Quiz 2

The client arrives at the emergency department, complaining of back spasms. The client states, "I have been taking 2 to 3 aspirin every 4 hours for the last week, and it hasn't helped my back." Since acetylsalicylic acid intoxication is suspected, the nurse would assess the client for which manifestation? 1. Tinnitus 2. Diarrhea 3. Constipation 4. Photosensitivity

1

An opioid analgesic is administered to a client in labor. The nurse assigned to care for the client ensures that which medication is readily accessible in the event that respiratory depression occurs? 1. Naloxone 2. Morphine sulfate 3. Betamethasone 4. Hydromorphone hydrochloride

1

A client receiving thrombolytic therapy with a continuous infusion of alteplase suddenly becomes extremely anxious and reports itching. The nurse hears stridor and notes generalized urticaria and hypotension. Which interventions would the nurse take? Select all that apply. 1. Stop the infusion. 2. Raise the head of the bed. 3. Administer protamine sulfate. 4. Administer diphenhydramine. 5. Call for the Rapid Response Team (RRT).

1, 4, 5

The nurse is monitoring a client in preterm labor who is receiving intravenous magnesium sulfate. The nurse would monitor for which adverse effects of this medication? Select all that apply. 1. Flushing 2. Hypertension 3. Increased urine output 4. Depressed respirations 5. Extreme muscle weakness 6. Hyperactive deep tendon reflexes

1, 4, 5

The nurse is monitoring a client with hypertension who is taking propranolol. Which assessment finding indicates a potential adverse complication associated with this medication? 1. Report of infrequent insomnia 2. Development of expiratory wheezes 3. A baseline blood pressure of 150/80 mm Hg followed by a blood pressure of 138/72 mm Hg after two doses of the medication 4. A baseline resting heart rate of 88 beats per minute followed by a resting heart rate of 72 beats per minute after two doses of the medication

2

The nurse is preparing to administer exogenous surfactant to a premature infant who has respiratory distress syndrome. The nurse prepares to administer the medication by which route? 1. Intradermal 2. Intratracheal 3. Subcutaneous 4. Intramuscular

2

The nurse is providing discharge instructions to a client receiving trimethoprim-sulfamethoxazole. Which instruction would be included in the list? 1. Advise that sunscreen is not needed. 2. Drink 8 to 10 glasses of water per day. 3. Decrease the dosage when symptoms are improving to prevent an allergic response. 4. If the urine turns dark brown, call the primary health care provider (PHCP) immediately.

2

A client has been taking isoniazid for 2 months. The client complains to the nurse about numbness, paresthesias, and tingling in the extremities. The nurse interprets that the client is experiencing which problem? 1. Hypercalcemia 2. Peripheral neuritis 3. Small blood vessel spasm 4. Impaired peripheral circulation

2

A client in preterm labor (31 weeks) who is dilated to 4 cm has been started on magnesium sulfate, and contractions have stopped. If the client's labor can be inhibited for the next 48 hours, the nurse anticipates a prescription for which medication? 1. Nalbuphine 2. Betamethasone 3. Rho(D) immune globulin 4. Dinoprostone vaginal insert

2

Methylergonovine is prescribed for a client to treat postpartum hemorrhage. Before administration of methylergonovine, what is the priority assessment? 1. Uterine tone 2. Blood pressure 3. Amount of lochia 4. Deep tendon reflexes

2

The nurse is providing instructions to the client newly diagnosed with diabetes mellitus who has been prescribed pramlintide. Which instruction would the nurse include in the discharge teaching? 1. "Inject the pramlintide at the same time you take your other medications." 2. "Take your prescribed pills 1 hour before or 2 hours after the injection." 3. "Be sure to take the pramlintide with food so that you don't upset your stomach." 4. "Make sure you take your pramlintide immediately after you eat so that you don't experience a low blood sugar."

2

The nurse would tell the client who is taking levothyroxine to notify the primary health care provider (PHCP) if which problem occurs? 1. Fatigue 2. Tremors 3. Cold intolerance 4. Excessively dry skin

2

A client has a prescription to take guaifenesin. The nurse determines that the client understands the proper administration of this medication if the client states that they will perform which action? 1. Take an extra dose if fever develops 2. Take the medication with meals only 3. Increase water intake when taking the medication 4. Decrease the amount of daily fluid intake

3

The nurse has just administered the first dose of omalizumab to a client with asthma. Which statement by the client alerts the nurse of a life-threatening effect? 1. "I have a severe headache." 2. "My feet are quite swollen." 3. "I am nauseated and may vomit." 4. "My lips and tongue are swollen."

