Pharmacology Test 1❌
A patient is receiving instructions regarding the use of caffeine. The nurse shares that caffeine should be used with caution if which of these conditions is present?
A history of peptic ulcers
The nurse is preparing to transfuse a patient with a unit of packed red blood cells (PRBCs). Which patient would be best treated with this transfusion?
A patient with severe anemia
How does the nurse best evaluate the patient's understanding of teaching about a new medication?
Ask specific questions to assess the patient's understanding.
A patient is receiving an infusion of fresh frozen plasma. Based on this order, the nurse interprets that this patient has which condition?
Coagulation disorder
A patient with a new prescription for a diuretic has just reviewed with the nurse how to include more potassium in her diet. This reflects learning in which domain?
Cognitive
Each statement describes a phase of pharmacokinetics. Put the statements in order, with 1 indicating the phase that occurs first and 4 indicating the phase that occurs last. a) Enzymes in the liver transform the drug into an inactive metabolite. b) Drug metabolites are secreted through passive glomerular filtration into the renal tubules. c) A drug binds to the plasma protein albumin and circulates through the body. d) A drug moves from the intestinal lumen into the mesenteric blood system.
D, C, A, B
Nurses have the ethical responsibility to tell the truth to their patients. What is this principle known as?
Veracity
Which statements is appropriate for the nurse to include in patient teaching regarding type 2 diabetes?
"A person with type 2 diabetes still has some functioning beta cells in his/her pancreas"
A nurse is collecting data from a client who has hypercalcemia as a result of long-term use of glucocorticoids. Which of the following findings should the nurse expect?
Confusion Bone pain Nausea Vomiting
A patient is suffering from tendonitis of the knee. The nurse is reviewing the patient's medication administration record and recognizes that which adjuvant medication is most appropriate for this type of pain?
Corticosteroid
A patient with a diagnosis of pneumonia asks the nurse, "Why am I receiving codeine when I have no pain?" The nurse's response is based on knowledge that codeine also has what effect?
Cough suppressant
A patient is receiving a nutritional supplement via an enteral feeding tube. The nurse will monitor for which common adverse effect?
Diarrhea
Which action by the nurse helps to prevent possible medication errors?
Encourage the patient to ask questions if the medication ordered is different than expected.
Drug transfer to the fetus is more likely during the last trimester of pregnancy for which reason?
Enhanced blood flow to the fetus
The nurse is assessing a newly admitted patient who has been living in his car for several months. Which of these are clinical signs of essential fatty acid deficiency?
Hair loss Wounds with delayed healing Scaly dermatits
During the night shift, a patient's total parenteral nutrition (TPN) infusion runs out, the pharmacy is closed, and a new TPN bag will not be available for about 6 hours. The nurse's most appropriate action at this time would be to
Hang a bag of 10% dextrose.
What legislation, which was passed in 1996, ensures that the privacy of patient information is protected?
Health Insurance Portability and Accountability Act
When assessing a patient for adverse effects related to morphine sulfate (MS Contin), which clinical findings are the nurse most likely to find? (Select all that apply.)
Inability to void Constipation
A nurse in a provider's office is reviewing the medical record of a client who is pregnant and at the first prenatal visit. Which of the following immunizations can the nurse administer safely to this client?
Inactivated influenza vaccine
The nurse is responsible for preoperative teaching for a patient who is mildly anxious about receiving pain medications postoperatively. The nurse recognizes that this level of anxiety in the patient may result in which of these?
Increased motivation to learn
What NSAID would the nurse anticipate administering parenterally for the treatment of acute postoperative pain?
Ketorolac
Which nursing action will increase the absorption of a medication administered intramuscularly (IM)?
Massage the site after injection.
The nurse is administering medications to the patient who is in liver failure resulting from end-stage cirrhosis. The nurse is aware that patients with liver failure would most likely have problems with which pharmacokinetic phase?
Metabolism
What is the nurse's role in the development of new and investigational drugs?
Monitor and report any adverse effects observed during Phase IV studies.
A nurse is planning care for a client who has cancer and is taking a glucocorticoid as an adjuvant medication for pain control. Which of the following interventions should the nurse include in the plan of care?
Monitor blood glucose
When monitoring a patient for signs of hypokalemia, the nurse looks for what early sign?
Muscle weakness
Which medication is used to treat a patient with severe adverse effects of a narcotic analgesic and reverse the adverse effects?
Naloxone (Narcan)
A patient is taking the nonsteroidal anti-inflammatory drug indomethacin (Indocin) as treatment for pericarditis. The nurse will teach the patient to watch for which adverse effect?
Nausea and vomiting
The nurse recognizes the manifestations of nonsalicylate NSAID toxicity include which of these?
Nausea and vomiting Numbness Drowsiness
A nurse is monitoring a patient who is on peripheral total parenteral nutrition (PPN). What is a common adverse effect of PPN?
Phlebitis
What things should the nurse check when reviewing a prescription before handing the written prescription to the patient? (Select all that apply.)
The route of administration The signature of the prescriber
The nurse is reviewing a list of scheduled drugs and notes that Schedule C-I drugs are not on the list. Which is a characteristic of Schedule C-I drugs?
They are used only with approved protocols.
Ergot alkaloids exert their therapeutic effect by which action?
Vasoconstriction
When reviewing the mechanism of action of a specific drug, the nurse reads that the drug works by selective enzyme interaction. This process occurs when the drug
binds to an enzyme molecule and inhibits or enhances the enzyme's action with the normal target cell.
The patient is receiving two different drugs. At current dosages and dosage forms, both drugs are absorbed into the circulation in identical amounts. Thus, because they have the same absorption rates, they are
bioequivalent.
Intravenous morphine is prescribed for a patient who has had surgery. The nurse informs the patient that which common adverse effects can occur with this medication?
Constipation Pruritis Nausea
During the medication administration process, it is important that the nurse remembers which guidelines?
If a patient expresses concern about a drug, stop, listen, and investigate the concerns
What oral hypoglycemic drug has a quick onset and short duration of action, enabling the patient to take the medication 30 minutes before eating and skip the dose if he or she does not eat?
Repaglinide
When taking a telephone order for a medication, which action by the nurse is most appropriate?
Repeat the order to the prescriber before hanging up the telephone.
What assessment is highest priority when monitoring a patient on an opioid analgesic?
Respiratory rate
The nurse is working with a graduate nurse to prepare an intravenous dose of potassium. Which statement by the graduate nurse reflects a need for further teaching?
"The intravenous potassium dose will be given undiluted."
The nurse is preparing a care plan for a patient who has been newly diagnosed with type 2 diabetes mellitus. Which of these reflect the correct order of the steps of the nursing process?
Assessment, human needs statement, planning, implementation, evaluation
The nurse is performing medication reconcilliation during a patient's admission assessment. Which question by the nurse reflects medication reconciliation?
"Do you have a list of all the medications, including OTC, you are currently taking?"
The nurse is reviewing a patient's medication list during a preoperative visit. the patient is scheduled for diagnostic laparoscopy in 2 weeks. He asks the nurse "I hope I can continue the Motrin because I really ache if I don't take it. It's just minor surgery right?" what is the nurse's best response?
"I'll check with your prescriber, but this drug is usually stopped a week before the surgery because it can cause increased bleeding tendencies"
A nurse is providing teaching to a client who has type 2 diabetes mellitus and is starting repaglinide. Which of the following statements by the client indicates understanding of the administration of this medication?
"I'll take this medicine 30 minutes before I eat"
Convert 250 mcg to mg
0.25 mg
An intravenous piggyback (IVPB) antibiotic needs to infuse over 90 minutes. The IVPB bag contains 150 mL. Calculate the setting for the infusion pump.
100 mL/hr
A Drug that delivers 300 mg has a half-life of 4 hours. How many mg fo drug will remain in the body after 1 half-life?
150 mg
The nurse is preparing to give an oral dose of acetaminophen/tylenol to a child who weighs 12 kg. The dose is 15 mg/kg. How many milligrams will the nurse administer for this dose?
180 mg
A nurse is discussing foods that are high in vitamin D with a client who is unable to be out in the sunlight. Which of the following should be included in the teaching?
2 large, poached eggs
A patient is to receive prednisone 7.5 mg PO daily. The tablets are available in a 2.5- mg strength. Identify how many tablets will the patient receive.
3 tablets
A nurse on a medical-surgical unit is caring for a group of clients. For which of the following clients should the nurse expect a prescription for fluid restriction?
A client who has heart failure
A nurse on a medical-surgical unit is caring for a group of clients. The nurse should identify that which of the following clients is at risk for hypovolemia?
A client who has nasogastric suctioning
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?
A client who takes prednisone and has a possible fungal infection A client who has chronic liver disease and is taking hydrocodone/acetaminophen A client who has a prosthetic heart valve, takes warfarin, and reports suspected pregnancy
A nurse is reviewing a client's prescribed medications. Which of the following situations represents a contraindication to medication administration?
A medication is approved for ages 12 and older, and the client is 8 years old
A nurse is reviewing a client's prescribed medications at the beginning of the day shift. Which of the following 0900 medications can be given at any time between 0700 and 1100?
A once-daily multivitamin
For best results when treating severe pain associated with pathologic spinal fractures related to metastatic bone cancer, the nurse should remember that the best type of dosage schedule is to administer the pain medication is which of these?
Around the clock, with additional doses as needed for breakthrough pain
A nurse is preparing to administer eye drops to a client. Which of the following actions should the nurse take?
Ask the client to look up at the ceiling Drop the medication into the client's conjunctival sac Instruct the client to close the eye gently after instillation
An 82-year-old patient is admitted to the hospital after an episode of confusion at home. The nurse is assessing the current medications he is taking at home. Which method is the best way to assess his home medications?
Ask the patient's wife to bring his medications to the hospital in their original containers
A nurse is talking with a client who has a new diagnosis of diabetes mellitus type 2 and their caregiver. Which of the following sweeteners should the nurse include as a zero-calorie sweetener option?
Aspartame Sucralose
The nurse is assessing a patient who is receiving an enteral tube feeding. Which are possible adverse effects associated with enteral feedings?
Aspiration Diarrhea
A nurse is preparing to administer pamidronate to a client who has bone pain related to cancer. Which of the following precautions should the nurse take when administering pamidronate?
Assess the IV site for thrombophlebitis frequently during administration
A nurse is reviewing a client's health record and notes that the client experienced permanent extrapyramidal effects caused by a previous medication. The nurse should recognize that the medication affected which of the following systems in the client?
CNS
While conducting a health history for an older adult patient with heart failure, the patient tells the nurse, "I have chronic constipation." The nurse suspects this gastrointestinal complaint is caused by which class of drugs the patient reports taking?
