Pharmacology

Nurse is reinforcing teaching with the parent of a preschooler who has otitis media. The child has had a low-grade fever and irritability for 2 days. Which of the following instructions should the nurse include in the teaching? "Administer amoxicillin twice a day for 3 days." "Apply cold packs every 4 hours for relief of pain." "Give acetaminophen as needed for discomfort and fever." "Return to the office in 72 hours for a follow-up appointment."

"Give acetaminophen as needed for discomfort and fever." Administer the full course of antibiotics, which is expected to be 5-7 days for mild-moderate infection and 10 days for severe infection. Lie on the affected side and apply heat to their ear to reduce discomfort. This position promotes drainage of exudate.

Nurse is reinforcing teaching with a client who has HIV and a new prescription for zidovudine. Which of the following client statements should indicate to the nurse an understanding of the teaching? "I can have unprotected sex after 6 months of taking this medication." "I can expect to have constipation while taking this medication." "I will be sure to have my blood tested for anemia." "My fingers might feel numb after I start therapy."

"I will be sure to have my blood tested for anemia." Zidovudine: cause severe anemia and neutropenia. Client should have blood tests performed before treatment begins and have continued monitoring during the course of treatment. Nail beds might have changes to pigmentation Gi disturbances such as diarrhea, abdominal pain, nausea, and vomiting.

Nurse is reinforcing teaching with a client who has a new prescription for ethinyl estradiol/norethindrone, an oral contraceptive. which of the following client statements should indicate to the nurse an understanding of the teaching? "I should expect my menstrual flow to increase." "I should monitor my blood pressure for hypotension while on this medication." "I will take the medication at the same time each day." "This type of medication is the most effective because it only contains estrogen."

"I will take the medication at the same time each day." To maintain a consistent level to reduce fertility and the chance of pregnancy. Menstrual flow volume will decrease, as well as the number of days of menses Monitor BP for hypertension because the medication causes increased secretion of aldosterone and angiotensin. Contains both estrogen and progestin.

Nurse is reinforcing teaching with a client who has a new prescription for colchicine to manage gouty arthritis, which of the following manifestations should the nurse include as an adverse effect of this medication? Abdominal pain Wheezing Excessive urination Tinnitus

Abdominal pain Abdominal pain indicates cellular damage to the gastrointestinal tract. The nurse should notify the provider, and the client should discontinue the medication immediately.

Nurse is reinforcing teaching with a client who has seizures and a new prescription for valproic acid. The nurse should instruct the client to report which of the following adverse effects of valproic acid to the provider immediately? Abdominal pain Hair loss Wt gain Ataxia

Abdominal pain Greatest risk to the client is hepatotoxicity and pancreatitis, which can cause abdominal pain. Therefore, the client should notify the provider immediately if experiencing a decrease in appetite, nausea, abdominal pain, or yellowing of the skin. Adverse effects: hair loss, weight gain, ataxia

Nurse is collecting data from a client who is taking exenatide to treat diabetes mellitus. For which of the following findings should the nurse withhold the exenatide dose and notify the provider immediately?

Abdominal pain Greatest risk to this client is the development of pancreatitis as an adverse effect of exenatide; therefore, the nurse should withhold the medication and immediately notify the provider of the client's abdominal pain. Manifestations of pancreatitis include severe, persistent abdominal pain with possible emesis.

Nurse is caring for a client who has genital herpes. Which of the following medications should the nurse expect to administer?

Acyclovir (antiviral) Levofloxacin: cystitis Ceftriaxone: Lyme disease metronidazole: Clostridium difficile

Nurse is contributing to the plan of care for a client who has schizophrenia and a new prescription for clozapine. The nurse should include in the plan to monitor the client for which of the following adverse effects of this medication? Hypoglycemia Iron-deficiency anemia Serotonin syndrome Agranulocytosis

Agranulocytosis Monitor WBC count and notify provider for a value below the expected reference range of 5,000 to 10,000/mm3 Monitor hyperglycemia, hyperlipidemia, tardive dyskinesia

Nurse is caring for a client who is having an acute asthma attack. Which of the following medications should the nurse administer first?

Albuterol Administer a short-acting beta2 agonist with a rapid onset Beclomethasone, cromolyn: chronic asthma Glucocorticoids, prednisone: relieve airway inflammation

Nurse is collecting data prior to administering digoxin to a client. For which of the following findings should the nurse withhold this medication and notify the provider?

Apical pulse 52/min Check the client's apical pulse prior to administering digoxin because it can cause bradycardia. If the client's heart rate is below 60/min, the nurse should withhold the dose and notify the provider.

