Pharmacology

A nurse is planning to screen a school-age child for impaired hearing because the child is receiving an antibiotic that affects hearing. Which medication does the nurse suspect may have caused hearing impairment?

Gentamicin (Garamycin)

A recently married 22-year-old woman is brought to the trauma center by the police. She has been robbed, beaten, and sexually assaulted. The client, although anxious and tearful, appears to be in control. The health care provider prescribes alprazolam (Xanax) 0.25 mg for agitation. The nurse should inform the client that the medication will administered when:

She requests something to calm her

When talking with a client who has been receiving paroxetine (Paxil), the nurse determines that more clarification is needed when the client says:

"I've been on the medication for 8 days now, and I don't feel any better."

Carbidopa/levodopa (Sinemet) is prescribed for a client with Parkinson disease. What should the nurse teach the client about this medication?

"You may experience dizziness when moving from sitting to standing."

An older female client who is hospitalized for depression is receiving citalopram (Celexa). During discharge teaching, she asks the nurse whether there is anything she should know about taking this medication. The nurse replies:

"You should take each dose of medication as prescribed."

An Rh-negative mother who gave birth at 10:30 am on January 7 should receive her Rh immune globulin (RhoGAM) injection no later than:

10:30 am on January 10

How long after the last dose should the nurse schedule to have a client's blood drawn to evaluate the serum lithium level?

8 to 12 hours

A nurse is caring for a client with diabetes who is scheduled for a radiographic study requiring contrast. Which should the nurse expect the health care provider to prescribe?

Acetylcysteine (Acetadote) before the test

Methylphenidate (Ritalin SR) is ordered for a 6-year-old boy with the diagnosis of attention deficit-hyperactivity disorder (ADHD). The nurse teaches the father about the safe administration of the medication and concludes that the instructions have been understood when the father says that he should administer it:

After breakfast

After a thyroidectomy, the client exhibits carpopedal spasm and some tremors. The client reports a sensation of tingling in the fingers and around the mouth. What medication should the nurse expect the health care provider to prescribe?

Calcium gluconate

Naltrexone (Depade) is used to treat clients with substance abuse problems. In which situation does the nurse anticipate that naltrexone will be administered?

Decrease the recovering alcoholic's desire to drink alcohol.

Amlodipine (Norvasc) is prescribed for a client with hypertension. Which response to the medication should the nurse instruct the client to report to the health care provider?

Difficulty breathing

Nesiritide (Natrecor), a vasodilator, is prescribed for a client with acute heart failure and pulmonary edema. The nurse is assessing the client's response to the medication. Which clinical manifestation should decrease when the medication is effective?

Dyspnea

A nurse is evaluating the results of treatment with erythropoietin (Epogen). Which client response is considered significant?

Elevation in hematocrit level

What should the nurse monitor when a client is receiving a platelet aggregation inhibitor such as clopidogrel (Plavix)?

Epistaxis

An antianxiety medication is prescribed for an extremely anxious client. The client says, "I'm afraid to take these pills because I heard they're addictive." The nurse teaches the client that antianxiety medications:

Have the potential for physiological and psychological dependence

Which medication is prescribed to an infant with congenital syphilis?

IV penicillin (Pfizerpen)

A client will be taking nitrofurantoin (Macrobid) 50 mg orally every evening at home to manage recurrent urinary tract infections. What instructions should the nurse give to the client?

Increase the intake of fluids

Six hours after initiation of total parenteral nutrition, the client's serum glucose level increases to 240 mg/dL. What does the nurse conclude is the most likely cause of the increase?

Infusion is flowing too rapidly

Famotidine (Pepcid) is prescribed for a client with peptic ulcer disease. The client asks the nurse what this medication does. The nurse responds, "It:

Inhibits gastric acid secretion."

The nurse is to administer a muscle relaxant just before a client undergoes electroconvulsive therapy. The major disadvantage of this drug is that it inhibits the:

Intercostal and diaphragmatic muscles

A client with type 2 diabetes develops gout, and allopurinol (Zyloprim) is prescribed. The client is also taking metformin (Glucophage) and an over-the-counter nonsteroidal antiinflammatory drug (NSAID). When teaching about the administration of allopurinol, what should the nurse instruct the client to do?