Calcium channel blockers
When administering total parenteral nutrition (TPN), the nurse is aware that one purpose of intravenous fat (lipid) emulsions is to provide which nutrients?
Calories and fatty acids
The nurse is reviewing the history of a patient who will be starting the triptan Sumatriptan/Imitrex as part of treatment for migraine headaches. Which condition, if present, may be a contraindication to triptan therapy?
Cardiovascular disease
The nurse is monitoring a patient who is in the 26th week of pregnancy and has developed gestational diabetes and pneumonia. She is given medications that pose a possible fetal risk, but the potential benefits may warrant the use of the medications in her situation. The nurse recognizes that these medications are in which U.S. Food and Drug Administration pregnancy safety category?
Category D
The nurse is administering a parenteral nutrition infusion to a patient. The nurse will implement which measures to prevent infection?
Change the intravenous tubing set every time a new bag is added to the infusion. Use a 1.2-micron filter with each tubing set. Report any increase in the patient's temperature over 100° F (37.8° C)
A nurse is planning care for a client who has dehydration. Which of the following actions should the nurse include?
Check the client's weight each morning
The nurse is setting up a teaching session with an 85-year-old patient who will be going home on anticoagulant therapy. Which educational strategy would reflect consideration of the age-related changes that may exist with this patient?
Develop large-print handouts that reflect the verbal information presented.
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 assessing a client who has salicylism. Which of the following findings should the nurse expect?
Dizziness Tinnitus Headache
When calculating pediatric dosages, the nurse understands which method is most accurate for dosing calculations?
Dosage calculation by body surface area because it takes into account the difference in size for children and neonates
During the IV administration of a hypertonic saline solution to treat a patient with severe hyponatremia, the nurse monitors for which signs and symptoms of hypernatremia?
Flushed skin and increased thirst
The nurse knows that which factors will affect the absorption of orally administered medications? (Select all that apply.)
Form of drug preparation Time of day pH of the stomach Presence of food in the stomach
A nurse is assessing a client during transfusion of a unit of whole blood. The client develops a cough, shortness of breath, elevated BP, and distended neck veins. The nurse should expect a prescription for which of the following medications?
Furosemide
A nurse is preparing medications for a preschooler. Which of the following factors should the nurse identify as altering how a medication affects children?
Immature liver High body water content Increased absorption of topical medications
The nurse is reviewing factors that influence pharmacokinetics in the neonatal patient. Which factors put the neonatal patient at risk with regard to drug therapy?
Immature renal function Reduced fast-pass elimination in the liver Decreased protein-binding of medications
In developing a plan of care for a patient receiving morphine sulfate (MS Contin), which nursing diagnosis has the highest priority?
Impaired gas exchange related to respiratory depression
A nurse is teaching a client about a new prescription for celecoxib. Which of the following information should the nurse include in the teaching?
Increases the risk for an MI
When admitting an older adult patient to an acute care setting, which nursing strategy is most appropriate to prevent medication errors?
Instruct the patient or family to bring in all medications the patient was taking at home.
During an assessment, the patient tells the nurse that he eats large amounts of garlic for its cardiovascular benefits. Which drug or drug class, if taken, would have a potential interaction with the garlic?
Insulin
The nurse is reviewing a patient's medication list and notes that sitagliptin (Januvia) is ordered. The nurse will question an additional order for which drug or drug class?
Insulin
Which is a rapid-acting insulin with an onset of action of less than 15 minutes?
Insulin aspart
Which long-acting insulin mimics natural, basal insulin with no peak action and a duration of 24 hours?
Insulin glargine
There are multiple factors that affect medication response. The nurse recognizes which factors have a possible effect on the medication response? (Select all that apply.)
Level of education Body composition Use of alternative therapies Genetic influences Diet and Nutrition Socioeconomic factors Patient compliance with therapy
A patient who has advanced cancer is receiving opioid medications around the clock to keep him comfortable as he nears the end of his life. Which term best describes this type of therapy?
Palliative therapy
A member of an investigational drug study team is working with healthy volunteers whose participation will help to determine the optimal dosage range and pharmacokinetics of the drug. The team member is participating in what type of study?
Phase I
A patient prescribed a tube feeding has a history of a seizure disorder. The absorption of what antiepileptic medication is reduced when given with tube feedings?
Phenytoin
The nurse is preparing to administer an injection to a preschool-age child. Which approaches are appropriate for this age group?
Provide a brief, concrete explanation about the injection Make use of magical thinking Provide comfort measures after the injection
Which activity best reflects the implementation phase of the nursing process for the patient who is newly diagnosed with hypertension?
Providing education on keeping a journal of blood pressure readings
A nurse is teaching clients 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 1-5 hours after administration?
Regular insulin
What is the best description of the consumer safety precautions for herbal supplements?
Reliable data on product efficacy is scarce.
The nurse is teaching patients about self-injection of insulin. Which statement is true regarding injection sites?
Rotate sites within the same location for about 1 week before rotating to a new location.
A nurse reviewing a client'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 prescriptions?
Routine
A nurse is discussing health problems associated with nutrient deficiencies with a group of clients. Which of the following conditions is associated with a deficiency of vitamin C?
Scurvy Bleeding gums
A 47-year-old patient with diabetes is being discharged home and must take insulin injections twice a day. The nurse keeps in mind which concepts when considering patient teaching?
Teaching needs to begin at the time of diagnosis or admission and is individualized to the patients reading level
The nurse is reviewing the drug history of a patient, and during the interview the patient asks, "Why are some drugs OTC and others are not?" The nurse keeps in mind that criteria for OTC status include:
The benefits of correct usage of the drug outweigh the risks. The drug has limited interaction with other drugs. The drug is easy to use.
In monitoring a patient for adverse effects related to morphine sulfate (MS Contin), the nurse assesses for stimulation of which area in the central nervous system (CNS)?
The chemoreceptor trigger zone
What information should the nurse chart when documenting medication administration? (Select all that apply.)
The dosage of medication administered The route of administration The time of administration
The nurse is reviewing the criteria for over-the-counter drugs. Which criteria for over-the- counter status in the United States are accurate?
The drug must be easy to use. The consumer must be able to monitor the drug's effectiveness. The drug must have a low potential for abuse.
The nurse is administering drugs to neonates and will consider which factor may contribute the most to drug toxicity?
The liver is not fully developed.
A patient has been selected as a potential recipient of an experimental drug for heart failure. The nurse knows that when informed consent has been obtained, it indicates which of these?
The patient has had the study's purpose, procedures, and the risks involved explained to him.
When the nurse considers the timing of a drug dose, which factor is appropriate to consider when deciding when to give a drug?
The patient's last meal
An emergency department nurse is documenting the medication history of a patient of Asian culture. The patient states, "I am not taking any medications," but the nurse observes a bottle of capsules in the patient's medicine bag. What information would the nurse collect next?
Use of herbs or over-the-counter medications
The nurse can prevent medication errors by following which principles?
Use two patient identifiers before giving medications Do not give a medication that another nurse has drawn up in a syringe Minimize the use of verbal and telephone orders
When a patient is receiving long-term NSAID therapy, which drug may be given to prevent the serious gastrointestinal adverse effects of NSAIDs?
misoprostol (Cytotec)
When reviewing pharmacology terms for a group of newly graduated nurses, the nurse explains that a drug's half-life is the time it takes for
one half of the original amount of a drug to be removed from the body.
When administering drugs, the nurse remembers that the duration of action of a drug is defined as the time
period when a drug's concentration is sufficient to cause a therapeutic response.
When caring for an older adult Chinese patient, the nurse recognizes that which of these cultural issues may influence the care of this patient?
the use of herbal products may be important practice for this patient`
The nurse has a prescription to administer 500 mL of lactated Ringer's solution over 4 hours. What is the correct pump setting for this prescription? __
125 mL/hr
You are reviewing newly prescribed medications with the wife of a patient who will be discharged today on a liquid diet after jaw surgery. She will be giving the patient his mediations. There is a prescription for liquid metoclopramide/Reglan, 10 mg PO before breakfast and dinner. The medication is available in a strength of 5mg/mL. How many mL will she need to give for each dose?
2 mL
A drug dose that delivers 750 mg has a half-life of 4 hours. How much drug will remain in the body after one half-life?
375 mg
The order reads: "Infuse 1000 mL of NS over the next 8 hours." The IV tubing has a drop factor of 15 gtt/mL. Calculate the mL/hour rate, and calculate the drops/minute setting for the IV tubing with this gravity infusion
125 mL/hr; 31 gtt/min
Digoxin is available in 0.125-mg tablet form. Convert this dose to microgram strength.
125 mcg
The nurse has a prescription to administer 250 mL of half-normal saline (0.45%NS) over 4 hours. What is the correct pump setting for this prescription? __
63 mL/hr
A patient is receiving a tube feeding via a percutaneous enteral gastrostomy (PEG) tube of Glucerna at 50 mL/hr. The orders also read to check the residual and flush the tubing every 4 hours with 30 mL of water. Calculate the total intake of fluid at the end of a 12-hour shift.
690 mL
The nurse would question a prescription to administer acetylsalicylic acid to what patient?
7-year-old patient with a history of flulike symptoms
The nurse is administering insulin lispro (Humalog) and will keep in mind that this insulin will start to have an effect within which time frame?
15 minutes
A patient is transferred from an intensive care unit (ICU) to a general medical-surgical unit. Which nursing action is most appropriate to prevent a medication error?
Perform a medication reconciliation of the patient's chart during care transition.
A patient has just received a prescription for an enteric-coated stool softener. When teaching the patient, the nurse should include which statements?
"Be sure to drink 6-8 oz of water with this tablet" "Be sure to swallow the table whole without chewing it"
A nurse is educating a client who has anemia about dietary intake of iron. Which of the following is a non-heme source of iron?
Dried beans
The physiologic changes that normally occur in older adult patients have which implication for drug response?
Drug half-life is lengthened.
A nurse working with older adult patients is concerned about the number of medications prescribed for each patient. Which older adult assessment should be of highest priority related to polypharmacy?
Drug interactions
The nurse working in a prenatal clinic recognizes that the safety or potential harm of drug therapy during pregnancy relates to which factor?
Drug properties
The nurse is reviewing facts about pharmacology for a review course. The term legend drug refers to which item?
Prescription drugs
A 6-year-old child who has chickenpox also has a fever of 102.9° F (39.4° C). The child's mother asks the nurse if she should use aspirin to reduce the fever. What is the best response by the nurse?
"Acetaminophen (Tylenol) should be used to reduce his fever, not aspirin."
When taking a patient's drug history, the nurse asks about use of OTC drugs. The patient responds by saying, "Oh, I frequently take aspirin for my headaches, but I didn't mention it because aspirin is nonprescription." What is the nurse's best response?