Nurse is caring for a client who has a history of psychosis and is taking chlorpromazine. Which of the following actions should the nurse take to counteract the adverse effects of this medication? Suggest that the client apply antiperspirant deodorant more frequently. Inform the client to apply sunblock before going outside. Give the client a list of over-the-counter antidiarrheal medications. Recommend that the client take the medication on an empty stomach.

Apply sunblock before going outside. Counteract the adverse effects of photosensitivity. Chlorpromazine increases skin's sensitivity to UV light causing temporary pigmentation changes and increases the risk of sunburn. Adverse effect: reduced perspiration, constipation, GI distress.

Nurse is monitoring a client who is 2 hr postop and has a prescription for opioid analgesics. Which of the following actions provides the nurse with the priority data to determine the client's need for analgesia?

Ask the client to rate their pain level.

Nurse is reviewing a client's medical history before administering hydromorphone for postop pain. The nurse should notify the provider of which of the following findings before administering this medication?

Benign prostatic hyperplasia Increased risk for developing acute urinary retention while taking opioids Experience a lowering of BP when taking an opioid due to vasodilation effects. History of severe pulmonary disease/allergy to bisulfates can be a contraindication for hydromorphone.

Nurse is reviewing the medical record of a client who has a new prescription for dimenhydrinate to treat motion sickness. Which of the following conditions in the client's medical record should the nurse report to the provider?

Benign prostatic hyperplasia Might have urinary hesitancy and retention and, therefore, should not take dimenhydrinate due to the anticholinergic adverse effects of the medication.

Nurse is collecting data from a client who is receiving digoxin for treatment of heart failure. The nurse should identify which of the following findings as adverse effects of this medication?

Blurred vision Nausea Dysrhythmia Fatigue Anorexia

Nurse is reinforcing teaching w/ nurse about using metoprolol to treat hypertension. Which of the following conditions should the nurse include as contraindication for this medication? Peripheral vascular disease Diabetes mellitus Bradycardia CKD

Bradycardia Metoprolol: beta blocker that slows the conduction through the AV node. Therefore, it is contraindicated for clients who have bradycardia, or a heart rate that is consistently less than 60/min. Adverse effect: urine frequency Those w/ diabetes mellitus should use caution because it can mask the manifestations of hypoglycemia

Nurse is reinforcing teaching with a client who experiences migraine headaches and has a new prescription for sumatriptan. The nurse should instruct the client to report which of the following manifestations to the provider as an adverse effect of this medication?

Chest tightness because this can be a manifestation of a vasospastic response. Adverse effects: drowsiness, visual changes, bronchospasm

Nurse is collecting data from a client who has bacterial pneumonia and is taking ceftriaxone. Which of the following findings indicates a therapeutic effect of the medication?

Clear, bilateral breath sounds Wheezing and crackles are findings of bacterial pneumonia. A decrease in these manifestations indicates a therapeutic effect of the medication. WBC count of 10,500/mm3 is above the expected reference range, which indicates a continuation of the infection. Tachycardia is a manifestation of pneumonia.

Client comes to an urgent care clinic and announces with great enthusiasm, "I am an expert at all things medical as they apply to me. and I require zolpidem." The client's pupils are dilated. along with an elevated heart rate and blood pressure level. The nurse should suspect intoxication with which of the following substances? Alcohol Cocaine Barbiturates Heroin

Cocaine Cocaine toxicity: tachycardia, elevated blood pressure, dilated pupils, and displays delusions. Alcohol toxicity: slurred speech, drowsiness, impaired judgment, irritability, and decreased blood pressure. Barbiturate toxicity: respiratory depression, constricted pupils, drowsiness, impaired judgment, irritability, and decreased blood pressure. Heroin toxicity: slurred speech, drowsiness, constricted pupils, and decreased blood pressure.

Nurse is collecting data from a client who has Parkinson's disease + is taking levodopa/carbidopa. Nurse should identify which of the following findings as an adverse effect of this medication? Dark urine Hypertension Increased salivation Bradycardia

Dark urine/sweat/saliva Orthostatic hypotension Dry mouth Tachycardia

Nurse is caring for a client who has hyperthyroidism and has been taking methimazole. Which of the following findings should indicate to the nurse that the medication has a therapeutic effect? Decreased blood glucose level Increased Hgb Increased platelets Decreased T4

Decreased T4 Inhibits the synthesis of thyroid hormone, reducing levels to provide a euthyroid state. Agranulocytosis is adverse effect.

Nurse is caring for a client who has multiple sclerosis and a new prescription for baclofen. Which of the following findings indicates to the nurse that the medication is having a therapeutic effect? Decreased muscle spasticity Increased urinary output Increased mental alertness Decreased heart rate

Decreased muscle spasticity Antispasmodic Adverse effects: Urine freq, drowsiness, fatigue, confusion

Nurse is caring for a client who has tuberculosis and will begin taking isoniazid. Which of the following actions should the nurse take? Determine the client's daily alcohol intake. Tell the client to expect red-orange colored urine. Reinforce teaching about a low-calorie diet. Instruct the client to have a yearly tuberculin skin test.