4

The nurse is providing discharge teaching for a client newly diagnosed with type 2 diabetes mellitus who has been prescribed metformin. Which client statement indicates the need for further teaching? 1. "It is okay if I skip meals once in a while." 2. "I need to let my doctor know if I get unusually tired." 3. "I need to constantly watch for signs of low blood sugar." 4. "I will be sure to not drink alcohol excessively while on this medication."

3

The nurse is providing medication instructions to a parent. Which statement by the parent indicates a need for further instruction? 1. "I need to cuddle my child after giving the medication." 2. "I can give my child a frozen juice bar after my child swallows the medication." 3. "I need to mix the medication in the baby food and give it when I feed my child." 4. "If my child does not like the taste of the medicine, I need to encourage my child to pinch the nose and drink the medication through a straw."

3

The nurse is reviewing the laboratory results for a client receiving tacrolimus. Which laboratory result would indicate to the nurse that the client is experiencing an adverse effect of the medication? 1. Potassium level of 3.8 mEq/L (3.8 mmol/L) 2. Platelet count of 300,000 mm3 (300 × 109/L) 3. Fasting blood glucose of 200 mg/dL (11.1 mmol/L) 4. White blood cell count of 6000 mm3 (6.0 × 109/L)

3

The nurse provides instructions to a client who is taking levothyroxine. The nurse would tell the client to take the medication in which way? 1. With food 2. At lunchtime 3. On an empty stomach 4. At bedtime with a snack

3

The nurse would report which assessment finding to the primary health care provider (PHCP) before initiating thrombolytic therapy in a client with pulmonary embolism? 1. Adventitious breath sounds 2. Temperature of 99.4° F (37.4° C) orally 3. Blood pressure of 198/110 mm Hg 4. Respiratory rate of 28 breaths per minute

3

The nurse, who is administering bethanechol chloride, is monitoring for cholinergic overdose associated with the medication. The nurse would check the client for which sign of overdose? 1. Dry skin 2. Dry mouth 3. Bradycardia 4. Signs of dehydration

3

A client who has a cold is seen in the emergency department with an inability to void. Because the client has a history of benign prostatic hyperplasia, the nurse determines that the client would be questioned about the use of which medication? 1. Diuretics 2. Antibiotics 3. Antilipemics 4. Decongestants

4

A client who is receiving digoxin daily has a serum potassium level of 3 mEq/L (3 mmol/L) and reports anorexia. The cardiologist prescribes a serum digoxin level to be done. Which level would the nurse recognize as being outside of the therapeutic range? 1. 0.5 ng/mL (0.63 nmol/L) 2. 0.8 ng/mL (1.02 nmol/L) 3. 0.9 ng/mL (1.14 nmol/L) 4. 2.2 ng/mL (2.8 nmol/L)

4

The nurse is caring for a client in the emergency department who has been diagnosed with Bell's palsy. The client has been taking acetaminophen, and acetaminophen overdose is suspected. Which antidote would the nurse prepare for administration if prescribed? 1. Pentostatin 2. Auranofin 3. Fludarabine 4. Acetylcysteine

4

The nurse prepares to administer an intramuscular injection to a 4-month-old infant. The nurse selects which best site to administer the injection? 1. Gluteus 2. Lateral deltoid 3. Rectus femoris 4. Vastus lateralis

4

The nurse provides instructions to the client about nicotinic acid prescribed for hyperlipidemia. Which statement by the client indicates understanding of the instructions? 1. "The medication needs to be taken with meals to decrease flushing." 2. "I don't need to stop drinking alcohol when taking nicotinic acid." 3. "Clay-colored stools are a common side effect and are not a concern." 4. "Ibuprofen taken 30 minutes before the nicotinic acid may decrease the flushing."