"Although aspirin is over the counter, it's still important to know why you take it, how much you take, and how often."
A nurse orienting 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"
The nurse is teaching a group of patients about management of diabetes. Which statement about basal dosing is correct?
"Basal dosing delivers a constant dose of insulin."
A nurse is reinforcing dietary teaching to a client who has type 2 diabetes mellitus. Which of the following instructions should the nurse include?
"Carbohydrates should comprise 55% of daily caloric intake" "You can add table sugar to cereal" "Eat something if you choose to drink alcohol" "Use the same portion sizes to exchange carbohydrates"
A nurse is providing discharge instruction for a client who has a new prescription for an antihypertensive medication. Which of the following statements should the nurse give?
"Change position slowly when you move from sitting to standing"
A charge nurse is providing information about fat emulsion added to TPN to a group of nurses. Which of the following statements by the charge nurse are appropriate?
"Concentration of lipid emulsion can be up to 30%" "Adding lipid emulsion gives the solution a milky appearance" "Check for allergies to soybean oil" "Lipid emulsion prevents essential fatty acid deficiency"
A patient has used enteric aspirin for several years as treatment for osteoarthritis. However, the symptoms are now worse and she is given a prescription for a nonsteroidal anti-inflammatory drug and misoprostol (Cytotec). The patient asks the nurse, "Why am I now taking two pills for arthritis?" What is the nurse's best response?
"Cytotec may help to prevent gastric ulcers that may occur in patients taking NSAIDs."
The patient is prescribed 30 units of regular insulin and 70 units of insulin isophane suspension (NPH insulin) subcutaneously every morning. The nurse would provide what teaching to the patient for insulin administration?
"Draw up the regular insulin into the syringe first, followed by the cloudy NPH insulin."
A mother of a 1-month-old infant calls the clinic and asks the nurse if the medication she is taking can be passed to her infant during breastfeeding. What is the nurse's best response to the mother's question?
"Drugs can cross from mother to infant in breast milk, it will depend on the specific drug you are taking."
A nurse is teaching a client how to administer medication through a jejunostomy tube. Which of the following instructions should the nurse include?
"Flush the tube before and after each medication"
A nurse in an outpatient clinic is caring for a client who has a new prescription for an antihypertensive medication. Which of the following instructions should the nurse give the client?
"Get up and change positions slowly"
A nurse is caring for a client receiving dextrose 5% in 0.9% sodium chloride IV at 120 ml/hr. Which of the following statements by the client should alert the nurse to suspect fluid overload?
"I feel as though my heart is racing" "I feel a little short of breath" "The nurse technician told me my blood pressure was 150/90"
A patient prescribed massage therapy for musculoskeletal pain asks the nurse, "How is rubbing my muscles going to make the pain go away?" What is the nurse's best response?
"Massaging muscles activates large sensory nerve fibers that send signals to the spinal cord to close the gate, thus blocking painful stimuli from reaching the brain."
A patient asks the nurse why a lower dose of IV pain medication is being given than the previous oral dose. What is the nurse's best response to the patient?
"Medications given intravenously are not affected by the first-pass effect."
A nurse is teaching a client about transdermal patches. Which of the following statements should the nurse identify as an indication that the client understands?
"I will apply the patch to an area of skin with no hair"
A nurse is teaching a client about medications at discharge. Which of the following statements should the nurse identify as an indication that the client understands instructions?
"I will eat two crackers with the pain pills"
A nurse is teaching an adult client how to administer ear drops. Which of the following statements should the nurse identify as an indication that the client understands?
"I will gently apply pressure with my finger to the front part of my ear after putting in the drops"
A nurse is demonstrating how to insert an IV catheter. Which of the following statements by a nurse viewing the demonstration indicates understanding of the procedure?
"I will insert the needle into the client's skin at an angle of 10-30 degrees with the bevel up"
A nurse is teaching a group of clients who have diabetes about meal planning. Which of the following client statements indicates understanding?
"I will not eat fruit canned in syrup"
A nurse educator is teaching newly licensed nurses about safe medication administration. Which of the following statements indicates understanding?
"I will observe for adverse effects" "I will monitor for therapeutic effects" "I will refuse to give a medication if I believe it is unsafe"
During new employee orientation, a nurse is explaining how to prevent IV infections. Which of the following statements by an orientee indicates understanding of the preventative strategies?
"I will replace any IV catheter when I suspect contamination during insertion"
The nurse is reviewing instructions for a patient with type 2 diabetes who also takes insulin injections as part of the therapy. The nurse asks the patient, "What should you do if your fasting blood glucose is 47 mg/dL?" Which response by the patient reflects a correct understanding of insulin therapy?
"I will take an oral form of glucose."
The nurse is teaching a patient how to self-administer triptan injections for migraine headaches. Which statement by the patient indicates that he needs further teaching?
"I will take this medication regularly to prevent a migraine headache from occurring."
A 25-year-old woman is visiting the prenatal clinic and shares with the nurse her desire to go "natural" with her pregnancy. She shows the nurse a list of herbal remedies that she wants to buy so that she can "avoid taking any drugs." Which statement by the nurse is correct?
"It's important to remember that herbal remedies do not have proven safety ratings for pregnant women."
When given a scheduled morning medication, the patient states, "I haven't seen that pill before. Are you sure it's correct?" The nurse checks the medication administration record and verifies that it is listed. Which is the nurse's best response?
"Let me check on the order first before you take it."
A nurse is reviewing dietary recommendations with a group of clients at a health fair. Which of the following information should the nurse include?
"Make protein 10% to 35% of total calories each day"
A nurse is providing teaching to a client who has a prescription for pramlintide for type 1 diabetes mellitus. Which of the following should the nurse include in the teaching?
"Inject pramlintide just before a meal" "Discard open vials after 28 days"
The nurse is teaching a review class to nurses about diabetes mellitus. Which statement by the nurse is correct?
"Insulin therapy is possible during pregnancy if managed carefully."
A patient who has a history of coronary artery disease has been instructed to take one 81-mg aspirin tablet a day. The patient asks about the purpose of this aspirin. Which response by the nurse is correct?
"It will help to prevent clot formation."
A charge nurse is teaching a group of nurses about medication compatibility with TPN. Which of the following statements should the charge nurse make?
"Regular insulin can be added to the TPN solution"
A nurse is providing education for a client who has severe hypomagnesemia and is prescribed oral magnesium sulfate. Which of the following information should the nurse include in the teaching?
"Report diarrhea while taking this medication"
The patient is to receive oral guaifenesin (Mucinex) twice a day. Today, the nurse was busy and gave the medication 2 hours after the scheduled dose was due. What type of problem does this represent?
"Right time" problem
A pregnant patient who is at 32 weeks' gestation has a cold and calls the office to ask about taking an OTC medication that is rated as pregnancy category A. Which answer by the nurse is correct?
"Studies indicate that there is no risk to the human fetus, so it is okay to take this medication as directed if you need it."
A patient with type 2 diabetes has a new prescription for repaglinide. After 1 week, she calls the office to ask what to do, because she keeps missing meals. "I work right through lunch sometimes, and I'm not sure whether I need to take it. What do i need to do?" What is the nurse's best response?
"You need to try not to skip meals, but if that happens you will need to skip that dose"
When teaching a patient who is starting metformin (Glucophage), which instruction by the nurse is correct?
"Take the medication with food to reduce gastrointestinal (GI) effects."
A 75-year-old woman with type 2 diabetes has recently been placed on glipizide (Glucotrol), 10 mg daily. She asks the nurse when the best time would be to take this medication. What is the nurse's best response?
"Take this medication in the morning, 30 minutes before breakfast."
A nurse is preparing to administer digoxin to a client who states, "I don't want to take that medication. I do not want one more pill." Which of the following responses should the nurse make?
"Tell me your concerns about taking this medication"
When given an intravenous medication, the patient says to the nurse, "I usually take pills. Why does this medication have to be given in the arm?" What is the nurse's best answer?
"The action of the medication will begin sooner when given intravenously."
A nurse is caring for a client who has end-stage cancer and is receiving morphine. The client's family member asks why the provider prescribed methylnaltrexone. Which of the following responses should the nurse make?
"The medication will relieve constipation"
A nurse on the IV team is conducting an in-service education program about the complications of IV therapy. Which of the following statements by an attendee indicates an understanding of the manifestations of infiltration?
"The temperature around the IV site is cooler" "The IV dressing is damp" "The tissue around the venipuncture site is swollen"
The patient asks the nurse about the use of herbal and dietary supplements to treat arthritis pain. What is the appropriate response by the nurse?
"There is evidence that glucosamine sulfate with chondroitin does decrease joint stiffness and pain. Discuss this with your health care provider."
The patient has been taking an over-the-counter (OTC) acid-reducing drug because he has had "stomach problems" for several months. He tells the nurse that the medicine helps as long as he takes it, but once he stops it, the symptoms return. Which statement by the nurse is the best advice for this patient?
"Using this drug may relieve your symptoms, but it does not address the cause. You should be seen by your health care provider."
During a nursing assessment, which question by the nurse allows for greater clarification and additional discussion with the patient?
"What medications do you take?"
A 77-year-old man has been diagnosed with an upper respiratory tract infection, tells the nurse that he is allergic to penicillin. Which is the most appropriate response by the nurse?
"What type of reaction did you have when you took penicillin?"
The nurse is compiling a drug history for a patient. Which questions from the nurse will obtain the most information from the patient?
"When you have pain, what do you do to relieve it?" "Tell me about what happened when you had the allergic reaction to penicillin" "What herbal products or over-the-counter medications do you use?"
A patient arrives at the urgent care center complaining of leg pain after a fall when rock climbing. The x-rays show no broken bones, but he has a large bruise on his thigh. The patient says he drives a truck and does not want to take anything strong because he needs to stay awake. Which statement by the nurse is most appropriate?
"You can take acetaminophen, also known as Tylenol, for pain, but no more than 3000 mg per day."
A mother calls the clinic to ask what medications to give her 5-year-old child for a fever during a bout of chickenpox. the nurse's best response would be
"You can use children's dosages of acetaminophen or ibuprofen, but aspirin is not recommended"
When teaching a patient about insulin glargine, which statement by the nurse about this drug is correct?
"You cannot mix this insulin with regular insulin, you will have to take two injections."
A nurse in an outpatient clinic is teaching a client who is in the first trimester of pregnancy. Which of the following statements should the nurse make?
"Your provider can prescribe medication for nausea if you need it"
The nurse is preparing to transfuse a patient with a unit of packed red blood cells (PRBCs). Which intravenous solution is correct for use with the PRBC transfusion?