Determine the client's daily alcohol intake. Reduce or avoid all use of alcohol because isoniazid can cause liver damage; therefore, it is important for the nurse to determine the client's daily alcohol intake. Rifampin: treat tuberculosis and causes the client's sweat, urine, saliva, and tears to appear red-orange in color.

Nurse is collecting data from a client who is taking oral amoxicillin to treat a respiratory infection. The nurse should monitor the client for which of the following manifestations as an adverse effect of the medication? Hearing loss Diarrhea Bruising Tendonitis

Diarrhea, adverse effect of antibiotics Aminoglycosides, amikacin: Hearing loss Cephalosporins, ceftriaxone: Bruising and bleeding Fluoroquinolones, ciprofloxacin: tendonitis and tendon rupture

Nurse is reinforcing teaching with a client who has a new prescription for theophylline. The nurse should instruct the client that which of the following is an expected outcome of this medication? Dilates bronchioles Reduces inflammation Loosens secretions Blocks leukotrienes

Dilates bronchioles Theophylline: bronchodilator, affects smooth muscle relaxation + leads to open airways Glucocorticoids: anti-inflammatory agents. Expectorants: help the flow of secretions. Leukotriene modifiers: block the results of leukotrienes, thereby reducing smooth muscle constriction and inflammatory responses.

Nurse is reinforcing teaching w/ client following placement of a cast for a fractured ankle. Client is to take oxycodone for pain management. Nurse should instruct client that which of the following OTC meds is contraindicated while taking oxycodone? Docusate sodium Famotidine Diphenhydramine Ibuprofen

Diphenhydramine (antihistamine) Diphenhydramine + oxycodone (opioid analgesic) can cause CNS depression. Using 2 of these medications together, increase risk for sedation, respiratory depression, injury.

Nurse is reinforcing teaching with a client who has a new prescription for etanercept to treat rheumatoid arthritis. which of the following instructions about self-administering this medication should the nurse include? Discard any solutions that are cloudy. Attach a 21-gauge needle to the syringe for injection. Self-administer the medication on alternate days. Shake the reconstituted solution well before self-administration.

Discard any solutions that are cloudy. 27-gauge needle to the syringe for injecting the medication subcutaneously. Self-administer the medication once per week. Swirl the solution gently before self-administration.

Nurse is collecting data from a client who has multiple sclerosis and a new prescription for baclofen. Which of the following findings should the nurse identify as an adverse effect of this medication?

Drowsiness Dizziness Constipation Fatigue Weight gain Hypotension

Nurse is reinforcing teaching with a client who is receiving enalapril 20 mg P0 daily. The nurse should instruct the client to monitor for which of the following adverse effects of this medication?

Dry cough Persistent dry or nonproductive cough is an adverse effect of enalapril. The underlying cause of the dry cough is the accumulation of bradykinin from the medication. The client should notify the provider of this adverse effect. Adverse effects: hyperkalemia, abnormal taste, dizziness

Nurse is caring for a client who has a new prescription for risperidone to manage schizophrenia. Which of the following laboratory tests should the nurse plan to obtain prior to administering the first dose?

Fasting blood glucose level Hyperglycemia can be an adverse effect Albumin level for protein Anorexia, polyuria are adverse effect

Nurse is reviewing the medication administration record of a client who has a history of Stevens-Johnson syndrome when taking sulfamethoxazole-trimethoprim. Which of the following medications should the nurse identify as contraindicated for this client?

Furosemide At risk for an allergic reaction to furosemide because the two medications are chemically related. The client should also avoid thiazide diuretics and sulfonylurea-type oral hypoglycemic agents.

Nurse is collecting data from a client who is taking tobramycin. Which of the following findings should the nurse report to me provider immediately?

Furosemide Tobramycin is an aminoglycoside antibiotic that can cause ototoxicity. Furosemide is a diuretic that also can cause ototoxicity. The client's risk for hearing loss is increased if receiving both of these medications at the same time. Propranolol: beta blocker Gabapentin: anticonvulsant Guaifenesin: expectorant

Nurse is collecting data from the parent of a toddler who is about to receive the varicella immunization. The nurse should identify that an anaphylactic reaction to which of the following substances is a contraindication for receiving this immunization? Geltain Pencillin Sulfa Eggs

Gelatin Hypersensitivity reaction to either gelatin or neomycin is a contraindication Administering measles/mumps/rubella vaccine requires caution for clients who have had a hypersensitivity reaction to eggs, gelatin, or neomycin. Sulfa contraindicated for vax containing sulfonamide

Nurse is monitoring a client who has type 2 diabetes mellitus and is receiving repaglinide. Which of the following laboratory tests should the nurse plan to review to obtain information about the long-term therapeutic effect of this medication? Fasting blood glucose level 1-hr oral glucose tolerance test Urinary ketones Glycosylated HbA1c

Glycosylated HbA1c HbA1c value measures the average of blood glucose levels over the past 2 to 3 months. Therefore, the nurse should review this laboratory test to obtain information about the long-term therapeutic effect of repaglinide.

