PN Pharmacology Online Practice 2020 B

A 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. Anyone who has a history of Stevens-Johnson syndrome when taking sulfonamides is at risk for an allergic reaction to furosemide because the two medications are chemically related.

A nurse is reviewing he medication administration record for a client who has a new prescription for tobramycin to treat pulmonary infection. Which of the following medications should the nurse identify as increasing the risk for ototoxicity while taking tobramycin?

Furosemide. Furosemide is a diuretic that can cause ototoxicity. So, the clients hearing loss is increased if receiving both of these medications

A 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 the medication?

Headache Tachycardia Blurred Vision

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

Hypokalemia It can cause hypokalemia due to excessive potassium excretion in the urine. Hypomagnesemia, hyponatremia, and hypercalcemia are other adverse effects.

A nurse is evaluating a client who is receiving amphotericin B via intermittent IV bolus. Which of the following findings indicated and adverse reaction to this medication?

Hypotension It is considered a high alert medication due to the potentially serious adverse effects like hypotension. The nurse should report nephrotoxicity, hypokalemia, and cardiac dysrhythmias.

A 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?

Implement seizure precautions. Grand mal seizures can occur during severe alcohol withdrawal, making the priority to implement seizure precautions to reduce the risk of injury.

A 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 Risperidone is an atypical antipsychotic that can minimize these manifestations, improving social interactions with others.

A nurse is reinforcing teaching with a client who recently began taking furosemide. 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.

A 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?

Increased HgB. Epoetin is used to elevate the erythrocyte count for clients who have kidney failure. An increased Hgb is the desired therapeutic effect of this medication.

A 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 Weight loss Diarrhea Lactic acidosis is a severe adverse effect of metformin that the nurse should report to the provider immediately.

A 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- greatest risk for nephrotoxicity. Others to report; nausea, fever, headache.

A 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. This could be an indication of heart failure, which is an adverse effect of metoprolol. Other adverse effects: bradycardia, blurred vision, and urinary frequency.

A nurse is reinforcing teaching with a client who has a new prescription for a new fluticasone inhaler. which of the following client statements indicates as understanding of the teaching?

"I will rinse my mouth after I use this inhaler." Rinse mouth after using glucocorticoids to reduce the risk of the development of oral thrush

A 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. Disulfiram is a medication used to treat alcohol abuse and when taking the medication and drinking alcohol, it can be fatal.

A 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?

Respiratory rate 11/min Remember ABC's Morphine will suppress respirations

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

Slurred speech This is a manifestation of Lithium toxicity.

A 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 Propylthiouracil- think "props to you for being hyped up" This drug is used to treat hyperthyroidism. The nurse should monitor for sore throat and fever because these are early indications of agranulocytosis, and adverse effect of the medication.

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

Albuterol The nurse should administer a short-acting beta2 agonist with a rapid onset when a client is experiencing an acute asthma attack.

A 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. This medication is used in patients with Parkinson's Disease. 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.

A 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. Gently roll the vial between the palms to disperse particles. Use the widest portion of the plunger and line it up with the prescribed number on the syringe. Inject air into the vial prior to inverting it.

A nurse is collecting data from a client who has been taking digoxin for 1 month. The nurse should identify which of the following findings as a manifestation of digoxin toxicity?

Vomiting

A nurse is caring for a client who is receiving methylprednisolone. Which of the following lab values should the nurse plan to monitor?

White Blood Cell Serum Potassium Blood Glucose

A 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 food choice?

Yogurt. Avoid foods like: avocados, smoked meats, pepperoni, bananas, raspberries, and dried fruits.

A nurse 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. Patients who take methotrexate should increase fluid intake to reduce the risk for renal damage and to increase medication excretion.

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

Measles, Mumps, and Rubella (MMR) Although most infants should receive the MMR vaccine between the ages of 12 months and 15 months, the nurse should identify that the MMR vaccine is composed of live viruses and is contraindicated for an infant who is immunocompromised.

A 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 Urinary ouput less than 30mL/hr respirations less than 12/min Bradycardia

A nurse in a community health clinic is preparing to administer the varicella vaccine to a young adult female client who has not previously had chieken pox or its vaccine. The nurse should withhold the vaccine and collect addition information when the client makes which of the following statements?

"I am allergic to neomycin." A contraindication for this vaccine are allergies to gelatin and neomycin

A 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." Adverse reactions: blurred vision, drowsiness, constipation, & dry mouth. The patch should be removed every 3 days. This is an anticholinergic mediation so it is going to dry you up.

A nurse is reinforcing teaching with a client who has a new prescription for timolol eye drops to treat glaucoma. which of the following client statements indicates an understanding of the teaching?

"I will look up when putting the medication into my eyes." Apply pressure to the nasolacrimal sac for 30-60 seconds after instilling drops. Clean eyes from inner canthus to outer canthus. Close eyes gently after instilling the eye drops.

A 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." The nurse should instruct the client to massage their nose gently to increase absorption of the medication. Medications should be administered intranasally once per week. Instruct patients to avoid hot liquids within 1 hr before and after taking the medication, because this will limit the medication. Store at room temperature.

A 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 to 60 seconds between puffs Hold their breath for at least 10 seconds after inhaling medication to allow distribution to the lungs. And shake the canister vigorously for 3 to 5 seconds.

A client who has terminal cancer reports pain as 5 on a scale of 0 to 10. The client has a 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.

A nurse is reinforcing teaching with a client who is to start therapy with a nitroglycerin transdermal patch. which of the following statements by the clients indicates and understanding of the teaching?

"While using the patch, I will be careful when rising from a chair." Nitroglycerin can cause orthostatic hypotension, which can result in dizziness.

A nurse on a medical-surgical unit is preparing to administer medications to a client. Which of the following questions should the nurse ask the client to verify the client's identity?

"what is your phone number?" Acceptable identifiers include the client's name, telephone number, facility ID number, DOB.

A 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. The 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.

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

Acyclovir -vir indicates it is a viral medication

A 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 provder?

Apical pulse 52/min If the clients HR is below 60/min the nurse should withhold the dose and notify the provider. Hypokalemia places a pt at risk for cardiac dysrhythmias when taking digoxin

A nurse is monitoring a c client who is 2 hr postoperative 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. Verbal report of pain is the priority indicator of the need for pain medication.

A 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. Clients who have benign prostatic hyperplasia might have urinary hesitancy and retention and, therefore, should not take dimenhydrinate due to the anticholinergic adverse effects of the medication.

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

Benign prostatic hyperplasia. A client who has benign prostatic hyperplasia is at increased risk for developing acute urinary retention while taking opioids.

A 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 This is a response of vasospastic response.

A 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, so a decrease in these indicates therapeutic effect of the medication.

A 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?

Diarrhea

A 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. Remember, the nurse is legally required to have a witness when disposing of a controlled substance.

A 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. The nurse should documents the objective facts pf the error, including follow-up actions and notification of the provider.

A 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, constipation, weight gain, hypotension. Baclofen is given for muscle spasms.

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

Dry Cough -pril so it is an ACE inhibitor ACE inhibitors are known to cause angioedema and a persistent dry nonproductive cough.

A nurse is caring for a client who has a new prescription for risperidone to manage schizophrenia. which of the following lab test should the nurse plan to obtain prior to administering the first dose?

Fasting blood glucose The development of hyperglycemia can be an adverse effect of risperidone.