0.9% sodium chloride (NS)
Levothyroxine is available in 88-mcg tablet form. Convert this dose to milligram strength.
0.088 mg
The nurse is administering an intravenous dose of morphine sulfate to a 48-yo postoperative patient. The dose ordered is 3 mg every 3 hours as needed for pain. The medication is supplied in vials of 4 mg/mL. How much will be drawn into the syringe for this dose?
0.75 mL
A patient is to receive codeine, 40 mg subcutaneously, every 6 hours as needed for pain. The solution is available in a concentration of 30 mg/mL. Identify how many milliliters of codeine will be drawn up for this dose. (record answer to one decimal place)
1.3 mL
There is a new order for Naproxen (Naprosyn) 250 mg PO every 6 hours. The drug is available as an oral suspension that contains 125 mg/5 mL. Identify how many milliliters will the nurse administer for 1 dose of this medication.
10 mL
New drugs must go through extensive research and testing before approval for use in humans. The nurse knows that the average length of time a medication is researched before being prescribed for humans is how many years?
10 to 12
The peripheral parenteral nutrition bag that has been infusing into the patient is empty, and the nurse realizes that the next bag is not ready. The nurse should immediately hang which of these intravenous solutions until the new bag arrives?
10% dextrose in water
A 7-year-old child will be receiving amoxicillin (Amoxil) 80 mg/kg/day in two divided doses. The child weighs 55 pounds. The medication, once reconstituted, is available as an oral suspension of 50 mg/mL. Identify how many milliliters will the child receive per dose.
20 mL
The insulin order reads, "Check blood glucose levels before meals and at bedtime. For every 5 mg/dL over 150, give 1 unit of regular Humulin insulin, subcutaneously." The patient's blood glucose level at 11:30 ., before lunch, was 233 mg/dL. In units, identify how much insulin will the nurse give. _
20 units
The nurse is providing education to a patient for the prescription glipizide. The nurse explains this medication is more effective when administered at which time?
30 minutes before a meal
The order reads, "Give 1500 mL of normal saline over 12 hours. The tubing drop factor is 15 gtt/mL." The nurse will set the gravity drip infusion at how many drops per minute (gtt/min).
31 gtt/min
A patient will receive ibuprofen, 1200 mg/day, divided into three doses. A liquid form is ordered because the patient cannot swallow tablets. The oral suspension contains 100 mg per 5 mL? How many mg will the patient receive for each dose, and how many mL will the nurse administer for each dose?
400 mg/dose; 20 mL/dose
While assessing the patient, the nurse notes edema of the hands and feet at +3 from third spacing. The patient is having signs and symptoms of intravascular dehydration, and the total protein laboratory result is 4.6 g/dL. The nurse anticipates the health care provider will prescribe which IV solution for this patient?
5% albumin
A patient comes to the clinic complaining of elbow pain after an injury. He states that he has been taking two pain pills, eight times a day, for the past few days. The medication bottle contains acetaminophen, 325-mg tablets. Calculate how much medication he has been taking per day. Is this a safe dose of this medication?
5200 mg/day; no
Assuming the patient eats breakfast at 8:30 A.M., lunch at noon, and dinner at 6:00 P.M., he or she is at highest risk of hypoglycemia after an 8:00 A.M. dose of NPH insulin at what time?
5:00 P.M.
The total parenteral nutrition (TPN) order reads, "Infuse TPN #2 over 24 hours." Bag #2 of TPN contains 1800 mL. At what rate will the nurse set the infusion pump?
75 mL/hr
Several patients have standard orders for acetaminophen as needed for pain. While reviewing their histories and assessments, the nurse discovers that one of the patients has a contraindication to acetaminophen therapy. Which patient should receive an alternate medication?
A patient admitted with severe hepatitis
The nurse is reviewing medication errors. Which situation is an example of a medication error?
A patient receives a double dose of a medication because the nurse did not cut the pill in half.
A patient has been diagnosed with late-stage cancer. After consulting with his family, he tells the nurse, "I would like to try to live long enough to see my granddaughter graduate in 3 months, but after that I don't want any extra treatments." This patient is demonstrating which of these?
Autonomy
The nurse is assessing a patient for contraindications to drug therapy with acetaminophen (Tylenol). Which patient should not receive acetaminophen?
A patient with a history of liver disease
When monitoring the patient receiving an intravenous infusion to reduce blood pressure, the nurse notes that the patient's blood pressure is extremely low, and the patient is lethargic and difficult to awaken. This would be classified as which type of adverse drug reaction?
A pharmacologic reaction
During the development of a new drug, which would be included in the study by the researcher to prevent any bias or unrealistic expectations of the new drug's usefulness?
A placebo
The patient is complaining of a headache and asks the nurse which over-the-counter medication form would work the fastest to help reduce the pain. Which medication form will the nurse suggest?
A powder
During an admission assessment, the nurse discovers that the patient does not speak English. Which is considered the ideal resource for translation?
A translator who does not know the patient
A patient with type 2 diabetes will be receiving a nasogastric tube feeding for a few days. The nurse expects which type of formula to be used?
Glucerna
The nurse knows that the medication reconciliation process involves which steps? (Select all that apply.)
Reconciliation Verification Clarification
A patient is taking metformin for new-onset type 2 diabetes mellitus. When reviewing potential adverse effects, the nurse will include information about:
Abdominal bloating Nausea Diarrhea Metallic taste
A nurse is admitting a client to the hospital following acetaminophen toxicity. Which of the following medications should the nurse expect to administer to this client?
Acetylcysteine
While admitting a patient for treatment of an acetaminophen (Tylenol) overdose, the nurse prepares to administer which medication to prevent toxicity?
Acetylcysteine (Mucomyst)
A nurse is caring for a client who is receiving TPN through a central venous access device, but the bag of solution is not available for administration at this time. Which of the following is an appropriate action by the nurse?
Administer 20% dextrose in water IV until the next bag is available
A patient is recieving an opioid via a PCA pump as part of his postoperative pain management program. During rounds, the nurse finds him unresponsive, with respirations of 8 breaths/min and blood pressure of 102/58 mmHg. After stopping the opioid infusion, what should the nurse do next?
Administer an opiate antagonist per standing orders
A patient in the emergency department was sowing signs of hypoglycemia and had a fingerstick glucose level of 34 mg/dL. The patient has just become unconscious. What is the nurse's next action?
Administer intravenous glucose (50% dextrose).
When checking a patient's fingerstick blood glucose level, the nurse obtains a reading of 42 mg/dL. The patient is awake, but states he feels a big "cloudy-headed." After double-checking the patient's glucose level and getting the same reading, which action by the nurse is most appropriate?
Administer oral glucose in the form of a semisolid gel
The nurse is administering an IV solution that contains potassium chloride to a patient in the critical care unit who has a severely decreased serum potassium level. Which action(s) by the nurse are appropriate?
Administer the potassium at a rate no faster than 20 mEq/hr Monitor the patient's cardiac rhythm with a heart monitor. Use an infusion pump for the administration of IV potassium chloride.
A 57-year-old woman being treated for end-stage breast cancer has been using a transdermal opioid analgesic as part of the management of pain. Lately, she has been experiencing breakthrough pain. The nurse expects this type of pain to be managed by which of these interventions?
Administering an immediate-release opioid
A 78-year-old patient is in the recovery room after having a lengthy surgery on his hip. As he is gradually awakening, he requests pain medication. Within 10 minutes after receiving a dose of morphine sulfate, he is very lethargic and his respirations are shallow, with a rate of 7 per minute. The nurse prepares for which priority action at this time?
Administration of naloxone (Narcan)
Which statement best reflects the nurse's understanding of cultural influences on drug therapy and other health practices?
Administration of some drugs may elicit varied responses in specific racial/ethnic groups.
Which information would the nurse include in a teaching plan for patients taking oral hypoglycemic drugs? (Select all that apply.)
Advise to avoid smoking and alcohol consumption. Report symptoms of anorexia and fatigue.
When the nurse teaches a skill such as self-injection of insulin to the patient, what is the best way to set up the teaching/learning session?
After demonstrating the procedure, allow the patient to do several return demonstrations.
The nurse recognizes that it is not uncommon for an elderly patient to experience a reduction in the stomach's ability to produce hydrochloric acid. This change may result in which effect?
Altered absorption of weakly acidic drugs
The nurse understands that drugs exert their actions on the body by what process? (Select all that apply.)
Altering metabolic chemical processes Interacting with receptors Inhibiting the action of a specific enzyme
A patient is undergoing major surgery and asks the nurse about a living will. He states, "I don't want anybody else making decisions for me. And I don't want to prolong my life." The patient is demonstrating which ethical term?
Autonomy
A nurse is reviewing the health history of a client who has migraine headaches and is to begin prophylaxis therapy with propranolol. Which of the following findings in the client history should the nurse report to the provider?
An ECG indicates a first-degree heart block
A nurse is caring for a client who is taking oral oxycodone. The client is also taking ibuprofen in three recommended doses daily. The nurse should identify that an interaction between those two medications will cause which of the following findings?
An increase in the expected therapeutic effects of both medications
A patient wants to take the herb gingko to help his memory. The nurse reviews his current medication list and would be concerned about potential interactions if he is taking a medication from which class of drugs?
Anticoagulants
A patient with atrial fibrillation requests a cup of chamomile tea. The nurse denies the patient's request because of the medication the patient is taking. What is the medication?
Anticoagulants
A 75-year-old woman has been given a nonsteroidal anti-inflammatory drug (an NSAID for the treatment of rheumatoid arthritis). The nurse is reviewing the patient's medication history and notes that which types of medications could have an interaction with the NSAID?
Anticoagulants Diuretics Corticosteroids
When the nurse is reviewing a list of medications taken by an 88-year-old patient, the patient says, "I get dizzy when I stand up." She also states that she has nearly fainted "a time or two" in the afternoons. Her systolic blood pressure drops 15 points when she stands up. Which type of medication may be responsible for these effects?
Antihypertensives
The nurse is reviewing the therapeutic effects of nonsteroidal anti-inflammatory drugs (NSAIDs), which include which effect?
Antipyretic
The acetic acid derivative indomethacin has what properties? (Select all that apply.)
Antipyretic Antiinflammatory Antirheumatic
The nurse is writing a nursing diagnosis for a plan of care for a patient who has been newly diagnosed with type 2 diabetes. Which statement reflects the correct format for a nursing diagnosis?
Anxiety related to new drug therapy, as evidenced by statements such as "I'm upset about having to test my blood sugars."
What phase of the nursing process is completed to gather information prior to providing education about a new medication to a patient and the family members?
Assessment
Place the phases of the nursing process in the correct order, with 1 as the first phase and 5 as the last phase.