Nurse is collecting data from a client who has angina and a new prescription for sublingual nitroglycerin. Which of the following manifestations should the nurse expect as an adverse effect of this medication?

Headache because it causes vasodilation. Nitroglycerin reduces oxygen demand and can improve breathing. Expect tachycardia caused by sympathetic stimulation of the heart + blurred vision as an adverse effect of taking sublingual nitroglycerin.

Nurse is collecting data from a client who is asking about taking celecoxib for treatment of joint pain. The nurse should identify that which of the following findings is a contraindication to receiving celecoxib? Hyperglycemia Penicillin allergy Hx of myocardial infarction Peptic ulcer disease

History of myocardial infarction Celecoxib: increases risk of myocardial infarction caused by increased vasoconstriction and unimpeded platelet aggregation. It is contraindicated for a client who has a history of myocardial infarction or heart disease. Can cause hypersensitivity reactions in clients who are allergic to sulfonamides or salicylates

Nurse is caring for a client who has a new prescription for eplerenone to treat hypertension. The nurse should monitor for which of the following adverse effects of this medication? Hematuria Hypernatremia Hyperkalemia Constipation

Hyperkalemia Can place the client at risk for increased K levels because eplerenone can cause K retention. Can cause vaginal bleeding, decreased Na levels, diarrhea.

Nurse is monitoring a client when has been receiving long-term hydrochlorothiazide therapy for recurring episodes of heart failure. Which of the following findings should me nurse identify as an adverse effect of this medication?

Hypokalemia Hydrochlorothiazide: thiazide diuretic that can cause hypokalemia due to excessive potassium excretion in the urine.

Nurse is assisting with collecting data for a client who is in preterm labor and is receiving magnesium sulfate via continuous IV infusion. Which of the following findings should the nurse identify as an indication of magnesium toxicity?

Hyporeflexia Magnesium sulfate depresses neuromuscular activity, causing muscle weakness and paralysis. Therefore, the nurse should identify hyporeflexia as an indication of magnesium toxicity and report it to the charge nurse. Urine output of less than 25 to 30 mL/hr, respirations less than 12/min, bradycardia can indicate magnesium toxicity.

Nurse is evaluating a client who is receiving amphotericin B via intermittent IV bolus. Which of the following findings indicates an adverse reaction to this medication?

Hypotension Amphotericin B is considered a high-alert medication due to potentially serious adverse effects, such as hypotension. Therefore, the nurse should report this or other adverse effects of amphotericin, such as nephrotoxicity, hypokalemia, and cardiac dysrhythmias.

Nurse is assisting with the care of a client who has a methicillin-resistant Staphylococcus aureus (MRSA) infection and is receiving vancomycin via IV infusion. Which of the following changes in the client's condition should the nurse identify as the priority finding to report to the provider? Nausea Back pain Hypotension Chills

Hypotension If vancomycin infusion is too rapid, it can cause red man syndrome, which is a group of adverse effects that includes tachycardia, hypotension, flushing, and urticaria. Report nausea, back pain, chills

Nurse is reinforcing teaching with a client who has a new prescription for regular insulin. which of the following statements by the client indicates an understanding of the teaching? "I should eat right before I give myself an insulin injection." "I should shake the vial gently prior to drawing up the insulin." "I should ensure that the insulin is clear prior to drawing it up." "I should inject the insulin deep into a muscle."

I should ensure that the insulin is clear prior to drawing it up Regular insulin is clear in appearance. Clients should discard the vial and use a new vial if the insulin appears cloudy. Onset of regular insulin, a short-acting insulin, is 30 to 60 min. Therefore, clients should self-administer the insulin at least 15 to 30 min before eating. Clients should eat within 15 min of taking insulin lispro, a rapid-acting insulin. Gently roll vial, not shake Administer insulin subcutaneously. An intramuscular injection will accelerate absorption.

Nurse is reinforcing teaching with a client who has a prescription for scopolamine transdermal patches to prevent motion sickness. Which of the following statements by the client indicates an understanding of the teaching?