Monitor blood glucose levels more frequently.

A client with a tentative diagnosis of myasthenia gravis is scheduled to receive edrophonium (Enlon) to confirm the diagnosis. What response should the nurse anticipate will confirm myasthenia gravis?

Rapid but brief symptomatic improvement

A nurse is caring for a 6-year-old child who has undergone craniotomy. The parents ask what effect mannitol (Osmitrol) has. The nurse responds that this medication is given to:

Relieve cerebral pressure

A health care provider prescribes steroid therapy for a 4-year-old child who has nephrotic syndrome. What goal of this treatment does the nurse explain to the child's parents?

Stimulates diuresis

When a client is being given an intravenous infusion of magnesium sulfate, the nurse should have its antidote readily available. Which of the following medications would the nurse administer if toxicity were to occur?

Calcium gluconate

A client with tuberculosis is started on a chemotherapy protocol that includes rifampin (RIF). The nurse evaluates that the teaching about rifampin is effective when the client states:

"I can expect my urine to turn orange from this medication."

A client with systemic lupus erythematosus (SLE) is at 39 weeks' gestation. What does the nurse anticipate regarding this client?

A need to discontinue the client's salicylate therapy

An infant with congenital heart disease is to be discharged with prescriptions for digoxin (Lanoxin) and furosemide (Lasix). The nurse discusses the danger signs of digoxin toxicity with the parents. What danger sign requires a call to the health care provider?

Difficulty feeding with vomiting

A client is admitted to the hospital with a diagnosis of acute salmonellosis. What does the nurse expect the health care provider to prescribe?

Electrolytes

A health care provider prescribes bed rest, loperamide (Imodium), and esomeprazole (Nexium) for a client who just had major surgery. After several days of this regimen, the client complains of diarrhea. The nurse concludes that the most likely cause of the diarrhea is:

Esomeprazole

A client is admitted and diagnosed with myasthenia gravis. Pyridostigmine bromide (Mestinon) therapy via tablets has been prescribed. The nurse anticipates that the dosage will be changed frequently during the first week of therapy. While the dosage is being adjusted, the nurse should:

Evaluate the client's muscle strength every hour after the medication is given

Before a cholecystectomy vitamin K is prescribed. Which element, formed in the presence of vitamin K, should the nurse determine is the purpose of administering this medication?

Prothrombin

A health care provider prescribes dexamethasone (Decadron) for a client with head trauma. A family member asks why this medication is being given. The nurse teaches the family member that the medication is an effective treatment for reducing swelling in the brain because it:

Reduces the inflammatory response of tissues.

A client with myasthenia gravis improves and is discharged from the hospital. The discharge medications include pyridostigmine bromide (Mestinon) 10 mg every six hours. The nurse evaluates that the drug regimen is understood when the client says, "I should:

Set an alarm so I take the medication on time."

Permethrin 1% lotion (Nix) is prescribed for a 5-year-old child with pediculosis capitis (head lice). What instruction should the nurse include while teaching the parents about treating the head lice?

The child's hair must be combed with a fine-toothed comb to remove nits.

A young woman has been using oral contraceptives. When she misses her regular menstrual period, she visits the women's health clinic and tells the nurse that she may be pregnant because she missed taking her contraceptive pills for 1 week when she had the flu. How should the nurse respond?

"You may be right. One of the reasons that an exact schedule is prescribed for birth control pills is that they have to be taken regularly to be effective."

When used in combination with certain foods and drugs, monoamine oxidase inhibitors (MAOIs) can cause serious side effects. Which condition could occur in clients treated with MAOIs for depression?

A serious increase in blood pressure

While a pacemaker catheter is being inserted, the client's heart rate drops to 38 beats/min. What medication should the nurse expect the health care provider to prescribe?

Atropine sulfate (Atropine)

A client is diagnosed with trigeminal neuralgia. Which medication should the nurse anticipate will be prescribed for this client?