4

Trimethoprim-sulfamethoxazole is prescribed for a client. The nurse would instruct the client to report which symptom if it develops during the course of this medication therapy? 1. Nausea 2. Diarrhea 3. Headache 4. Sore throat

4

Oxybutynin chloride is prescribed for a client with urge incontinence. Which sign would indicate a possible toxic effect related to this medication? 1. Pallor 2. Drowsiness 3. Bradycardia 4. Restlessness

4

A client with chronic pancreatitis has begun medication therapy with pancrelipase. The nurse evaluates that the medication is having the optimal intended benefit if which effect is observed? 1. Weight loss 2. Relief of heartburn 3. Reduction of steatorrhea 4. Absence of abdominal pain

3

A client with gastroenteritis has an as-needed prescription for loperamide hydrochloride. For which condition would the nurse administer this medication? 1. Constipation 2. Abdominal pain 3. An episode of diarrhea 4. Hematest-positive nasogastric tube drainage

3

A client with trigeminal neuralgia is being treated with carbamazepine, 400 mg orally daily. Which value indicates that the client is experiencing an adverse effect to the medication? 1. Sodium level, 140 mEq/L (140 mmol/L) 2. Uric acid level, 4.0 mg/dL (240 mcmol/L) 3. White blood cell count, 3000 mm3 (3.0 × 109/L) 4. Blood urea nitrogen level, 10 mg/dL (3.6 mmol/L)

3

A client with tuberculosis is starting antituberculosis therapy with isoniazid. Before giving the client the first dose, the nurse would ensure that which baseline study has been completed? 1. Electrolyte levels 2. Coagulation times 3. Liver enzyme levels 4. Serum creatinine level

3

A daily dose of prednisone is prescribed for a client. The nurse provides instructions to the client regarding administration of the medication and would instruct the client that which time is best to take this medication? 1. At noon 2. At bedtime 3. Early morning 4. Any time, at the same time, each day

3

A pediatric client with ventricular septal defect repair is placed on a maintenance dosage of digoxin. The dosage is 8 mcg/kg/day, and the client's weight is 7.2 kg. The pediatrician prescribes the digoxin to be given twice daily. The nurse prepares how many mcg of digoxin to administer to the child at each dose? 1. 12.6 mcg 2. 21.4 mcg 3. 28.8 mcg 4. 32.2 mcg

3

An older client with peptic ulcer disease recently has been taking cimetidine. The nurse monitors the client for which most frequent central nervous system side effect of this medication? 1. Tremors 2. Dizziness 3. Confusion 4. Hallucinations

3

Following kidney transplantation, cyclosporine is prescribed for a client. Which laboratory result would indicate an adverse effect from the use of this medication? 1. Hemoglobin level of 14.0 g/dL (140 mmol/L) 2. Creatinine level of 0.6 mg/dL (53 mcmol/L) 3. Blood urea nitrogen level of 25 mg/dL (8.8 mmol/L) 4. Fasting blood glucose level of 99 mg/dL (5.5 mmol/L)

3

Sulfisoxazole, 1 g orally twice daily, is prescribed for an adolescent with a urinary tract infection. The medication label reads "500-mg tablets." The nurse has determined that the dosage prescribed is safe. The nurse administers how many tablets per dose to the adolescent? 1. ½ tablet 2. 1 tablet 3. 2 tablets 4. 3 tablets

3

Terbutaline is prescribed for a client with bronchitis. Which disorder in the client's medical history requires caution by the nurse? 1. Osteoarthritis 2. Hypothyroidism 3. Diabetes mellitus 4. Polycystic disease

3

The nurse is teaching a client with diabetes mellitus how to mix regular insulin and NPH insulin in the same syringe. Which action, if performed by the client, indicates the need for further teaching? 1. Withdraws the NPH insulin first 2. Withdraws the regular insulin first 3. Injects air into NPH insulin vial first 4. Injects an amount of air equal to the desired dose of insulin into each vial

1

The nurse is teaching the client about prescribed prednisone. Which statement, if made by the client, indicates that further teaching is necessary? 1. "I can take aspirin or my antihistamine if I need it." 2. "I need to take the medication every day at the same time." 3. "I need to avoid coffee, tea, cola, and chocolate in my diet." 4. "If I gain 5 pounds or more a week, I will call my doctor."

1

The nurse receives a call from a client concerned about eliminating brown-colored urine after taking nitrofurantoin for a urinary tract infection. The nurse would make which appropriate response? 1. "Continue taking the medication; the brown urine occurs and is not harmful." 2. "Take magnesium hydroxide with your medication to lighten the urine color." 3. "Discontinue taking the medication, and make an appointment for a urine culture." 4. "Decrease your medication to half the dose, because your urine is too concentrated."