I should place the patch behind my ear Replace every 3 days Blurred vision, drowsiness, constipation, and dry mouth are adverse effects of anticholinergic medications.

Nurse is reinforcing teaching with a client who has a new prescription for a fluticasone inhaler. Which of the following client statements indicates an understanding of the teaching?

I will rinse my mouth after I use this inhaler. Rinse mouth after using inhaled glucocorticoids to reduce the risk for the development of oral thrush Wait 1-2 min between inhalations of the medication to increase absorption. Use this medication as a prophylactic measure to prevent an asthma attack. Increase intake of dairy products to reduce the risk for bone loss while taking this medication.

Nurse is reinforcing teaching with a client who has a prescription for alendronate. Which of the following client responses indicates to the nurse an understanding of the teaching? "I will take the medication with my breakfast." "I will take the medication with 1 tablespoon of an antacid." "I will lie down for 30 minutes after taking the medication." "I will take the medication with 8 ounces of water."

I will take the medication with 8 ounces of water Take on an empty stomach with 240 mL/8 oz of water to ensure it does not lodge in the esophagus, which can result in esophageal ulcerations. Take upon arising and at least 30 minutes before eating or drinking liquids other than water. Avoid taking alendronate with antacids because they can decrease absorption of alendronate. Sit upright for 30 min after taking the medication because alendronate can cause erosion of the esophagus.

Nurse is caring for a client who has a 10-year history of alcohol use disorder and is experiencing acute alcohol withdrawal. The nurse should identify which of the following interventions as the priority? Suggest the client attend a support group. Administer naltrexone. Implement seizure precautions. Assist the client to identify triggers of alcohol use.

Implement seizure precautions. Greatest risk to the client is injury from seizures and falls. Grand mal seizures can occur during severe alcohol withdrawal. Therefore, the nurse's priority is to implement seizure precautions to reduce the risk of injury if the client experiences a seizure. Administer naltrexone to the client to assist with maintaining abstinence after detoxification.

Nurse is caring for a client who has schizophrenia and is to start therapy with risperidone. For which of the following manifestations should the nurse monitor to determine whether the treatment is effective?

Improved social interactions

Nurse is reinforcing teaching with a client who recently began taking furosemides. Which of the following instructions should the nurse include in the teaching?

Increase dietary potassium while taking the medication. Furosemide causes potassium to be excreted in the urine. Increasing dietary potassium will help prevent hypokalemia. Change positions slowly while taking this medication to avoid orthostatic hypotension. Take no later than 1700 to avoid disruption of sleep.

Nurse is reinforcing teaching with a client who has rheumatoid arthritis and a new prescription for methotrexate. Which of the following information should the nurse include in the teaching?

Increase fluid intake to reduce risk for renal damage and increase medication excretion

Nurse is caring for a client who is taking phenylephrine. Nurse should plan to monitor the client for which of the following manifestations as an adverse effect of this medication? Increased drowsiness Increased HR Decreased BP Decreased WBC

Increased HR Adverse: tachycardia and other cardiac dysrhythmias, insomnia, increased BP

Nurse is caring for a client who has kidney failure and has been taking epoetin. Which of the following is a therapeutic effect of this medication? Albumin is within the expected reference range Urine output increases to 60 mL/hr Hemoglobin rises 0.5 g/dL Blood urea nitrogen level is within the expected reference range

Increased Hgb Used to elevate the erythrocyte count for clients who have kidney failure

Nurse is collecting data from a client who is taking ferrous sulfate orally. Which of the following findings reported by the client should indicate to the nurse that the medication is having a therapeutic effect? Passing of a soft, formed stool daily Decreased number of viral illnesses Improved ability to fall asleep Increased tolerance to exercise

Increased tolerance to exercise Ferrous sulfate: treat iron-deficiency anemia, can have fatigue, SOB due to low hemoglobin. Increased tolerance to exercise occurs when the hemoglobin increases, allowing more O2 to be carried. Can cause constipation.

Nurse is reinforcing teaching with a client who has a new prescription for vitamin B12 intranasal to treat malabsorption syndrome. Which of the following instructions should the nurse include in the teaching?

Massage your nose gently after medication administration to increase absorption Administer vitamin B12 intranasally once per week. Oral vitamin B12 formulations require daily dosing. Avoid hot liquids 1 hr before and after taking intranasal vitamin B12. Hot liquids or spicy foods can cause rhinitis, which limits the effectiveness of the medication. Store at room temp.

Nurse in a provider's office is reviewing the immunization records of a 12-month-old infant who immunocompromised. which of the following vaccines should the nurse identify as contraindicated for this client?