Assessment Nursing diagnosis Planning Implementation Evaluation
A 60-year-old patient is on several new medications and expresses worry that she will forget to take her pills. Which action by the nurse would be most helpful in this situation?
Assisting the patient with obtaining and learning to use a calendar or pill container
When reviewing the various schedules of controlled drugs, the nurse knows that which description correctly describes Schedule II drugs?
Drugs with high potential for abuse that have accepted medical use
The nurse keeps in mind that which measures are used to reduce the risk of medication errors?
Avoid abbreviations and acronyms Use two patient identifiers before giving medications Always double-check the many drugs that sound-alike and look-alike names because of the high risk for errors
When teaching a patient about potential adverse effects of NSAID therapy, the nurse will teach the patient to immediately notify the health care provider of what effect?
Black tarry stools
What action by the nurse is the best way to assess a patient's learning needs?
Begin with validation of the patient's present level of knowledge
A nurse is preparing to adminiser 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?
Butophanol can cause abstinence syndrome in opioid-dependent clients
The nurse is caring for a patient who has peripheral edema and is hypotensive after receiving 5000 mL of normal saline intravenous (IV). The nurse anticipates administering which IV solution to correct the fluid imbalance?
Hetastarch
The nurse is reviewing the four clinical phases of investigational drug studies. Place the four phases in the correct order of occurrence.a. Studies that are voluntarily conducted by pharmaceutical companies to obtain more information about the therapeutic and adverse effects of a drug.b. Studies that involve small numbers of volunteers who have the disease or ailment that the drug is designed to diagnose or treat.c. Studies that involve small numbers of healthy subjects who do not have the disease or ailment that the drug is intended to treat.d. Studies that involve large numbers of patients who have the disease that the drug is intended to treat; these studies establish the drug's clinical effectiveness, safety, and dosage range.
C, B, D, A
The nurse is giving medications to a newly admitted patient who is to receive NPO and finds an order written as follows: "Digoxin, 250 mcg stat." Which action is appropriate?
Clarify the order with the prescriber before giving the drug
The nurse is reviewing interactions between drugs and herbal products. Which of these herbal products may interact with anticoagulants, resulting in altered bleeding?
Chamomile Gingko Garlic
The nurse is monitoring a patient who is receiving a total parenteral nutrition (TPN) infusion and notes that the patient has cold clammy skin, shows tachycardia, and is complaining of feeling dizzy. What is the immediate action of the nurse?
Check the patient's blood glucose level
A nurse is working with a newly licensed nurse who is administering medications to clients. Which of the following actions should the nurse identify as an indication that the newly hired nurse understands medication error prevention?
Checking the prescription when a single dose requires administration of multiple tablets
The nurse is administering medications. Examples of high-alert medications include:
Chemotherapeutic drugs Opiates Antithrombotics Potassium chloride for injection
A patient was diagnosed with pancreatic cancer last month, and has complained of a dull ache in the abdomen for the past 4 months. This pain has been gradually increasing, and the pain relievers taken at home are no longer effective. What type of pain is the patient experiencing?
Chronic pain
Vicodin (acetaminophen/hydrocodone) is prescribed for a patient who has had surgery. The nurse informs the patient that which common adverse effects can occur with this medication?
Constipation Lightheadedness Urinary retention Itching
A patient who has type 2 diabetes is scheduled for an oral endoscopy and has been NPO (nothing by mouth) since midnight. What is the best action by the nurse regarding the administration of her oral antidiabetic drugs?
Contact the prescriber for further orders.
During a period of time when the computerized medication order system was down, the prescriber wrote admission orders, and the nurse is transcribing them. The nurse is having difficulty transcribing one order because of the prescriber's handwriting. Which is the best action for the nurse to take at this time?
Contact the prescriber to clarify the order.
The medication order reads, "Give ondansetron (Zofran) 4 mg, 30 minutes before beginning chemotherapy to prevent nausea." The nurse notes that the route is missing from the order. What is the nurse's best action?
Contact the prescriber to clarify the route of the medication ordered.
Which are appropriate considerations when the nurse is assessing the learning needs of a patient?
Cultural background Level of education Readiness to learn Health beliefs
A patient is recovering from abdominal surgery, which he had this morning. He is groggy but complaining of severe pain around his incision. What is the most important assessment data to consider before the nurse administers a dose of morphine sulfate to the patient?
His respiratory rate
An opioid analgesic is prescribed for a patient. The nurse checks the patient's medical history knowing this medication is contraindicated in which disorders?
Severe asthma Sleep apnea Severe head injury
A patient who has a new diagnosis of type 2 diabetes asks the nurse about a new insulin that can be inhaled. "Is there a reason I can't take that drug?" Which conditions if present in the patient would be a concern?
History of smoking Chronic lung disease
A nurse is reviewing the medical record of a client who has hypocalcemia. The nurse should identify which of the following findings as a risk factor for the development of this electrolyte imbalance?
Crohn's disease
When administering morning medications for a newly admitted patient, the nurse notes that the patient has an allergy to sulfa drugs. There is an order for the sulfonylurea glipizide (Glucotrol). Which action by the nurse is correct?
Hold the drug, and check the order with the prescriber.
Knowing that the albumin in neonates and infants has a lower binding capacity for medications, the nurse anticipates the health care provider will perform which action to minimize the risk of toxicity?
Decrease the amount of drug given.
While teaching a 76-year-old patient about the adverse effects of his medications, the nurse encourages him to keep a journal of the adverse effects he experiences. This intervention is important for the older adult patient because of which alterations in pharmacokinetics?
Decreased blood flow to the liver, resulting in altered metabolism
Which nursing diagnosis is appropriate for the patient who has just received a prescription for a new medication?
Deficient knowledge related to newly prescribed drug therapy
A nurse is planning care for a client who has brain cancer and is experiencing headaches. Which of the following adjuvant medications are indicated for this client?
Dexamethasone
A nurse is assessing a client who has hypoglycemia. Which of the following findings should the nurse expect?
Diaphoresis
When preparing an adult nutrition supplementation to add to formula for a gastrostomy tube feeding, the nurse is aware to observe for what adverse effect?
Diarrhea
A nurse is reviewing the medication administration record for a client who is receiving transdermal fentanyl for severe pain. The nurse should identify that which of the following medications can cause an adverse effect when administered concurrently with fentanyl?
Diazepam
Which entity regulates medicinal herbs?
Dietary Supplement Health and Education Act of 1994 (DSHEA)
What is an adverse effect must be assessed for when providing nutritional supplements to an infant?
Digestive intolerance
The nurse is reviewing a list of verbal medication orders. Which is the proper notation of the dose of the drug ordered?
Digoxin 0.125 mg
The nurse is reviewing medication orders. Which digoxin dose is written correctly?
Digoxin 0.25 mg
The nurse is giving medications to a patient in heart failure. The IV route is chosen instead of the IM route. What physical function does the nurse recognize as the most influential when deciding to use the IV route of drug administration?
Diminished circulation
Elemental formulations are used for patients with conditions in which minimum digestion is needed. What substances are in elemental formulations? (Select all that apply.)
Dipeptides Tripeptides Crystalline amino acids
Which drugs would be affected by the first-pass effect?
Diphenhydramine/Benadryl elixir Levothyroxine/Synthroid tablets Esomeprazole/Nexium capsules
A nurse is collecting data from a client who is receiving IV therapy and reports pain in the arm, chills, and "not feeling well." The nurse notes warmth, edema, induration, and red streaking on the client's arm close to the IV insertion site. Which of the following actions should the nurse plan to take first?
Discontinue the infusion
During a blood transfusion, the patient begins to have chills and back pain. What is the nurse's priority action?
Discontinue the infusion immediately, and notify the prescriber.
A patient is to receive acetylcysteine (Mucomyst) as part of the treatment for an acetaminophen (Tylenol) overdose. Which action by the nurse is appropriate when giving this medication?
Disguising the flavor with soda or flavored water
An older adult patient needs to receive an enteral supplement to improve her overall nutritional status. When considering enteral supplements, the nurse notes that which formulation provides complex nutrients?
Ensure Plus
The nurse is instructing an older adult patient on how to use his walker. Which education strategies are appropriate?
Ensure a quiet environment for learning Repeat information frequently Allow for an increased number of return demonstrations
In which step of the nursing process does the nurse determine the outcome of medication administration?
Evaluation
The nurse has been monitoring the patient's progress on a new drug regimen since the first dose and documenting the patient's therapeutic response to the medication. Which phase of the nursing process do these actions illustrate?
Evaluation
The nurse teaches a patient prescribed the fentanyl (Duragesic) transdermal delivery system to change the patch at what interval?
Every 72 hours
A nurse is planning care for a client who has a new prescription for PPN. Which of the following actions should the nurse include in the plan of care?
Examine trends in weight loss Review prealbumin finding Add a micron filter to IV tubing Use an IV infusion pump
Patients with renal failure would most likely have problems with which pharmacokinetic process?
Excretion
A patient with type 2 diabetes is scheduled for MRI with contrast dye. The nurse reviews the orders and notices the patient is receiving Metformin/Glucophage. Which action by the nurse is appropriate?
Expect to hold the metformin the day of the test and for 48 hours after the test is performed
When monitoring a patient's response to oral antidiabetic drugs, the nurse knows that which laboratory result would indicate a therapeutic response?
Fasting blood glucose level between 92 mg/dL
An 83-year-old woman has been given a thiazide diuretic to treat mild heart failure. She and her daughter should be told to watch for which problems?
Fatigue, leg cramps, and dehydration
When caring for a pregnant patient with gestational diabetes, the nurse would question a prescription for which drug?
Glipizide
The nurse will instruct the patient to treat hypoglycemia with which drug?
Glucagon
The nurse is teaching a pregnant patient about the effects of medication on fetal development. The nurse understands the greatest risk for negative effects from medications on a developing fetus occurs during which time period?
First trimester
A patient has been receiving total parenteral nutrition. Upon assessment, the nurse notes these assessment findings: blood pressure 150/92 mm Hg (elevated from previous readings); pulse rate 110 beats/min and weak; pitting edema on both ankles; and new-onset confusion. The nurse suspects that the patient is experiencing which condition?
Fluid overload
While monitoring a patient who is receiving an infusion of a crystalloid solution, the nurse will monitor for which potential problem?
Fluid overload
During an infusion of albumin, the nurse monitors the patient closely for the development of which adverse effect?
Fluid volume overload
Which action by the nurse is most appropriate for the patient receiving an infusion of packed red blood cells?
Flush the IV line with normal saline before the blood is added to the infusion
A nurse is caring for a client who has an activated 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
The nurse is preparing an infusion for a patient who has a deficiency in clotting factors. Which type of infusion is most appropriate?
