions. Which of the following interventions should the nurse make? (Select all that apply.)

Use an infusion pump for medication administration. Obtain vital signs frequently and with every dosage change. Monitor fetal heart rate continuously.

A nurse is admitting a patient and completing a preassessment before administering medications. Which of the following data should the nurse include in the preassessment (SATA)?

Use of herbal teas Current health status Food allergies

A nurse is caring for an older adult client who has a new prescription for digoxin and takes multiple other medications. The nurse should recognize that concurrent use of which of the following medications places the client at risk for digoxin toxicity?

Verapamil

A nurse is completing an assessment of a client's current medications. The client states she also takes gingko biloba. Which of the following medications is contraindicated for a client taking gingko biloba?

Warfarin

A nurse is teaching an adolescent client who has a new prescription for clomipramine for OCD. Which of the following instructions should the nurse include to minimize an adverse effect of his medication?

Wear sunglasses when outdoors

A nurse is teaching a client who has a prescription for long‐term use of oral prednisone for treatment of chronic asthma. The nurse should instruct the client to monitor for which of the following adverse effects of this medication?

Weight gain

B. it is more potent than morphine C. topical preparations are used to treat chronic pain D. IV administration may be to treat acute pain or anesthesia

Which of the following statements is true about fentanyl? Select all that apply A. it is more effective than morphine B. it is more potent than morphine C. topical preparations are used to treat chronic pain D. IV administration may be to treat acute pain or as anesthesia

A nurse is assessing a client who has taken procainamide to treat dysrhythmias for the last 12 months. The nurse should assess the client for which of the following adverse effects of this medication? (Select all that apply.)

Widened QRS complex Easy bruising Swollen joints

A nurse is preparing to administer an Im dose of penicillin to a client who has a new prescription. The client states she took penicillin 3 years ago and developed a rash. Which of the following actions should the nurse take?

Withhold the medication

A nurse is preparing to administer a transfusion of 300 mL of pooled platelets for a client who has severe thrombocytopenia. The nurse should plan to administer the transfusion over which of the following time frames?

Within 30 min/unit

B. Do you drink alcoholic beverages

Your 55 year old patient has a fractured rib. She is being released from the emergency room with a prescription for a narcotic analgesic. Before discharging this patient, you assess the patient's lifestyle, diet, and habits. Which of the following questions should be included in this assessment? A. Are you able to drink 3 liters of water a day B. Do you drink alcoholic beverages C. Do you take other medications D. Do you have stairs in your home

D. Frequently monitor the patient's level of consciousness

Your patient in the emergency department arrived nonresponsive. The friend of the patient states "I think he took an overdose of methadone but I'm not sure." You administer IV naloxone and the patient awakes. What is the most essential nursing action for this patient? A. Contact psychiatry services for an admit consult B. Administer sodium bicarbonate to keep the patient's blood pH normal C. Draw blood for a methadone level D. Frequently monitor the patient's level of consciousness

C. Health status, lifestyle, diet and habits, environment

Your patient is being discharged with a prescription for tylenol with codeine. Which of these areas of assessment needs special attention? A. Health status and environment B. Culture and lifestyle, diet and habits C. Health status, lifestyle, diet and habits and environment D. Health status and culture

A. This is an expected adverse effect to the use of codeine. Increase your fluid intake and take a bulk laxative such as metamucil.

Your patient is taking tylenol with codeine No. 3 to control the pain from a fractured arm. Five days later, the patient call the clinic and states she's having trouble having a bowel movement since she started this drug. Which of the following is the most appropriate response? A. this is an expected adverse effect to the use of codeine. Increase your fluid intake and take a bulk laxative such as Metamucil B. This is an additive effect of codeine. Stop taking this medication C. This is an expected adverse effect to the use of codeine. Double the dose, and it will clear out your bowel D. You are probably allergic to the codeine. Stop taking the medication

D. all of the above

Your patient take acetaminophen daily for chronic headaches. The patient should have which of the following lab tests done periodically? A. CBC B. Liver function test C. Kidney function test D. All of the above

A nurse is caring for a client who is taking propylthiouracil. For which of the following adverse effects of this medication should the nurse monitor? a.) Bradycardia b.) Insomnia c.) Heat intolerance d.) weight loss

a.) Bradycardia is an adverse effect of proylthiouracil.