Measles, mumps, and rubella (MMR) as it contains a live virus HepA vaccine series should be administered between 12-23 months. It does not contain a live virus Pneumococcal conjugate (PCV13) vaccine series should be administered between 2-15 months. It does not contain a live virus Haemophilus B conjugate (Hib) vaccine series should be administered between 2-15 months. It does not contain a live virus

Nurse is reinforcing teaching with a client about the adverse effects of simvastatin. For which of the following adverse effects should the nurse instruct the client to notify the provider? Muscle pain Fine hand tremors Urinary retention Double vision

Muscle pain Notify the provider if muscle pain or tenderness develops because this can indicate the client is developing rhabdomyolysis.

Nurse is reinforcing teaching with a client who has type 2 diabetes mellitus about adverse effects of metformin. The nurse should instruct the client to monitor for which of the following findings as manifestations of lactic acidosis?

Muscle pain Hyperventilation Dizziness

Nurse is collecting data from a client who is postoperative and taking morphine for pain. Which of the following findings is the priority for the nurse to report to the provider? Constipation Oxygen saturation 87% Vomiting Urinary output 25 mL over 1 hr

Oxygen saturation 87% Monitor all, but ABC

Nurse is reviewing the history of a client who is to start taking cefotetan to treat a bacterial infection. Which of the following information from the client's medical record should the nurse report to the provider before the client begins receiving this medication? Hearing impairment Milk-protein allergy Tendon pain Penicillin allergy

Penicillin allergy Cefotetan: a cephalosporin, an antibiotic structurally similar to penicillin. A client who has a severe allergy to penicillin can develop cross-reactivity and have an allergic reaction to cephalosporins. Therefore, the nurse should report this information to the provider before the client starts taking the medication. Cefditoren, a cephalosporin, can cause an allergic reaction in clients who have milk-protein hypersensitivity. Tendon pain should use fluoroquinolone antibiotics with caution due to the possible adverse effect of tendon rupture. Hearing loss is a contraindication to certain antibiotics, such as aminoglycosides, due to their ototoxic effects.

Nurse is reinforcing teaching with a client who is newly diagnosed with hypertension and is taking metoprolol. The nurse should instruct the client to report which of the following manifestations to the provider as an adverse effect of this medication?

Peripheral edema Peripheral edema can be an indication of heart failure, which is an adverse effect of metoprolol. Monitor for bradycardia, blurred vision, urinary freq

Nurse is reinforcing teaching with a client who is to start therapy using a nitroglycerin transdermal patch. Which of the following instructions should the nurse include? Cover the patch with a dry dressing. Apply another patch if experiencing chest pain. Leave each patch in place for 24 hr. Place the patch on a different site for each application.

Place the patch on a different site for each application. Prevent skin irritation. To prevent tolerance, the client should remove the patch after 12-14 hr with a 10-12 hr break before applying a new patch. Not used for acute chest pain

Nurse is instilling timolol eyedrops for a client who has glaucoma. Which of the following actions should the nurse take after instilling the eyedrops? Press the nasolacrimal duct. Apply pressure to the upper eyelid. Ask the client to blink their eyes several times. Tell the client to keep their eyes open for at least 15 seconds.

Press the nasolacrimal duct. To prevent the medication from absorbing into systemic circulation. Avoid applying pressure to the client's upper eyelid after instilling the eye drops because it might force the medication out of the conjunctival sac. Avoid asking the client to blink their eyes after instilling the eye drops because it can prevent the medication from entering the conjunctival sac.

Nurse is collecting data from a female client who has been taking propylthiouracil (PTU) for 2 months to treat Graves' disease. Which of the following findings should the nurse recognize as an indication that the medication is effective? Wt loss Pulse 82/min RR 22/min Decreased menstrual flow

Pulse 82/min Tachycardia, amenorrhea, weight loss is a manifestation of hyperthyroidism.

Nurse is collecting data from a client who received morphine IV for pain relief. Which of the following findings is the nurse's priority to report to the provider?

RR 11/min

Nurse is caring for a client who is taking disulfiram and consumed alcohol 12 hr ago. Which of the following adverse reactions is the priority finding to report to the provider?

Respiratory depression can indicate the client is experiencing acetaldehyde syndrome, a life-threatening event.

Nurse is reinforcing teaching w/ a client who has hypertension and a new prescription for spironolactone. Which of the following instructions should the nurse include in the teaching? Increase foods high in zinc. Restrict foods high in potassium. Restrict foods high in vitamin K. Increase foods high in magnesium.

Restrict food high in K Spironolactone: potassium-sparing diuretic, which can cause hyperkalemia. Restrict foods that are high in potassium and salt substitutes that contain potassium. Can increase Mg levels.