Carbamazepine (Tegretol)

A nurse is caring for a client who was admitted with the diagnosis of severe preeclampsia and is now receiving an intravenous infusion of magnesium sulfate. What is the classification of this medication?

Central nervous system depressant

What should the nurse include in a teaching plan to help reduce the side effects associated with diltiazem (Cardizem)?

Change positions slowly

A client with schizophrenia who is receiving an antipsychotic medication begins to exhibit a shuffling gait and tremors. The practitioner prescribes the anticholinergic medication benztropine (Cogentin) 2 mg daily. What should the nurse assess the client for daily when administering these medications together?

Constipation

A nurse administers an intramuscular injection of vitamin K to a newborn. What is the purpose of the injection?

It provides protection until the intestinal flora has been established

A health care provider prescribes divalproex (Depakote). What does the nurse consider an appropriate indication for the use of this drug?

Management of manic episodes of bipolar disorder

An individual is prescribed a tricyclic antidepressant to help manage acute depression after a stressful life event. What is the rationale used for determining the information that has the greatest priority in regard to client safety?

Physical side effects can increase the client's risk of falls, accidental injuries, and even death; the safety of the client and of others is at risk when the client takes a TCA.

A school-aged child is receiving 45 units of intermediate-acting insulin (Novolin N) at 7 am and 7 pm. What should the nurse tell the parents regarding a bedtime snack?

Provide a bedtime snack to prevent hypoglycemia during the night.

Warfarin (Coumadin) is prescribed for a client who has been receiving intravenous (IV) heparin for a partial occlusion of the left common carotid artery. The client expresses concern about why both drugs are needed at the same time. The nurse explains that this approach:

Provides an anticoagulant intravenously until the oral drug reaches therapeutic levels

A toddler is receiving succimer (Chemet) for plumbism. Which nursing intervention is most important to minimize the side effects of this therapy?

Providing adequate fluids to increase urine output

A man is found to have paranoid schizophrenia, and the practitioner prescribes a typical antipsychotic medication. After taking the medication for 1 month the client comes to the clinic and says, "I feel stiff, my hands shake, and I started drooling." The picture illustrates the client's physical status observed by the nurse in the clinic. What extrapyramidal side effect does the nurse conclude has developed?

Pseudoparkinsonism

The nurse is caring for a client who is receiving azathioprine (Imuran), cyclosporine, and prednisone before receiving a kidney transplant. The nurse explains that the purpose of the medication is to:

Reduce antibody production

Before administering Rho(D) immune globulin (RhoGAM), a nurse reviews a pregnant client's laboratory data. What combination of factors in the blood directs the need for RhoGAM?

Rh negativity and a negative Coombs test result

Which medication requires the nurse to monitor the client for signs of hyperkalemia?

Spironolactone (Aldactone)

A client with a hemoglobin level of 6.2 g/dL is receiving packed red blood cells. Twenty minutes after the infusion starts, the client complains of chest pain, difficulty breathing, and feeling cold. What is the first action the nurse should take?

Stop the transfusion

A nurse is administering a histamine H2 antagonist to a client who has extensive burns. The nurse explains to the client that this drug is given prophylactically during the first few weeks after extensive burns. What complication of burns will it prevent?

Stress ulcer

A 12-year-old child has just received a dose of epinephrine. What is the priority assessment after this medication is administered?

Tachycardia

A client has been receiving lithium for the past 2 weeks for the treatment of bipolar disorder, manic phase. What should the nurse include in the teaching plan for this client?

The blood level of lithium must be checked every month

A client with gastric ulcer disease asks the nurse why the health care provider has prescribed metronidazole (Flagyl). The nurse explains, "Antibiotics are prescribed to:

Treat Helicobacter pylori infection."

A 3-year-old child with nephrotic syndrome has been receiving prednisone (Meticorten) for 1 week. The nurse reviews the child's progress record and determines that the medication has been effective. What information supports this conclusion? Select all that apply.

Weight loss Shorter rest periods Increased urine output

A monoamine oxidase inhibitor (MAOI) is prescribed, and the nurse is formulating a teaching plan. What should the nurse instruct the client to avoid while taking this drug?