Fresh frozen plasma
The nurse is caring for a patient with renal insufficiency and thrombocytopenia. Along with platelet transfusions, the nurse would expect to administer which blood product to increase deficient clotting factors in this patient?
Fresh-frozen plasma
Which is the most appropriate timing regarding the nurse's administration of a rapid-acting insulin to a hospitalized patient?
Give it 15 minutes before the patient begins a meal
Which action is most appropriate regarding the nurse's administration of a rapid-acting insulin to a hospitalized patient?
Give it within 15 minutes of mealtime.
The nurse is trying to give a liquid medication to a -year-old child and notes that the medication has a strong taste. Which technique is the best way for the nurse to give the medication to this child?
Give the medication with a spoonful of ice cream.
A nurse is reviewing the laboratory test results for a client who has an elevated temperature. The nurse should identify which of the following findings is a manifestation of dehydration?
Hct 55% Blood sodium 150 mEq/L Urine specific gravity 1.035
When assessing a patient who is about to receive an albumin infusion, which of these conditions must a nurse recognize as a possible contraindication to albumin infusion?
Heart failure Renal insufficiency
After starting treatment for type 2 diabetes mellitus 6 months earlier, a patient is in the office for a follow-up examination. The nurse will monitor which laboratory test to evaluate the patient's adherence to the antidiabetic therapy over the past few months?
Hemoglobin A1C level
The nurse monitoring a patient for a therapeutic response to oral diabetes drugs will look for which of these?
Hemoglobin A1C levels less than 7%
A 38-year-old man has come into the urgent care center with severe hip pain after falling from a ladder at work. He says he has taken several pain pills over the past few hours but cannot remember how many he has taken. He hands the nurse an empty bottle of acetaminophen (Tylenol). The nurse is aware that the most serious toxic effect of acute acetaminophen overdose is which condition?
Hepatic necrosis
A patient will be discharged with a 1-week supply of an opioid analgesic for pain management after abdominal surgery. The nurse will include which information in the teaching plan?
How to prevent constipation
A mother brings her toddler into the emergency department and tells the nurse that she thinks the toddler has eaten an entire bottle of chewable aspirin tablets. The nurse will assess for which most common signs of salicylate intoxication in children?
Hyperventilation and drowsiness
A patient is taking a sulfonylurea medication for new-onset type 2 diabetes mellitus. When reviewing potential adverse effects during patient teaching, the nurse will include information about which of these effects?
Hypoglycemia Nausea Weight gain
To achieve the most rapid onset of action, the health care provider will prescribe the medication to be administered by which route?
IV
A nurse is providing teaching to a client who is experiencing migraine headaches. Which of the following instructions should the nurse provide?
Identify and avoid triggers Lie down in a dark quiet room at the onset of a migraine Avoid foods that contain tyramine
The nurse is reviewing dietary supplements and US Food and Drug Administration (FDA) requirements. Which of these actions are required by the FDA for manufacturers of dietary supplements?
Identify the active ingredients on the label.
A nurse in an outpatient surgical center is admitting a client for a laparoscopic procedure. The client has a prescription for preoperative diazepam. Prior to administering the medication, which of the following actions is the nurse's priority?
Identifying the client's medication allergies
The nurse is teaching a 16-year-old patient who has a new diagnosis of type 1 diabetes about blood glucose monitoring and the importance of regulating glucose intake. When developing a teaching plan for this teenager, which of Erikson's stages of development should the nurse consider?
Identity versus role confusion
An elderly woman took a prescription medicine to help her to sleep ;however, she felt restless all night and did not sleep at all. The nurse recognizes that this woman has experienced which type of reaction/effect?
Idiosyncratic reaction
The nurse administered a sleeping pill to an elderly patient at bedtime. Two hours later, the patient was irritable, restless, and unable to sleep. The nurse describes the patient's response as which type of reaction?
Idiosyncratic reaction
A client in a a provider's office tells the nurse that "I fast for several days each week to control my weight." The client takes several medications for various chronic issues. The nurse should explain to the client that which of the following mechanisms that result from fasting put her at risk for medication toxicity?
Increasing the protein-binding response
A patient is prescribed an opioid analgesic for chronic pain. Which information would the nurse discuss with the patient to minimize the GI adverse effects?
Increase fluid intake and fiber in the diet.
When administering two medications that are highly protein bound, the nurse understands to monitor the patient carefully for which effect?
Increase in the risk of drug-drug interactions
A nurse is reviewing a client's medications. They include cimetidine and imipramine. Knowing that cimetidine decreases the metabolism of imipramine, the nurse should identify that this combination is likely to result in which of the following effects?
Increased risk of imipramine toxicity
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?
Infants have immature liver function Infants blood-brain barrier is poorly developed Infants have an increased ability to absorb topical medication
A nurse is planning care for a client who has hypernatremia. Which of the following actions should the nurse include in the plan of care?
Infuse hypotonic IV fluids
The nurse is reviewing the concept of drug polymorphism. Which factors contribute to drug polymorphism?
Inherited factors The patient's diet and nutritional status The patient's health beliefs and practices
Which actions describe the beneficial effects produced by sulfonylurea oral hypoglycemics? (Select all that apply.)
Inhibit breakdown of insulin by liver Enhance action of insulin in various tissues Stimulate insulin secretion from beta cells
What is the mechanism of action of nonsteroidal antiinflammatory drugs (NSAIDs)?
Inhibiting prostaglandin production
A nurse receives a laboratory report for a client indicating a potassium level of 5.2 mEq/L. When notifying the provider, the nurse should expect which of the following actions?
Initiating continuous cardiac monitoring
A patient shows the nurse an article in the newspaper about a new black box warning and states, "I take this drug! Is it safe for me to take now?" Which of these statements about black box warnings is true?
It can still be prescribed as long as the prescriber and patient are aware of the potential risks
The nurse is assessing an enteral feeding that is infusing via a nasogastric feeding tube. Which statement about this tube is accurate?
It is inserted through the nose into the stomach.
A patient calls the clinic to ask about taking cranberry dietary supplement capsules because a friend recommended them. The nurse will discuss which possible concern when a patient is taking cranberry supplements?
It may reduce elimination of drugs that are excreted by the kidneys.
The nurse is caring for a patient with opioid addiction. The nurse anticipates that the patient will be prescribed which medication?
Methadone (Dolophine)
During diuretic therapy, the nurse monitors the fluid and electrolyte status of the patient. Which assessment findings are symptoms of hyponatremia?
Lethargy Hypotension Stomach cramps
A patient who takes ginseng to improve memory takes many prescription drugs as well. Which laboratory parameter should the nurse check before administering medication as a means of assessing the pharmacokinetic effect of ginseng in this patient?
Liver enzymes
A nurse educator is reviewing medication metabolism at an in-service presentation. Which of the following factors should the educator include as a reason to administer lower medication dosages?
Liver failure Concurrent use of medication the same pathway metabolizes
A nurse is caring for a client 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
What is an advantage of COX-2 inhibitors over other NSAIDs?
Maintain GI mucosa
When caring for a patient with a serum potassium of 2.8 mEq/L, what is the appropriate nursing intervention when giving IV replacement therapy?
Maintain infusion rate at no greater than 20 mEq/hr.
A patient who has hypertension is now taking a daily beta blocker. Which term best describes this type of therapy?
Maintenance therapy
The patient is asking the nurse about current U.S. laws and regulations of herbal products. According to the Dietary Supplement and Health Education Act of 1994, which statement is true?
Medicinal herbs are viewed as dietary supplements.
The nurse is caring for a patient with cirrhosis or hepatitis, and recognizes that abnormalities in which phase of pharmocokinetics may occur in this patient?
Metabolism
What is another term for biotransformation of a drug?
Metabolism
The nurse is preparing a patient for a computed tomography scan using iodine contrast media. What medication would the nurse question if prescribed 1 day before the scheduled procedure?
Metformin
A patient with renal cancer needs an opiate for pain control. Which opioid medication would be the safest choice for this patient?
Methadone
When teaching a patient about the legalities regarding a prescription for methylphenidate (Ritalin), which statement is most accurate?
Methylphenidate (Ritalin) is a C-II controlled substance that cannot be refilled automatically and can only be filled with a written prescription every month.
The nurse is reviewing herbal therapies. Which is a common use of the herb feverfew?
Migraine headaches
When discussing dosage calculation for pediatric patients with a clinical pharmacist, the nurse notes that which type of dosage calculation is used most commonly in pediatric calculations?
Milligram per kilogram of body weight formula
What are nursing responsibilities associated with the care of a patient receiving total parenteral nutrition (TPN)? (Select all that apply.)
Monitoring capillary serum glucose every 6 hours Maintaining sterile asepsis when handling the site or solution
A patient with bone pain caused by metastatic cancer will be receiving transdermal fentanyl patches. The patient asks the nurse what benefits these patches have. The nurse's best response includes which of these features?
More constant drug levels for analgesic
A patient needs to switch analgesic drugs secondary to an adverse reaction to the current treatment regimen. The patient is concerned that the new prescription will not provide optimal pain control. The nurse's response is based on knowledge that doses of analgesics are determined using an equianalgesic table with which drug prototype?
Morphine
A nurse is caring for a client who is 1 day postoperative and reports a pain level of 10 on a scale of 0 to 10. After reviewing the client's medication administration record, which of the following medications should the nurse administer?
Morphine 2 mg IV
A nurse prepares an injection of morphine to administer to a client who reports pain, then asks a second nurse to give the injection because another assigned client needs to use a bedpan. Which of the following actions should the second nurse take?
Offer to assist the client who needs the bedpan
For which cultural group must the health care provider respect the value placed on preserving harmony with nature and the belief that disease is a result of ill spirits?
Native Americans
A nurse is caring for a client who has cancer and is taking morphine and carbamazepine for pain. Which of the following effects should the nurse monitor for when giving the medications together?
Need for reduced dosage of the opioid Reduced adverse effects of the opioid Increased analgesic effects
An 18-year-old basketball player fell and twisted his ankle during a game. The nurse will expect to administer which type of analgesic?
Nonopioid analgesic, such as indomethacin (Indocin)
The nurse administers a medication to the wrong patient. Which is the appropriate nursing action following this error?
Notify the health care provider and document a medication error incident report.
During a busy night shift, a new nurse administered an unfamiliar medication without checking it in a drug handbook. Later that day, the patient had a severe reaction because he has renal problems, which was a contraindication to that drug. The nurse may be liable for which of these?
Nursing negligence
When evaluating polymorphism and medication administration, the nurse considers which factors?