1

A client begins therapy with theophylline. The nurse plans to teach the client to limit the intake of which items while taking this medication? 1. Coffee, cola, and chocolate 2. Oysters, lobster, and shrimp 3. Melons, oranges, and pineapple 4. Cottage cheese, cream cheese, and dairy creamers

1

A client with a urinary tract infection is receiving ciprofloxacin by the intravenous (IV) route. The nurse appropriately administers the medication by performing which action? 1. Infusing slowly over 60 minutes 2. Infusing in a light-protective bag 3. Infusing only through a central line 4. Infusing rapidly as a direct IV push medication

1

A client with chronic kidney disease is receiving epoetin alfa. Which laboratory result would indicate a therapeutic effect of the medication? 1. Hematocrit of 33% (0.33) 2. Platelet count of 400,000 mm3 (400 × 109/L) 3. White blood cell count of 6000 mm3 (6.0 × 109/L) 4. Blood urea nitrogen level of 15 mg/dL (5.4 mmol/L)

1

The nurse asks a nursing student to describe the procedure for administering erythromycin ointment to the eyes of a newborn. Which student statement indicates that further teaching is needed about administration of the eye medication? 1. "I will flush the eyes after instilling the ointment." 2. "I will clean the newborn's eyes before instilling ointment." 3. "I need to administer the eye ointment within 1 hour after delivery." 4. "I will instill the eye ointment into each of the newborn's conjunctival sacs."

1

The nurse is caring for a client receiving an albuterol/ipratropium nebulized breathing treatment. Which report from the client would the nurse note as an expected side effect of this combination medication? 1. "I feel as though my heart is racing." 2. "I feel more bloated than usual." 3. "My eyes have been watering lately." 4. "I haven't had a bowel movement in 4 days."

1

The nurse is teaching a client who is beginning antiviral therapy for influenza. Which statement by the client indicates an understanding of the instructions? 1. "I must take the medication exactly as prescribed." 2. "Once I start the medication, I will no longer be contagious." 3. "I will not get any colds or infections while taking this medication." 4. "This medication has minimal side effects, and I can return to normal activities."

1

The primary health care provider (PHCP) prescribes semaglutide for a client with type 1 diabetes mellitus who takes insulin. The nurse would plan to take which most appropriate intervention? 1. Withhold the medication and call the PHCP, questioning the prescription for the client. 2. Teach the client about the signs and symptoms of hypoglycemia and hyperglycemia. 3. Monitor the client for gastrointestinal side effects after administering the medication. 4. Withdraw the insulin from the prefilled pen into an insulin syringe to prepare for administration.

1

The home health care nurse is visiting a client who was recently diagnosed with type 2 diabetes mellitus. The client is prescribed repaglinide and metformin. The nurse would provide which instructions to the client? Select all that apply. 1.Diarrhea may occur secondary to the metformin. 2.The repaglinide is not taken if a meal is skipped. 3.The repaglinide is taken 30 minutes before eating. 4.A simple sugar food item is carried and used to treat mild hypoglycemia episodes. 5.Muscle pain is an expected effect of metformin and may be treated with acetaminophen. 6.Metformin increases hepatic glucose production to prevent hypoglycemia associated with repaglinide.

1, 2, 3, 4

Rifabutin is prescribed for a client with active Mycobacterium avium complex (MAC) disease and tuberculosis. The nurse would monitor for which side and adverse effects of rifabutin? Select all that apply. 1. Signs of hepatitis 2. Flulike syndrome 3. Low neutrophil count 4. Vitamin B6 deficiency 5. Ocular pain or blurred vision 6. Tingling and numbness of the fingers

1, 2, 3, 5

The nurse determines that the client needs further instruction on cimetidine if which statements were made? Select all that apply. 1. "I will take the cimetidine with my meals." 2. "I'll know the medication is working if my diarrhea stops." 3. "My episodes of heartburn will decrease if the medication is effective." 4. "Taking the cimetidine with an antacid will increase its effectiveness." 5. "I will notify my doctor if I become depressed or anxious." 6. "Some of my blood levels will need to be monitored closely since I also take warfarin for atrial fibrillation."