Aged cheeses

On the psychiatric unit a client has been receiving high doses of haloperidol (Haldol) for 2 weeks. The client says, "I just can't sit still, and I feel jittery." Which side effect does the nurse suspect that the client is experiencing?

Akathisia

A nurse is reviewing a newly admitted client's medication administration record (MAR). The nurse identifies that it is incomplete when the record is lacking information regarding the client's:

Allergies

A nurse is interviewing an adolescent who is to start a chemotherapeutic drug regimen that includes vincristine. Which side effect is it most important for the nurse to prepare the adolescent to expect?

Alopecia

A nurse is caring for a 10-year-old child with cystic fibrosis that is taking a pancreatic enzyme replacement. Which effect of the medication should the nurse look for that may indicate the enzyme is inadequate?

Abdominal cramping

A client with burns is to receive the exposure method of treatment with application of mafenide (Sulfamylon) twice a day. With this type of treatment the nurse plans to:

Administer prescribed pain medication

A client with type 1 diabetes mellitus has a fingerstick glucose level of 258 mg/dL at bedtime. A prescription for sliding scale regular insulin (Novolin R) exists. What should the nurse do?

Administer the insulin as prescribed

A client will be discharged with a peripherally inserted central venous catheter (PICC) for administration of peripheral parenteral nutrition (PPN). What would be appropriate for the nurse to include in the client's discharge teaching?

Arranging for professional help to monitor the alternate nutrition

The nurse is teaching an adolescent with type 1 diabetes about taking a combination of regular insulin (Novolin R) and an intermediate-acting insulin (Novolin N). The nurse asks the adolescent at what time of day the second dose of Novolin N should be administered if the first dose was taken at breakfast. Which response by the adolescent demonstrates that the teaching has been understood?

At dinnertime

A 19-year-old adolescent is admitted to the emergency department with multiple fractures and potential internal injuries. The client's history reveals multiple drug abuse for the past 8 months. When caring for this client, the nurse determines that the most serious life-threatening responses usually result from withdrawal from:

Barbiturates

A client with type 1 diabetes of long duration takes Novolin 70/30 (combination of Novolin N 70% and Novolin R 30%) every morning. At 11:30 AM, before eating lunch, the client is admitted to the emergency department with an acute myocardial infarction. At 1:30 PM, the client's serum glucose level drops to 30 mg/dL, and insulin coma is diagnosed. What does the nurse conclude is the reason for the development of acute hypoglycemia?

Because the client took an insulin shot and did not eat, the client's glucose level dropped more quickly

A health care provider prescribes peak and trough levels of an antibiotic for a client who is receiving vancomycin intravenous piggyback (IVPB). When should the nurse have the laboratory obtain a blood sample to determine a peak level of the antibiotic?

Between 30 and 60 minutes after a dose

A nurse is giving an educational program to paramedics who have volunteered to give the smallpox vaccine in a community vaccination drive. Which type of needle and method of administration should the nurse teach the volunteers to use when administering the smallpox vaccine?

Bifurcated needle for 15 injections within 5 mm

What client response indicates to the nurse that a vasodilator medication is effective?

Blood pressure changes from 154/90 to 126/72

A nurse is providing discharge instructions about digoxin (Lanoxin). Which response should a nurse include as a reason for a client to withhold the digoxin?

Blurred vision

A client with a diagnosis of bipolar I disorder with rapid cycling is readmitted 4 months after discharge. On the first day on the unit the client continually interrupts the nurse and is increasingly talkative and loud. What is the most therapeutic response by the nurse?

"Tell me about the medication you've been taking."

Ampicillin 250 mg by mouth every six hours is prescribed for a client who is to be discharged. Which statement indicates to the nurse that the client understands the teaching about ampicillin?

"The medicine should be taken one hour before or two hours after meals."

A 7-year-old boy with a diagnosis of attention deficit-hyperactivity disorder (ADHD) is receiving methylphenidate (Concerta). His mother asks about its action and side effects. What is the nurse's initial response?