Nutritional status Genetic factors Cultural beliefs Patient's age
The nurse is preparing to give an injection to a 4-year-old child. Which intervention is age appropriate for this child?
Offer a brief, concrete explanation of the procedure at the patient's level and with the parent or caregiver present.
A nurse is caring for a client who has diabetes mellitus and reports feeling shaky and weak. The client's blood glucose is 53 mg/dL. Which of the following actions should the nurse take?
Offer the client 120 mL/4 oz fruit juice
When planning care for an assigned patient, the nurse identifies the outcome of "Patient will be able to safely self-administer enoxaparin (Lovenox) subcutaneously upon discharge." Which method is best for the nurse to use in evaluating the patient's achievement of this outcome?
Observe the patient's return demonstration of the administration procedure.
A nurse reviewing a client's medical record notes a new prescription for verifying the trough level of the client's medication. Which of the following actions should the nurse take?
Obtain a blood specimen immediately prior to administering the next dose of medication
Which technique would be most appropriate to use when the nurse is teaching a patient with a language barrier?
Obtain an interpreter who can speak in the patient's native tounge for teaching sessions
A nurse is preparing to transfuse a unit of packed red blood cells to a client who has severe anemia. Which of the following interventions can prevent an acute hemolytic reaction?
Obtain help from another nurse to confirm the correct client and blood product
A provider prescribes phenobarbital for a client 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?
Once
If a student nurse realizes that he/she has made a drug error, the instructor should remind the student of which concept?
Once the student has committed a medication error, his/her responsibility is to the patient and to being honest and accountable
The nurse is preparing to administer insulin intravenously. Which statement about the administration of intravenous insulin is true?
Only regular insulin can be administered intravenously.
A patient has been treated for lung cancer for 3 years. Over the past few months, the patient has noticed that the opioid analgesic is not helping as much as it had previously and more medication is needed for the same pain relief. The nurse is aware that this patient is experiencing which of these?
Opioid tolerance
A drug given by which route is altered by the first-pass effect?
Oral
A patient is in an urgent care center and is receiving treatment for mild hyponatremia after spending several hours doing gardening work in the heat of the day. The nurse expects that which drug therapy will be used to treat this condition?
Oral administration of sodium chloride tablets
For accurate medication administration to pediatric patients, the nurse must take into account which criteria?
Organ maturity
A nurse is administering amitriptyline to a client who is experiencing cancer pain. For which of the following adverse effects should the nurse monitor?
Orthostatic hypotension
A patient who is severely anemic also has acute heart failure with severe edema due to fluid overload. The prescriber wants to raise the patient's hemoglobin and hematocrit levels. The nurse anticipates that the patient will receive which blood product?
Packed red blood cells (PRBCs)
A patient is receiving gabapentin (Neurontin), an anticonvulsant, but has no history of seizures. The nurse expects that the patient is receiving this drug for which condition?
Pain associated with peripheral neuropathy
The nurse plans pharmacologic management for a patient with pain. The nurse would administer the pain medication based on what dosage schedule?
Pain relief is best obtained by administering analgesics around the clock.
The nurse is administering parenteral drugs. Which statement is true regarding parenteral drugs?
Parenteral drugs bypass the first-pass effect.
Which of the following would indicate a need for further patient teaching by the nurse related to medication therapy?
Patient is unable to verbalize reason for taking the medication.
A woman has been receiving both radiation and chemotherapy for her cancer. Lately, she has developed anorexia caused by the treatments, so she needs short-term nutrition supplementation. The nurse anticipates that the physician will initiate which therapy?
Peripheral parenteral nutrition
What is the study of physiochemical properties of drugs and how they influence the body called?
Pharmacodynamics
A new drug has been approved for use, and the drug manufacturer has made it available for sale. During the first 6 months, the FDA receives reports of severe adverse effects that were not discovered during the testing and considers withdrawing the drug. This illustrates which phase of investigational drug studies?
Phase IV
A pharmaceutical company is voluntarily conducting a postmarketing study to obtain further data to support the therapeutic effects of a new drug. What phase of drug study is this considered?
Phase IV
The nurse is preparing to administer medications to a patient who is receiving a feeding via a gastric tube. When reviewing the patient's medication list, the nurse notes a potential concern about a food-drug interaction if which medication is listed?
Phenytoin (Dilantin)
When monitoring a patient who has been receiving peripheral parenteral nutrition for more than 3 weeks, the nurse will watch for which potential complication?
Phlebitis
A patient has a new prescription for a blood pressure medication that may cause him to feel dizzy during the first dew days of therapy. Which is the best human needs statement for this situation?
Physical safety
To promote adherence with medication self-administration, a nurse is making recommendations for an older adult client. Which of the following instructions should the nurse include?
Place pills in daily pill holders Ask for liquid forms if the client has difficulty swallowing pills Ask a relative to assist periodically
The nurse is assessing a patient's culture and race on admission to the hospital. Which concept is important for the nurse to understand regarding drug therapy as it relates to different races of individuals?
Polymorphism
A nurse is providing teaching to a client who has migraine headaches and a new prescription for ergotamine. For which of the following manifestations indicating a possible adverse reaction should the nurse instruct the client to stop taking the medication and notify the provider?
Positive home pregnancy test Numbness and tingling in the fingers Muscle pain
Pramlintide is prescribed as supplemental drug therapy to the treatment plan for a patient with type 1 diabetes mellitus. What information would the nurse include when teaching the patient about the action of this medication?
Pramlintide slows gastric emptying.
In which step of the medication process can a medication error occur? (Select all that apply.)
Prescribing Transcribing Administration Procurement
The nurse is providing discharge teaching to an older patient with short-term memory problems. Which strategies will the nurse use in educating the patient? (Select all that apply.)
Provide written instructions for home use. Perform several short teaching-learning sessions. Repeat information frequently. Encourage use of daily medication containers with alarms.
The nurse is educating a patient with newly diagnosed type 1 diabetes mellitus. When the nurse has the patient demonstrate self-injection of insulin, which domain of learning is the nurse assessing?
Psychomotor domain
During the night shift, a patient's total parenteral nutrition (TPN) infusion ran out, and the nurse discovered that there was no TPN solution on hand to continue the infusion. The pharmacy is closed and will not reopen for 5 hours. The nurse will have to implement measures to prevent which consequence of abruptly discontinuing TPN infusions?
Rebound hypoglycemia
The nurse is reviewing the various forms of topical medications. Which of these are considered topical medications?
Rectal ointment for hemorrhoids Eye drops for inflammation Inhaled medication for asthma
A nurse on a medical-surgical unit administers a hypotonic 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
Which insulin can be administered by continuous intravenous (IV) infusion?
Regular insulin
During assessment of a patient with osteoarthritis pain, the nurse knows that which condition is a contraindication to the use of nonsteroidal anti-inflammatory drugs (NSAIDs)?
Renal disease
When reviewing the health history of a patient, the nurse will note that a potential contraindication to potassium supplements exists if the patient has which problem?
Renal disease
While the nurse is providing care to a patient, the health care provider prescribes an IV potassium chloride infusion. For which condition would this prescription be given?
Renal failure
A patient tells the nurse that he has been using an herbal supplement that contains kava for several years to help him to relax in the evening. However, the nurse notes that he has a yellow tinge to his skin and sclera, and is concerned about liver toxicity. The nurse advises the patient to stop taking the kava and to see his health care provider for an examination. What else, if anything, should the nurse do at this time?
Report this incident to MedWatch.
The nurse is assessing a patient who has been admitted to the emergency department for a possible opioid overdose. Which assessment finding is characteristic of an opioid drug overdose?
Respiration rate of 6 breaths/min
A nurse in an emergency department is performing an admission assessment for a client who has severe aspirin toxicity. Which of the following findings should the nurse expect?
Respiratory depression
A nurse is preparing to administer lipid emulsion and notes a layer of fat floating in the IV solution bag. Which of the following actions should the nurse take?
Return the bag to the pharmacy
The nurse plans care for a male patient who is 80 years old. The nursing diagnosis is noncompliance with the medication regimen related to living alone, as evidenced by uncontrolled blood pressure. What should the nurse do next?
Set up a home care nurse for pharmacotherapy.
When giving medications, the nurse will follow the rights of medication administration, which include what rights?
Right drug Right route Right dose Right time Right patient Right documentation
The nurse is aware that confusion, forgetfulness, and increased risk for falls are common responses in an elderly patient who is taking which type of drug?
Sedatives
The patient wants to take the herb valerian to help him rest at night. The nurse would be concerned about potential interactions if he is taking a medication from which class of drugs?
Sedatives
A nurse is preparing to inject heparin subcutaneously for a client who is postoperative. Which of the following actions should the nurse take?
Select a site on the client's abdomen
The nurse is preparing to give a potassium supplement. Which laboratory test should be checked before the patient receives a dose of potassium?
Serum potassium level
When preparing an IV solution that contains potassium, which of these conditions must a nurse recognize as a contraindication to the potassium infusion?
Serum sodium level of 145 mEq/L; Serum potassium level of 5.6 mEq/L
A patient of Japanese descent describes a family trait that manifests frequently: She says that members of her family often have "strong reactions" after taking certain medications, but her white friends have no problems with the same dosages of the same drugs. The nurse recognizes that, because of this trait, which statement applies?
She may need lower dosages of the medications prescribed
The nurse is reviewing new medication orders that have been written for a newly admitted patient. The nurse will need to clarify which orders?
Sitagliptin (Januvia) 50 mg daily Docusate (Colace) as needed for constipation
A patient is about to receive a dose of the nonprotein plasma expander, dextran. The nurse knows that this product is indicated for which type of blood loss?
Slow loss of 20% to 50%
A nurse is providing teaching for a client who has a new prescription for metformin. Which of the following findings should the nurse instruct the client to report as an adverse effect of metformin?
Somnolence
A male patient who abuses alcohol tells the nurse that he is treating himself with kava. Which instruction should the nurse include in patient teaching?
Stop taking the kava now.
A patient receiving an IV infusion of one unit of packed red blood cells suddenly develops shortness of breath, chills, and is feeling hot. What is the nurse's priority action?
Stop the blood transfusion.
A nurse is assessing the IV catheter insertion site for a client receiving a nonvesicant solution and notes swelling at the site with decreased skin temperature. Which of the following actions should the nurse take?
Stop the infusion Apply warm compresses to the insertion site Elevate the client's arm
A nurse is transfusing a unit of packed red blood cells to a client who has anemia due to chemotherapy. The client reports a sudden headache and chills. The client's temperature is s degrees higher than baseline reading. In addition to notifying the provider, which of the following actions should the nurse take?
Stop the transfusion Remove the blood bag and tubing from the IV catheter Obtain a urine specimen
The nurse will be injecting a drug into the fatty tissue of the patient's abdomen. Which route does this describe?