1, 2, 4

The nurse is monitoring a client receiving levothyroxine sodium for hypothyroidism. Which findings indicate the presence of a side effect associated with this medication? Select all that apply. 1.Insomnia 2.Weight loss 3.Bradycardia 4.Constipation 5.Mild heat intolerance

1, 2, 5

A client with diabetes mellitus is taking Humulin NPH insulin and regular insulin every morning. The nurse would provide which instructions to the client? Select all that apply. 1.Hypoglycemia may be experienced before dinnertime. 2.The insulin dose needs to be decreased if illness occurs. 3.The insulin should be administered at room temperature. 4.The insulin vial needs to be shaken vigorously to break up the precipitates. 5.The NPH insulin would be drawn into the syringe first, then the regular insulin.

1, 3

A client with hyperthyroidism has been given methimazole. Which nursing considerations are associated with this medication? Select all that apply. 1.Administer methimazole with food. 2.Place the client on a low-calorie, low-protein diet. 3.Assess the client for unexplained bruising or bleeding. 4.Instruct the client to report side and adverse effects such as sore throat, fever, or headaches. 5.Use special radioactive precautions when handling the client's urine for the first 24 hours following initial administration.

1, 3, 4

The nurse is monitoring a client for adverse effects of medications. Which findings are characteristic of adverse effects of hydrochlorothiazide? Select all that apply. 1. Sulfa allergy 2. Osteoporosis 3. Hypokalemia 4. Hypouricemia 5. Hyperglycemia 6. Hypercalcemia

1, 3, 5, 6

A client is to begin a 6-month course of therapy with isoniazid. The nurse would plan to teach the client to take which action? 1. Use alcohol in small amounts only. 2. Report yellow eyes or skin immediately. 3. Increase intake of Swiss or aged cheeses. 4. Avoid vitamin supplements during therapy.

2

A client with Crohn's disease is scheduled to receive an infusion of infliximab. What intervention by the nurse will determine the effectiveness of treatment? 1. Monitoring the leukocyte count for 2 days after the infusion 2. Checking the frequency and consistency of bowel movements 3. Checking serum liver enzyme levels before and after the infusion 4. Carrying out a Hematest on gastric fluids after the infusion is completed

2

A client with diabetes mellitus visits a health care clinic. The client's diabetes mellitus previously had been well controlled with glyburide daily, but recently the fasting blood glucose level has been 180 to 200 mg/dL (10 to 11.1 mmol/L). Which medication, if added to the client's regimen, may have contributed to the hyperglycemia? 1. Atenolol 2. Prednisone 3. Phenelzine 4. Allopurinol

2

A client with gastritis who uses nonsteroidal antiinflammatory drugs (NSAIDs) has been taking misoprostol. The nurse determines that the misoprostol is having the intended therapeutic effect if which finding is noted? 1. Resolved diarrhea 2. Relief of epigastric pain 3. Decreased platelet count 4. Decreased white blood cell count

2

A client with peptic ulcer disease has been taking omeprazole for 4 weeks. The ambulatory care nurse evaluates that the client is receiving the optimal intended effect of the medication if the client reports the absence of which symptom? 1. Diarrhea 2. Heartburn 3. Flatulence 4. Constipation

2

A client with valvular heart disease who has a clot in the right atrium is receiving a heparin sodium infusion at 1000 units/hr and warfarin sodium 7.5 mg at 1600 daily. The morning laboratory results are as follows: aPT time, 32 seconds; international normalized ratio, 1.3. Which action would the nurse take based on the client's laboratory results? 1. Collaborate with the PHCP to discontinue the heparin infusion and administer the warfarin sodium as prescribed. 2. Collaborate with the PHCP to obtain a prescription to increase the heparin infusion and continue the warfarin sodium as prescribed. 3. Collaborate with the PHCP to withhold the warfarin sodium since the client is receiving a heparin infusion and the aPTT is within the therapeutic range. 4. Collaborate with the PHCP to continue the heparin infusion at the same rate and to discuss use of dabigatran etexilate in place of warfarin sodium.

2

Bethanechol chloride is prescribed for a client with urinary retention. The nurse would contact the prescriber if which disorder, a contraindication to the medication, was documented in the client's record? 1. Gastric atony 2. Urinary strictures 3. Neurogenic atony 4. Gastroesophageal reflux

2

Intravenous heparin therapy is prescribed for a client with atrial fibrillation. While implementing this prescription, the nurse ensures that which medication is available on the nursing unit? 1. Vitamin K 2. Protamine sulfate 3. Potassium chloride 4. Aminocaproic acid

2

Phenazopyridine is prescribed for a client with a urinary tract infection. The nurse evaluates that the medication is effective based on which observation? 1. Urine is clear amber. 2. Urination is not painful. 3. Urge incontinence is not present. 4. A reddish-orange discoloration of the urine is present.