"It is a stimulant that has a calming effect on children with your son's disorder."

A client with rheumatoid arthritis takes aspirin (ASA) routinely to reduce pain. The client asks whether it is the arthritis, the aspirin, or some other ear problem that causes the bilateral ear buzzing the client is now experiencing. What is an appropriate nursing response?

"Aspirin may have damaged your eighth cranial nerve, the acoustic nerve."

A client is receiving epoetin (Epogen) for the treatment of anemia associated with chronic renal failure. Which client statement indicates to the nurse that further teaching about this medication is necessary?

"I realize it is important to take this medication because it will cure my anemia."

A client who has been taking ibuprofen (Advil) for rheumatoid arthritis asks the nurse if acetaminophen (Tylenol) can be substituted instead. An appropriate nursing response is

"Ibuprofen is an antiinflammatory and acetaminophen is not."

A nurse is caring for a client with severe preeclampsia who is receiving magnesium sulfate. What side effects indicate that the serum magnesium level may be excessive? Select all that apply.

Absence of the knee-jerk reflex Respiratory rate of 11 breaths/min

A client is to receive intraarterial chemotherapy for cancer of the liver. What benefit of chemotherapy via this method does the nurse explain to the client?

It reduces systemic toxicity.

A client with alcohol dependence is admitted to the detoxification unit. Which class of medication does the nurse anticipate that the practitioner will prescribe?

Benzodiazepine

A 20-year-old woman visiting the clinic says that she wishes to begin using depot medroxyprogesterone acetate (Depo-Provera) as a form of birth control. What important information should the nurse include when teaching the client about Depo-Provera?

Calcium intake and exercise should be increased because of possible loss of bone mineral density with increasing duration of use

A client who had a myocardial infarction receives a prescription for a beta-blocker and a nitroglycerin patch. The nurse determines that the purpose of the nitroglycerin patch is to decrease the:

Preload of the heart, thereby reducing the cardiac workload

The nurse is teaching a client who is receiving a monoamine oxidase inhibitor about dietary restrictions. The nurse plans to caution the client to avoid:

Cheese, beer, and products with chocolate

Shortly after birth the nurse instills erythromycin ophthalmic ointment in the newborn's eyes. The father asks why an antibiotic is needed because the mother does not have an infection. The nurse explains that it protects the newborn from:

Chlamydia and gonorrhea

A client with type 1 diabetes is found to have a psychosis and is to receive haloperidol (Haldol). Which response should a nurse anticipate with this drug combination?

Decreased control of the diabetes

A client with acquired immunodeficiency syndrome (AIDS) is receiving a treatment protocol that includes a protease inhibitor. When assessing the client's response to this drug, which common side effect should the nurse expect?

Diarrhea

A client has been given a prescription for furosemide (Lasix) 40 mg every day in conjunction with digoxin (Lanoxin). The nurse concludes that potassium supplements are needed also because:

Digoxin toxicity occurs rapidly in the presence of hypokalemia

A client with arthritis is taking ibuprofen (Motrin), a nonsteroidal antiinflammatory drug, and large doses of aspirin (ASA). The nurse teaches the client about the clinical manifestations of aspirin toxicity, including:

Disturbances in hearing

A client is receiving metoprolol (Lopressor). Which side effect should the nurse teach the client to expect?

Dizziness with strenuous activity

A client with stage III Hodgkin disease is started on ABVD therapy, a multiple drug regimen. The client asks why so many drugs need to be given all at once. Which is the best response by the nurse?

Each drug destroys the cancer cell at a different time in the cell cycle

A client is receiving furosemide (Lasix) to relieve edema. The nurse should monitor the client for which response to the medication?

Excessive loss of potassium ions

A 15-year-old adolescent is admitted with partial- and full-thickness burns of the arms and upper torso. What are the purposes of administering pain medication by way of the intravenous route rather than the intramuscular route? Select all that apply.

It decreases the risk of tissue irritation. Severe pain is reduced more effectively. Impaired peripheral circulation is bypassed.