Subcutaneous
A nurse is performing an admission assessment on a client who has hypovolemia due to vomiting and diarrhea. The nurse should expect which of the following findings?
Tachycardia Syncope Decreased skin turgor
A nurse is teaching a client who is lactating about taking medications. Which of the following actions should the nurse recommend to minimize in the entry of medication in the breast milk?
Take each dose right after breastfeeding
A nurse is teaching a client who has a new prescription for oxybutynin about managing the medication's anticholinergic effects. Which of the following instructions should the nurse include?
Take sips of water frequently Wear sunglasses when outdoors in sunlight Urinate prior to taking the medication
A patient has a new prescription for sumatriptan (Imitrex). The nurse providing patient teaching on self-administration will include which information?
Take the medication before the headache worsens
When educating patients about the safe use of herbal products, the nurse remembers to include which concept?
Take the products with caution because labels may not contain reliable information.
A nurse is preparing a client's medications. Which of the following actions should the nurse take in following legal practice guidelines?
Teach the client about the medication Monitor for adverse effects Lock compartments for controlled substances
A nursing student is identifying situations that involve the psychomotor domain of learning as part of a class project. Which are examples of learning activities that involve the psychomotor domain?
Teaching a patient how to self-administer eye drops Teaching a patient how to measure the pulse before taking a beta blocker Teaching a family member how to give an injection
A patient with a history of chronic obstructive pulmonary disease (COPD) and type 2 diabetes has been treated for pneumonia for the past week. The patient has been receiving intravenous corticosteroids as well as antibiotics as part of his therapy. At this time, the pneumonia has resolved, but when monitoring the blood glucose levels, the nurse notices that the level is still elevated. What is the best explanation for this elevation?
The corticosteroids may cause an increase in glucose levels.
When administering a new medication to a patient, the nurse reads that it is highly protein bound. Assuming that the patient's albumin levels are normal, the nurse would expect which result, as compared to a medication that is not highly protein bound?
The duration of action of the medication will be longer.
Which statements are true regarding the elderly and pharmacokinetics?
The levels of microsomal enzymes are decreased Fat content is increased because of decreased lean body mass The number of intact nephrons is decreased Gastric pH is less acidic
Which statements are true regarding pediatric patients and pharmacokinetics?
The levels of microsomal enzymes are decreased. Perfusion to the kidneys may be decreased and may result in reduced renal function First-pass elimination is reduced because of the immaturity of the liver. Gastric emptying is slowed because of slow or irregular peristalsis.
A patient's medical record includes an order that reads as follows: "Atenolol 25 mg once daily at 0900." Which action by the nurse is correct?
The nurse contacts the prescribed to clarify the dosage route
The nurse is assessing an elderly Hispanic woman who is being treated for hypertension. During the assessment, what is important for the nurse to remember about cultural aspects?
The nurse's assessment needs to include gathering information regarding religious practices and beliefs regarding medication, treatment, and healing.
An 86-year-old patient is being discharged to home on drug therapy for hyperthyroidism and has very little information regarding the medication. Which statement best reflects a realistic outcome of patient teaching activities?
The patient and patient's daughter will state the proper way to take the drug
A patient is being counseled for possible participation in a clinical trial for a new medication. After the patient meets with the physician, the nurse is asked to obtain the patient's signature on the consent forms. The nurse knows that this "informed consent" indicates which of the following?
The patient has been informed of all potential hazards and benefits of the therapy
Which statement is an example of objective data? (Select all that apply.)
The patient has clear urine noted by microscopic examination. The patient has had a fever for 5 days.
During discharge patient teaching, the nurse reviews prescriptions with a patient. Which statement is correct about refills for an analgesic that is classified as Schedule C-III?
The patient may have no more than five refills in a 6-month period.
The nurse is performing an assessment of a newly admitted patient. Which is an example of subjective data?
The patient reports that he uses the herbal product ginkgo.
The nurse is performing an admission assessment. Which findings reflect components of a cultural assessment?
The patient uses aspirin as needed for pain The patient uses herbal tea to relax in the evenings The patient does not speak english The patient does not eat pork products for religious reasons
The nurse is assessing a newly admitted 83-year-old patient and determines that the patient is experiencing polypharmacy. Which statement most accurately illustrates polypharmacy?
The patient uses multiple medications simultaneously
The nurse is assigned to a patient who is newly diagnosed with type 1 diabetes mellitus. Which statement best illustrates an outcome criterion for this patient?
The patient will demonstrate correct blood glucose testing technique.
The nurse is developing a care plan for a patient who will be self-administering insulin injections. Which statement reflects a measurable outcome?
The patient will demonstrate the proper technique of self-administering insulin injections.
The nurse is developing a teaching plan for a patient with a new diagnosis of type 1 diabetes mellitus. Which of these outcome statements are appropriate?
The patient will list three signs and symptoms of hypoglycemia The patient will demonstrate how to self-administer an insulin injection with an insulin pen The patient will describe steps to take in case of hypoglycemia`
An elderly patient with a new diagnosis of hypertension will be receiving a new prescription for an antihypertensive drug. The nurse expects which type of dosing to occur with this drug therapy?
The patient will receive the lowest possible dose at first, and then the dose will be increased as needed.
What is the term for ratio between a drug's therapeutic effects and toxic effects?
Therapeutic index
A patient has new orders for administration of peripheral parenteral nutrition (PPN). The nurse knows that PPN is most appropriate in which situation?
Therapy is expected to last fewer than 14 days.
Why are specific medications identified as "high-alert" medications?
These drugs have increased potential for significant patient harm.
The drug nalbuphine (Nubain) is an agonist-antagonist (partial agonist). The nurse understands that which is a characteristic of partial agonists?
They have a lower dependency potential than agonists.
A nurse is assessing a client before administering medications. Which of the following data should the nurse obtain?
Use of herbal products Ability to swallow Allergies
A 49 year old patient has been admitted with possible chronic salicylate intoxication after self-treatment for arthritis pain, the nurse will asses for which symptoms of salicylate intoxication?
Tinnitus Headache Nausea
A patient has been diagnosed with metabolic syndrome and is started on the biguanide metformin (Glucophage). The nurse knows that the purpose of the metformin, in this situation, is which of these?
To decrease insulin resistance
What is the professional responsibility of the nurse when the nurses' ethics conflict with the patient?
Transfer care of a patient to another professional nurse if caring for the patient would violate personal ethical principles.
A nurse is collecting data from a client who takes haloperidol to treat schizophrenia. Which of the following findings should the nurse document as extrapyramidal symptoms?
Tremors Acute dystonia Restlessness
A nurse is conducting a nutritional class on minerals and electrolytes. The nurse should include which of the following foods is a major source of magnesium?
Tuna
What organization announced implemented regulations requiring bar codes for all prescription and over-the-counter (OTC) medications?
U.S. Food and Drug Administration (FDA)
The patient is experiencing chest pain and needs to take a sublingual form of nitroglycerin. Where does the nurse instruct the patient to place the tablet?
Under the tongue
What is the most appropriate time the nurse should begin the patient education and the teaching-learning process?
Upon the patient's admission to the health care setting
A nurse is preparing to administer an opioid agonist to a client who has acute pain. For which of the following manifestations should the nurse monitor as an adverse effect of this medication?
Urinary retention
The nurse is conducting a class for senior citizens about the use of over-the-counter (OTC) drugs. Which statements are true regarding the use of OTC drugs?
Use of OTC drugs may delay treatment of serious ailments. OTC drugs may relieve symptoms without addressing the cause of the problem. Patients may misunderstand product labels and use the drugs improperly.
Which descriptions apply to the market for medicinal herbs in the United States? (Select all that apply.)
Used with traditional therapies Growing in numbers of users
The nurse is reviewing the history of a patient who has a new order for a nonsteroidal anti- inflammatory drug (NSAID) to treat tendonitis. Which conditions are contraindications to the use of NSAIDs?
Vitamin K deficiency Peptic ulcer disease
A patient with a partial bowel obstruction will be given a 1-week course of enteral tube feeding via a nasogastric tube. Which formulation is appropriate for this patient?
Vivonex Plus, an elemental formulation
The nurse is reviewing data collected from a medication history. Which of these data are considered objective data?
WBC count 22,000 mm3 Blood pressure 150/94 mm Hg Patient's weight is 68 kg
A nurse is taking a history for a client who reports taking aspirin about four times daily for a sprained wrist. Which of the following prescribed medications taken by the client is contraindicated with aspirin?
Warfarin
The nurse is reviewing definitions for a pharmacology review class. Which of these products would be categorized as "legend drugs?"
Warfarin/Comuadin Morphine Sulfate
The physiologic differences in the pediatric patient compared with the adult patient affect the amount of drug needed to produce a therapeutic effect. The nurse is aware that one of the main differences is that infants have which of these factors?
Water composition of approximately 75%
Which statement best describes pharmacokinetics?
What the body does to the drug after it is administered
The nurse is teaching a group of patients about self-administration of insulin. What content is important to include?
When mixing insulins, the clear (such as regular) insulin is drawn up into the syringe first.
A nurse is preparing to administer an IM dose of penicillin to a client who has a new prescription. The client states when they took penicillin 3 years ago, they developed a rash. Which of the following actions should the nurse take?
Withhold the medication
The nurse is preparing to administer an intravenous injection of morphine to a patient. The nurse assesses a respiratory rate of 10 breaths/min. What is the appropriate action of the nurse?
Withhold the medication and notify the health care provider.
A nurse is planning to administer morphine IV to a client who is postoperative. Which of the following actions should the nurse take?
Withhold this medication if respiratory rate is less than 12/min
A nurse is preparing to administer a transfusion at 300 mL of pooled platelets to a client who has severe thrombocytopenia. The nurse should plan to administer the transfusion over which of the following time frames?
Within 30 minute/unit
After a severe auto accident, a patient has been taken to the trauma unit and has an estimated blood loss of more than 30% of his blood volume. The nurse prepares to administer which product?
Whole blood
The nurse knows to administer acarbose (Precose), an alpha-glucosidase inhibitor, at which time?
With the first bite of each main meal
A nurse is caring for a client experiencing IV extravasation. The facility requires the administration of an antidote for the prescribed IV solution. After stopping the IV infusion, which of the following actions should the nurse take first?
Withdraw the solution from the IV access
Drug's half-life is defined as the amount of time required for 50% of a drug to
be eliminated by the body.
When teaching about hypoglycemia, the nurse will make sure that the patient is aware of the early signs of hypoglycemia, including:
confusion and sweating.
How would a patient receiving narcotic analgesics for chronic pain can minimize the GI side effects?
increasing fluid and fiber in the diet