2

The home care nurse visits a client recently diagnosed with diabetes mellitus who is taking Humulin NPH insulin daily. The client asks the nurse how to store the unopened vials of insulin. The nurse would tell the client to take which action? 1. Freeze the insulin. 2. Refrigerate the insulin. 3. Store the insulin in a dark, dry place. 4. Keep the insulin at room temperature.

2

The nurse administered intravenous bumetanide to a client being treated for heart failure. Which outcome indicates that the medication has achieved the expected effect? 1. Cough becomes productive of frothy pink sputum. 2. Urine output increases from 10 mL/hr to greater than 50 mL hourly. 3. The serum potassium level changes from 3.8 to 3.1 mEq/L (3.8 to 3.1 mmol/L). 4. B-type natriuretic peptide (BNP) factor increases from 200 to 262 ng/mL (200 to 262 mcg/L).

2

The nurse has a prescription to give a client salmeterol, 2 puffs, and beclomethasone dipropionate, 2 puffs, by metered-dose inhaler. The nurse would administer the medication using which procedure? 1. Beclomethasone first and then the salmeterol 2. Salmeterol first and then the beclomethasone 3. Alternating a single puff of each, beginning with the salmeterol 4. Alternating a single puff of each, beginning with the beclomethasone

2

The nurse provides discharge instructions to a client with atrial fibrillation who is taking warfarin sodium. Which statement by the client reflects the need for further teaching? 1. "I will avoid alcohol consumption." 2. "I will take coated aspirin for my headaches." 3. "I will take my pills every day at the same time." 4. "I have already called my family to pick up a MedicAlert bracelet."

2

Oxycodone has been prescribed for a client to treat pain. Which side and adverse effects would the nurse monitor for? Select all that apply. 1. Diarrhea 2. Tremors 3. Drowsiness 4. Hypotension 5. Urinary frequency 6. Increased respiratory rate

2, 3, 4

Glimepiride is prescribed for a client with diabetes mellitus. The nurse instructs the client that which food items are most acceptable to consume while taking this medication? Select all that apply. 1.Alcohol 2.Red meats 3.Whole-grain cereals 4.Low-calorie desserts 5.Carbonated beverages

2, 3, 5

A pregnant client is receiving magnesium sulfate for the management of preeclampsia. The nurse determines that the client is experiencing toxicity from the medication if which findings are noted on assessment? Select all that apply. 1. Proteinuria of 3+ 2. Respirations of 10 breaths per minute 3. Presence of deep tendon reflexes 4. Urine output of 20 mL in an hour 5. Serum magnesium level of 4 mEq/L (2 mmol/L)

2, 4

The nurse is monitoring a client with heart failure who is taking digoxin. Which findings are characteristic of digoxin toxicity? Select all that apply. 1. Tremors 2. Diarrhea 3. Irritability 4. Blurred vision 5. Nausea and vomiting

2, 4, 5

The nurse teaches the client who is newly diagnosed with diabetes insipidus about the prescribed intranasal desmopressin. Which statements by the client indicate understanding? Select all that apply. 1."This medication will turn my urine orange." 2."I need to decrease my oral fluids when I start this medication." 3."The amount of urine I make should increase if this medicine is working." 4."I need to follow a low-fat diet to avoid pancreatitis when taking this medicine." 5."I need to report headache and drowsiness to my doctor since these symptoms could be related to my desmopressin."

2, 5

A client with atrial fibrillation is receiving a continuous heparin infusion at 1000 units/hr. Which result would indicate to the nurse that the client is receiving a therapeutic dose? 1. Prothrombin time of 12.5 seconds 2. Activated partial thromboplastin time of 28 seconds 3. Activated partial thromboplastin time of 60 seconds 4. Activated partial thromboplastin time longer than 120 seconds

3

A client has been started on long-term therapy with rifampin. The nurse would provide which information to the client about the medication? 1. Would always be taken with food or antacids 2. Would be double-dosed if one dose is forgotten 3. Causes orange discoloration of sweat, tears, urine, and feces 4. May be discontinued independently if symptoms are gone in 3 months

3

A client is being treated with procainamide for a cardiac dysrhythmia. Following intravenous administration of the medication, the client complains of dizziness. Which intervention would the nurse implement first? 1. Obtain a 12-lead electrocardiogram. 2. Check the client's fingerstick blood glucose level. 3. Auscultate the client's apical pulse and blood pressure. 4. Measure the QRS interval duration on the rhythm strip.