Nurse is reinforcing teaching about comfort measures with the parent of a 10-year-old child who has a viral infection. The nurse should plan to tell the parent that aspirin is contraindicated because of the risk for which of the following conditions? Juvenile idiopathic arthritis Reye syndrome Glomerulonephritis Iron-deficiency anemia

Reye syndrome Aspirin is contraindicated for children and adolescents who have a viral illness because it increases the risk for the development of Reye syndrome.

Nurse is reinforcing teaching with a client who has a new prescription for omeprazole oral capsules. Which of the following instructions should the nurse include? Take the medication at bedtime. Swallow the medication whole. Take the medication with food. Avoid antacids when taking this medication.

Swallow the medication whole. Swallow whole and do not chew or crush them. Omeprazole, a proton pump inhibitor, blocks the secretion of gastric acid. It is available in delayed-release capsules and over the counter in delayed-release tablets, as well as suspensions and powders. Take in the morning, prior to the first meal of the day, to increase the absorption of the medication. Food can reduce the absorption. Therefore, the client should avoid taking the medication with food.

Nurse is reinforcing discharge teaching with a client who has a prescription for a metered—dose inhaler (MDI). Which of the following information should the nurse include in the teaching?

Take a slow, deep breath lasting 3 to 5 seconds after releasing the medication Wait 20-60 sec between puffs of the same medication. If two different medications are administered, the client should wait 2 to 5 min between administrations. Hold their breath for at least 10 seconds after inhaling the medication to allow the medication to be distributed deeply into the lungs. Shake the canister vigorously for 3-5 secs to ensure that fine particles are aerosolized.

Nurse is collecting data from a client who has been taking levodopa/carbidopa. Which of the following findings should indicate to the nurse that the medication is effective?

The client is able to wash their face. Levodopa works by activating dopamine receptors, restoring nerve transmission for clients who have Parkinson's disease. Carbidopa enhances these effects by inhibiting the breakdown of levodopa in the intestine and periphery. These therapeutic effects assist the client with moving freely and resuming ADLs. Adverse effects of levodopa: Abnormal involuntary movements (reduce w/ amantadine administration), nausea, vomiting, vivid dreams, hallucinations

Nurse is reinforcing teaching with a client who has type 1 diabetes mellitus and is learning to self-administer NPH insulin. Which of the following client actions indicates an understanding of the teaching?

The client wipes the cap with alcohol prior to filling the syringe. Injecting air into the vial prior to inverting it will reduce the risk of creating air bubbles. Gently roll the vial of NPH insulin between the palms to disperse the particles in the solution. In order to draw up the correct dose of medication, the client should use the widest portion of the plunger and line it up with the prescribed number on the syringe.

Client who has terminal cancer reports pain as 5 on a scale of 0-10. The client has e prescription for morphine 15 mg orally every 4 hr. The client's adult children express concern that the client is receiving too much of the medication. Which of the following responses should the nurse make?

The dose should remain constant to prevent breakthrough pain Fixed or scheduled dosing around the clock offers the best pain control for clients who have severe and persistent pain.

Nurse is caring for a client who has a new prescription for sumatriptan. The nurse notes that the client takes fluoxetine. The nurse should notify the provider that the combination of these medications will place the client at risk for which of the following adverse effects? Tremors Renal calculi Dysphagia Hearing loss

Tremors Concurrent use of sumatriptan and fluoxetine can lead to excessive stimulation of serotonin receptors, placing the client at risk for serotonin syndrome. Experience tremors, confusion, and hallucinations.

Nurse is caring for a client who is receiving methylprednisolone which of the following laboratory values should the nurse plan to monitor?

WBC count, can increase the client's risk for infection and cause leukocytosis. Serum potassium, can cause hypokalemia, as well as fluid and sodium retention. Blood glucose

Nurse is planning to administer metoprolol to a client who has heart failure and a heart rate of 48/min. Which of the following actions should the nurse take? Encourage the client to ambulate. Request a different beta blocker medication to administer. Administer one-half of the client's prescribed dose. Withhold the client's medication.

Withhold the client's medication. Beta blocker medication, results in a decrease in heart rate and should withhold the medication for a heart rate less than 50/min. The nurse should also notify the client's provider of the client's heart rate.

Nurse is reinforcing dietary teaching with a client who has a new prescription for phenelzine. Which of the following foods should the nurse include in the teaching as an appropriate land choice?

Yogurt Avoid consuming tyramine, which can cause high blood pressure Avocados, smoke salmon, pepperoni has high tyramine content

Nurse is reinforcing teaching with a female client who has a new prescription for isotretinoin. Which of the following information should the nurse include in the teaching?

You will need to have your liver enzymes monitored after 1 month because isotretinoin is metabolized in liver. You can have nosebleeds while taking this medication due to drying effects. You should report any thoughts of harming yourself because it can cause depression. You will need to have two negative pregnancy tests prior to starting the medication due to potential severe birth defects. Vitamin A increases risk of isotretinoin toxicity.