A nurse is reviewing the admission laboratory report of an infant with severe gastroenteritis. The serum potassium is 3 mEq/L. Potassium chloride 20 mEq/L is prescribed to be added to the infant's IV. What should the nurse do next?

Find out when the infant last had a wet diaper.

A client is admitted to the intensive care unit with acute pulmonary edema. Which rapidly acting intravenous diuretic should the nurse anticipate will be prescribed?

Furosemide (Lasix)

A young adult being treated for substance abuse asks the nurse about methadone. The nurse responds that methadone is useful in the treatment of opioid addiction because it:

Has an effect of longer duration

A nurse is teaching a female client about using oral contraceptives and when to report complications. What clinical findings should alert the client to stop taking the contraceptive and notify the health care provider immediately? Select all that apply.

Headaches Visual disturbances

The mother of a school-aged child with type 1 diabetes asks why it was recommended that her child use an insulin pump rather than insulin injections. What should the nurse tell the mother concerning the greatest advantage of the insulin pump?

Independence is fostered.

The nurse assesses a client who is receiving total parenteral nutrition for the specific complication of:

Infection

A client has had a total gastrectomy. What should the nurse include in the discharge teaching?

Injections of vitamin B12 for life

The nurse is explaining insulin needs to a client with gestational diabetes who is in her second trimester of pregnancy. Which information should the nurse give to this client?

Insulin needs will increase during the second trimester.

The nurse is caring for a client with deep partial-thickness burns who is receiving a low dosage of an opioid for pain management. The preferred mode of medication administration for this client is:

Intravenous

A client with myasthenia gravis, who is living in a nursing home, experiences inadequate symptomatic control with pyridostigmine bromide (Mestinon), and long-term steroid therapy has been initiated. It is especially important for the nurse to ensure that the client:

Is monitored for an exacerbation of symptoms

The nurse is teaching parents about the side effects of immunization vaccines. What expected side effect associated with the Haemophilus influenzae (Hib) vaccine should the nurse include in the teaching?

Low-grade fever

A client has been in an acute care psychiatric unit for 3 days and is receiving haloperidol (Haldol) tablets orally to reduce agitation and preoccupation with auditory hallucinations. There has been no decrease in the client's agitation or preoccupation with auditory hallucinations since the medication was started. What should the nurse's priority intervention be?

Making certain that the client is swallowing the medication

A client with type 1 diabetes consistently has high glucose levels on awakening in the morning. What should the nurse instruct the client to do to differentiate between the Somogyi effect and the dawn phenomenon?

Measure the blood glucose level between 2 AM and 4 AM

A client had an abdominal cholecystectomy. Postoperatively, the client refuses to deep breathe and cough, saying, "It's too painful." The nurse should:

Medicate the client for pain before coughing and deep breathing

In the postanesthesia care unit it is reported that the client received intrathecal morphine intraoperatively to control pain. Considering the administration of this medication, what should the nurse include as part of the client's initial 24-hour postoperative care?

Monitoring of respiratory rate hourly

A school-aged child with a seizure disorder has been taking carbamazepine (Tegretol) for 3 years. What nursing intervention is most important at this time?

Monitoring the child's complete blood cell counts

A client is receiving doxepin (Sinequan). For which most dangerous side effect of tricyclic antidepressants should a nurse monitor the client?

Mydriasis

A health care provider prescribes ampicillin for a client with an infection. What information should the nurse include in the teaching plan about this medication?

Notify the health care provider if diarrhea develops

A 7-lb newborn is admitted to the nursery with a prescription for intramuscular phytonadione (vitamin K, AquaMEPHYTON) 1 mg. The nurse explains to the parents that this vitamin is administered to:

Promote clotting of the blood.

A client with a family history of diabetes is concerned about the effects of psychiatric medication on the endocrine system. Which psychotropic medication is most likely to cause metabolic syndrome?

Risperidone (Risperdal)

What should a nurse teach the client to do to avoid lipodystrophy when self-administering insulin therapy?

Rotate injection sites

A health care provider prescribes one unit of whole blood for a client after gastrointestinal surgery. What is an important nursing action when administering blood?