A nurse is admitting a client to an acute care facility for a total hip arthoplasty. The client takes hydrocortisone for Addison's disease. Which of the following actions is the nurse's priority? a.)Administering a supplement dose of hydrocortisone b.) Instructing the client about coughing and deep breathing c.) collecting additional information from the client about his history of Addison's disease d.) Inserting an indwelling urinary catheter

a.) administering a supplement dose of hydrocortisone Acute adrenal insufficiency (adrenal crisis) is the greatest risk to a client who has addison's disease, is taking a glucocorticoid, and is undergoing surgery. To prevent acute adrenal insufficiency, supplemental doses are administered during times of increased stress.

a nurse in an outpatient facility is preparing to administer nafcillin IM to an adult client who has an infection which of the following actions should the nurse plan to take

administer the medication deeply into the ventrogluteal muscle ask the client about an allergy to penicillin before administering the medication monitor the client for 30 minutes following the injection

a nurse is reinforcing teaching with a client who is beginning a course of metronidazole. the nurse should remind the client to stop taking the medication and notify the provider if which of the following manifestations occur

ataxia

A nurse is teaching a client who has Graves disease about her prescription medications. Which of the following statements by the client indicates an understanding of the use of propranolol in the treatment of Graves disease? a.) Propranolol helps increase blood flow to my thyroid glands b.) Propranolol is used to prevent excess glucose in my blood c.) Propranolol will decrease my tremors and fast heart beat d.) Propranolol promotes a decrease of thyroid hormone in body

c.) Propranolol will decrease my tremors and fast heartbeat Propranolol is a beta-adrenergic antagonist that decreases heart rate and controls tremors.

a nurse is reviewing prescriptions for a client who has celebral spinal fluid infection with gram-negative bacteria which of the following and cephalosporin antibiotics should the nurse expect the provider to prescribe IV to treat the infection

cefepime

A nurse is caring for a client who is taking for somatropin to stimulate growth. The nurse should plan to monitor the client's urine for which of the following? a.) bilirubin b.)Protein c..) Potassium d.) Calcium

d.) calcium A large amount of calcium can be presented in the urine of a client who takes somatropin. This puts the client at risk for renal calculi

A nurse is assessing a client who takes desmopressin for diabetes insipidus. For which of the following adverse effects should the nurse monitor? a.) hypovolemia b.) hypercalcemia c.) Agitation d.) headache

d.) headache headaches during desmopressin therapy is an indication of water intoxication

A nurse is caring for an older adult client in a long-term care facility who has hypothyroidism and a new prescription for levothyroxine. Which of the following dosage schedules should the nurse expect for this client? a.) The client will start at a high dose, and the dose will be tapered as needed. b.) The client will remain on the inital dosage during the course of treatment c.) the clients dosage will be adjusted daily based on blood levels d.) the client will start on a low dose, which will gradually increase

d.) the client will start on a low dose, which will gradually increase must increase for 6 to 8 wks

a nurse is caring for a client who has Subacute bacterial endocarditis and is receiving several antibiotics including streptomycin IM. for which of the following manifestation should the nurse monitor as an adverse effect of this medication

extremity paresthesias

a nurse is caring for a client who takes several antiretroviral medications, including the NRTI zidovudine, to treat HIV infections. the should monitor for which of the following adverse effects of zidovudine?

fatigue, hyperventilation vomiting

a nurse is reviewing discharge teaching with a client who has active tuberculosis the client asked why he must take four different medications which of the following responses should the nurse make

four medications reduce the chance that bacteria will become resistant

a nurse is caring for a client who is taking ritonavir, a protease inhibitor, to treat HIV infection. the nurse should monitor for which of the following adverse effects of this medication

hiperlipidemia

a nurse is administering IV acyclovir to a client who has varicella. which of the following actions should the nurse take

infuse acyclovir over 1 hour

a nurse is caring for a client receiving IV amphotericin B infusion. which of the following serum laboratory values should the nurse plan to monitor

magnesium hematocrit creatinine

a nurse is preparing to administer penicillin V to a client who has a streptococcal infection the client tells the nurse that she has difficulty swallowing tablet and doesn't tolerate liquid or chewable medication because the taste gags her even when mixed with food the nurse should request a prescription for which of the following medications

nafcillin

a nurse is caring for a client who is undergoing preparation for extensive colorectal surgery which of the following oral antibiotic should the nurse expect to administer specifically to suppress normal flow in the GI tract

neomycin

a nurse is caring for a client who has a new prescription for enfuvirtide to treat HIV infection. the nurse should monitor the client for which of the adverse reactions to this medication

pneumonia localized erythema hypotension

a nurse is caring for a client who is starting a course of Gentamicin IV for a serious serious respiratory infection for which of the following manifestations should the nurse monitor as an adverse effect of this medication

pruritus hematuria muscle weakness vertigo

a nurse is caring for a client who is diabetes mellitus pulmonary tuberculosis and a new prescription for isoniazid. which of the following supplements should the nurse expect to administer to prevent an adverse effect of inh.

pyridoxine

a nurse is reinforcing teaching with a client about ways to prevent medication resistance when taking highly active antiretroviral therapy which of the following information should the nurse include

taking the medication at the same time daily without missing dose minimizing resistance

a nurse is reviewing discharge teaching with a client who has a new prescription for a combination oral NRTIs (abacavir, lamivudine, and zidovudine) for treatment of HIV. which of the following statements should the nurse include

these medications work by inhibiting enzymes to prevent HIV replication

a nurse is obtaining a medication history from a client who is to receive imipenem-cilastatin IVto treat infection. which of the following medications puts the client at risk for a medication interaction

valproic acid


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