3

A client is diagnosed with an ST segment elevation myocardial infarction (STEMI) and is receiving a tissue plasminogen activator, alteplase. Which action is a priority nursing intervention? 1. Monitor for kidney failure. 2. Monitor psychosocial status. 3. Monitor for signs of bleeding. 4. Have heparin sodium available.

3

A client is taking the prescribed dose of phenytoin to control seizures. Results of a phenytoin blood level study reveal a level of 35 mcg/mL. Which finding would be expected as a result of this laboratory result? 1. Hypotension 2. Tachycardia 3. Slurred speech 4. No abnormal finding

3

A client with a peptic ulcer is diagnosed with a Helicobacter pylori infection. The nurse is teaching the client about the medications prescribed, including clarithromycin, esomeprazole, and amoxicillin. Which statement by the client indicates the best understanding of the medication regimen? 1. "My ulcer will heal because these medications will kill the bacteria." 2. "These medications are taken only when I have pain from my ulcer." 3. "The medications will kill the bacteria and stop the acid production." 4. "These medications will coat the ulcer and decrease the acid production in my stomach."

3

The home health nurse visits a client who is taking phenytoin for control of seizures. During the assessment, the nurse notes that the client is taking birth control pills. Which information would the nurse include in the teaching plan? 1. Pregnancy must be avoided while taking phenytoin. 2. The client may stop the medication if it is causing severe gastrointestinal effects. 3. There is the potential of decreased effectiveness of birth control pills while taking phenytoin. 4. There is the increased risk of thrombophlebitis while taking phenytoin and birth control pills together.

3

The nurse has given instructions to a client with biliary disease who has just been prescribed cholestyramine. Which statement by the client indicates a need for further instruction? 1. "I will continue to take vitamin supplements." 2. "This medication will help lower my cholesterol." 3. "This medication would only be taken with water." 4. "A high-fiber diet is important while taking this medication."

3

The nurse is preparing to administer a dose of naloxone intravenously to a client with an opioid overdose. Which supportive medical equipment would the nurse plan to have at the client's bedside? 1. Nasogastric tube 2. Paracentesis tray 3. Resuscitation equipment 4. Central line insertion tray

3

The nurse is providing dietary instructions to a client who has been prescribed cyclosporine. Which food item would the nurse instruct the client to exclude from the diet? 1. Red meats 2. Orange juice 3. Grapefruit juice 4. Green, leafy vegetables

3

Zafirlukast is prescribed for a client with bronchial asthma. Which laboratory test does the nurse expect to be prescribed before the administration of this medication? 1. Platelet count 2. Neutrophil count 3. Liver function tests 4. Complete blood count

3

The client with hyperparathyroidism is taking alendronate. Which statements by the client indicate understanding of the proper way to take this medication? Select all that apply. 1."I need to take this medication with food." 2."I need to take this medication at bedtime." 3."I need to sit up for at least 30 minutes after taking this medication." 4."I need to take this medication first thing in the morning on an empty stomach." 5."I can pick a time to take this medication that best fits my lifestyle as long as I take it at the same time each day."

3, 4

The nurse is monitoring a client who is receiving oxytocin to induce labor. Which assessment findings would cause the nurse to immediately discontinue the oxytocin infusion? Select all that apply. 1. Fatigue 2. Drowsiness 3. Uterine hyperstimulation 4. Late decelerations of the fetal heart rate 5. Early decelerations of the fetal heart rate

3, 4

Nitrofurantoin is prescribed for a client with a urinary tract infection. The client contacts the nurse and reports a cough, chills, fever, and difficulty breathing. The nurse would make which interpretation about the client's complaints? 1. The client may have contracted the flu. 2. The client is experiencing anaphylaxis. 3. The client is experiencing expected effects of the medication. 4. The client is experiencing a pulmonary reaction requiring cessation of the medication.