Nurse is caring for a client who has a prescription for an IM injection of penicillin G benzathine. The client asks why the injection must be given IM instead of through the IV line. Which of the following responses should the nurse make? "The medication is more rapidly absorbed when given IM." "Your medication can't be given IV because it is not water-soluble." "You will experience less discomfort with an IM injection." "An IM injection allows more precise control of the medication level in your blood."

Your medication can't be given IV because it is not water-soluble. Penicillin has poor water solubility and is never administered intravenously. Absorbed slowly over several weeks, maintaining a continuous low blood level. Medications given intravenously are absorbed faster than IM medications.

Nurse is reinforcing teaching with a client who is using phenylephrine nasal spray three times daily and reports rebound congestion. Which of the following instructions should the nurse include to reduce the effects of rebound congestion? "Decrease the frequency to twice daily." "Continue use for one more week." "Discontinue use in the left nostril, then in the right nostril." "Add oxymetazoline nasal spray to relieve symptoms."

"Discontinue use in the left nostril, then in the right nostril." Discontinuing the medication one nostril at a time can overcome rebound congestion. Oxymetazoline can also cause rebound congestion.

Nurse is reinforcing teaching with a client who has a new prescription for propranolol. which of the following information should the nurse include in the teaching? "If you miss a dose, double the next scheduled dose." "Discontinue this medication if lightheadedness occurs." "If your pulse rate is less than 50 beats per minute, notify your provider." "This medication can cause heat intolerance."

"If your pulse rate is less than 50 beats per minute, notify your provider." Bradycardia, lightheadedness, dizziness is a common adverse effect of beta blockers. Can cause cold intolerance

Nurse is planning to reinforce teaching about newborn immunizations w/ client who is 24 hr postpartum. Which of the following info should the nurse plan to include? "Your baby will receive the first hepatitis B vaccine before discharge." "Your baby will receive the rotavirus vaccine if your blood titer is low." "Your baby will receive their first influenza vaccine at the 4-week checkup." "Your baby will receive the varicella vaccine if you have a history of chickenpox."

"Your baby will receive the first hepatitis B vaccine before discharge." MY ANSWER Newborn should receive the first hepatitis B vaccine at birth, with the next dose at age 1 to 2 months. Rotavirus: 2 to 3 doses starting at age 2 months. Influenza: annual at 6 months. Varicella: 1st of 2 doses btwn 12 and 15 months.

Nurse is performing the third check before administering hydromorphone to a client. After opening the unit-dose packet, the client tells the nurse they do not want to take the medication now. Which of the following actions should the nurse take?

Dispose of the medication with a second nurse as a witness. The nurse is legally required to have a witness when disposing of a controlled substance. Do not need to complete an occurrence report when discarding a controlled substance.

Nurse erroneously administered zolpidem to the wrong client. Which of the following actions should the nurse take?

Document the notification of the client's provider.

Nurse is caring for a client who has chronic kidney disease and has been receiving epoetin for 2 weeks. Which of the following findings should indicate to the nurse that the client's medication is having the desired therapeutic effect?

Hemoglobin rises 0.5 g/dL Hemoglobin should reach target levels of 10 to 11 g/dL in 2 to 3 months. Does not affect albumin, urine output, BUN level.

Nurse is reinforcing teaching with a client who has bipolar disorder and a new prescription for lithium. Which of the following instructions should the nurse include in the teaching? Take the medication on an empty stomach. Monitor for signs of hyperthyroidism. Watch for signs of urinary retention. Maintain a consistent sodium intake.

Maintain a consistent sodium intake. Decreased serum sodium levels cause lithium excretion to decline, which can lead to toxicity. Adverse effects: polyuria, hypothyroidism Take with meals/milk to reduce GI upset

Nurse is collecting data from a client who is taking tobramycin. Which of the following findings should the nurse report to the provider immediately?

Oliguria indicates the client is at greatest risk for nephrotoxicity.

Nurse is collecting data from a client who is taking lithium to treat bipolar disorder. Which of the following findings should me nurse report to the provider?

Slurred speech, manifestation of lithium toxicity Adverse effect: bloating

Nurse is collecting data from a client who has hyperthyroidism and a new prescription for propylthiouracil. The nurse should monitor the client for which of the following manifestations as an adverse effect of this medication?

Sore throat + fever because these are early indications of agranulocytosis, which is an adverse effect of propylthiouracil. Monitor for loss of taste, drowsiness, glomerulonephritis

Nurse is collecting data from a client who has been taking digoxin for I month. The nurse should identify which of the following findings as a manifestation of digoxin toxicity?

Vomiting Hypotension