Run the blood at a slower rate during the first few minutes of the transfusion.

A health care provider prescribes haloperidol (Haldol) for a client. What should the nurse teach the client to avoid while taking this medication?

Staying in the sun

A client newly diagnosed with type 2 diabetes is receiving glyburide (Micronase) and asks the nurse how this drug works. The nurse explains that glyburide:

Stimulates the pancreas to produce insulin

A preterm infant, born at 30 weeks' gestation, is receiving an intravenous electrolyte solution at a rate of 20 mL/hr by way of an umbilical arterial line. At the hourly intake measurement, the nurse observes that 40 mL has infused in the past hour. What is the nurse's first action?

Taking the vital signs

A client with the diagnosis of schizophrenia is given one of the antipsychotic drugs. The nurse understands that antipsychotic drugs can cause extrapyramidal side effects. Which effect is cause for the greatest concern?

Tardive dyskinesia

A nurse evaluates that a client understands appropriately how to take the antacids prescribed by the primary health care provider when the client states, "I will take my antacids:

Thirty minutes after meals."

What is the planned effect of naloxone when it is administered for a heroin overdose?

To compete with opioids for receptors that control respiration

A client who has been taking a conventional antipsychotic for several days comes to the clinic complaining of neck spasms. The figure illustrates the client's physical status observed by the nurse. What extrapyramidal side effect has the client developed?

Torticollis

Carbidopa-levodopa (Sinemet) is prescribed for a client with Parkinson's disease. The nurse monitors the client for which side effects of the medication? Select all that apply.

Vomiting Anorexia Changes in mood

A client on prolonged cortisone therapy for adrenal insufficiency is being discharged. Which side effects should the nurse teach the client and family to expect? Select all that apply.

Weakness Moon face Weight gain

After 3 months of supplemental oral iron therapy, there is no significant increase in a female adolescent's hemoglobin level. Iron dextran (Imferon) is ordered. What is the best way for the nurse to administer this medication?

With the use of the Z-track method

Several hours after administering insulin, the nurse is assessing a client for an adverse response to the insulin. Which client responses are indicative of a hypoglycemic reaction? Select all that apply.

Confusion Tremors Diaphoresis

The nurse is teaching a parent of a 2-year-old toddler how to administer ear drops. In what direction should the nurse teach the parent to gently pull the pinna?

Down and back

A client requires intravenous fluids postoperatively. The health care provider has prescribed D5W to infuse at 125 mL/hr. To deliver the solution at the correct drip rate, the nurse must first calculate the:

Drops per milliliter delivered by the infusion set

A nurse is administering hydroxyzine (Vistaril) to a client. For which common side effects of this drug should the nurse monitor the client?

Drowsiness and dry mouth

A depressed client is given sertraline (Zoloft) 50 mg at bedtime. For what drug-related side effects should the nurse monitor the client? Select all that apply

Dry mouth Constipation

A nurse is caring for a client who is admitted to the hospital with a diagnosis of unstable angina. Sublingual nitroglycerin has been prescribed. What client response indicates that nitroglycerin is effective?

Pain subsides as a result of arteriole and venous dilation

A nurse is reviewing a plan of care for a client who was admitted with dehydration as a result of prolonged watery diarrhea. Which prescription should the nurse question?

Parenteral albumin (Albuminar)

A male client who is receiving prolonged steroid therapy complains of always being thirsty and urinating frequently. What is the nurse's best initial action?

Perform a finger stick to test the client's blood glucose level.

What dietary choices should the nurse instruct the client taking spironolactone (Aldactone) to avoid? Select all that apply.

Potatoes Cantaloupe

The nurse administers the prescribed vitamin K intramuscularly to a newborn immediately after birth to:

Promote the synthesis of prothrombin

After radioactive iodine therapy, a female client becomes hypothyroid and levothyroxine (Synthroid) is prescribed. The client asks the nurse whether the hormone replacement therapy will interfere with the ability to become pregnant. What is the nurse's best response?

"If your thyroid function is controlled, the medicine should not interfere with your ability to become pregnant."