4

A client with a gastric ulcer has a prescription for sucralfate 1 gram by mouth 4 times daily. The nurse would schedule the medication for which times? 1. With meals and at bedtime 2. Every 6 hours around the clock 3. One hour after meals and at bedtime 4. One hour before meals and at bedtime

4

A client with gastroenteritis has an as-needed prescription for ondansetron. For which condition(s) would the nurse administer this medication? 1. Paralytic ileus 2. Incisional pain 3. Urinary retention 4. Nausea and vomiting

4

A client with gastroesophageal reflux disease has a new prescription for metoclopramide. On review of the chart, the nurse identifies that this medication can be safely administered with which condition? 1. Intestinal obstruction 2. Peptic ulcer with melena 3. Diverticulitis with perforation 4. Vomiting following cancer chemotherapy

4

A cromolyn sodium inhaler is prescribed for a client with allergic asthma. The nurse provides instructions regarding the adverse effects of this medication and would tell the client that which undesirable effect is associated with this medication? 1. Insomnia 2. Constipation 3. Hypotension 4. Bronchospasm

4

A pediatrician's prescription reads "ampicillin sodium 125 mg IV every 6 hours." The medication label reads "when reconstituted with 7.4 mL of bacteriostatic water, the final concentration is 1 g/7.4 mL." The nurse prepares to draw up how many milliliters to administer 1 dose? 1. 1.1 mL 2. 0.54 mL 3. 7.425 mL 4. 0.925 mL

4

Carbidopa-levodopa is prescribed for a client with Parkinson's disease. The nurse monitors the client for side and adverse effects of the medication. Which finding indicates that the client is experiencing an adverse effect? 1. Pruritus 2. Tachycardia 3. Hypertension 4. Impaired voluntary movements

4

Methylergonovine is prescribed for a client with postpartum hemorrhage. Before administering the medication, the nurse would contact the obstetrician who prescribed the medication if which condition is documented in the client's medical history? 1. Hypotension 2. Hypothyroidism 3. Diabetes mellitus 4. Peripheral vascular disease

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Penicillin G procaine, 1,000,000 units IM (intramuscularly), is prescribed for an adolescent with an infection. The medication label reads "1,200,000 units per 2 mL." The nurse has determined that the dose prescribed is safe. The nurse administers how many milliliters per dose to the adolescent? Round answer to the nearest tenth position. 1. 0.8 mL 2. 1.2 mL 3. 1.4 mL 4. 1.7 mL

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Prior to administering a client's daily dose of digoxin to treat heart failure, the nurse reviews the client's laboratory data and notes the following results: serum calcium, 9.8 mg/dL (2.45 mmol/L); serum magnesium, 1.0 mEq/L (0.4 mmol/L); serum potassium, 4.1 mEq/L (4.1 mmol/L); serum creatinine, 0.9 mg/dL (79.5 mcmol/L). Which result would alert the nurse that the client is at risk for digoxin toxicity? 1. Serum calcium level 2. Serum potassium level 3. Serum creatinine level 4. Serum magnesium level

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Rho(D) immune globulin is prescribed for a client after delivery, and the nurse provides information to the client about the purpose of the medication. The nurse determines that the client understands the purpose if the client states that it will protect the next baby from which condition? 1. Having Rh-positive blood 2. Developing a rubella infection 3. Developing physiological jaundice 4. Being affected by Rh incompatibility

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Tacrolimus is prescribed for a client who underwent a kidney transplant. Which instruction would the nurse include when teaching the client about this medication? 1. Eat at frequent intervals to avoid hypoglycemia. 2. Take the medication with a full glass of grapefruit juice. 3. Change positions carefully due to risk of orthostatic hypotension. 4. Take the oral medication every 12 hours at the same times every day.

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The home health care nurse is visiting a client with coronary artery disease with elevated triglyceride levels and a serum cholesterol level of 398 mg/dL (10 mmol/L). The client is taking cholestyramine, and the nurse teaches the client about the medication. Which statement by the client indicates the need for further teaching? 1. "Constipation and bloating might be a problem." 2. "I'll continue to watch my diet and reduce my fats." 3. "Walking a mile each day will help the whole process." 4. "I'll continue my nicotinic acid from the health food store."

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The nurse has given a client taking ethambutol information about the medication. The nurse determines that the client understands the instructions if the client states that they will immediately report which finding? 1. Impaired sense of hearing 2. Gastrointestinal side effects 3. Orange-red discoloration of body secretions 4. Difficulty in discriminating the color red from green

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