Random Questions PHARM

A nurse is teaching a client who has a new ezetimibe prescription for hyperlipidemia. Which of the following client statements should indicate to the nurse that the teaching was effective? A. "I should let my doctor know if I have yellowing of my eyes." B. "This medication will stop my liver from making cholesterol." c. "I should expect to experience some bruising when I begin this medication." D. "I will take this medication at the same time as my gemfibrozil."

A. "I should let my doctor know if I have yellowing of my eyes." The nurse should include in the teaching that jaundice can be an adverse effect of ezetimibe as a result of hepatitis. The client should notify the provider if this occurs.

A nurse is administering subcutaneous heparin to a client who is at risk for deep vein thrombosis. Which of the following actions should the nurse take? A. Administer the medication into the client's abdomen B. Inject the medication into a muscle C. Massage the site after administering the medication D. Use a 22-gauge needle to administer the medication

A. Administer the medication into the client's abdomen

A nurse is caring for a client who has a new prescription for tamoxifen. The nurse should recognize that tamoxifen has which of the following therapeutic effects? A. Anti-estrogenic B. Antimicrobial C. Androgenic D. Anti-inflammatory

A. Anti-estrogenic Tamoxifen is an anti-estrogen medication used to treat cancer of the breast in both premenopausal and postmenopausal women. It is also used to prevent breast cancer in women who are at an increased risk.

A nurse is preparing to administer the varicella vaccine to a 12-month-old infant. The nurse asks the infant's guardian if the infant has any allergies. Which of the following allergies is a contraindication to the infant receiving the vaccine? A. Gelatin B. Milk C. Eggs D. Peanuts

A. Gelatin eggs = influenza vaccine

A nurse is providing teaching to a group of new parents about medications. The nurse should include that aspirin is contraindicated for children who have a viral infection due to the risk of developing which of the following adverse effects? A. Reye's syndrome B. Visual disturbances C. Diabetes mellitus D. Wilms' tumor

A. Reye's syndrome Aspirin should not be given to children or adolescents who have a viral infection like chickenpox or influenza due to the risk of developing Reye's syndrome.

A nurse is caring for a client who has asthma and requires long-term treatment. The nurse should identify that which of the following medications used for long-term treatment places the client at an increased risk of asthma-related death? A. Salmeterol B. Fluticasone C. Budesonide D. Theophylline

A. Salmeterol The nurse should identify that salmeterol is a long-acting beta2-agonist. When this medication is used alone for the long-term treatment of asthma, this class of medication increases the client's risk of asthma-related death. To decrease this risk, the client should be prescribed both a long-acting beta2-agonist along with an inhaled corticosteroid.

A nurse is assessing a client who reports using several herbal and vitamin supplements daily, including saw palmetto. The nurse should recognize that saw palmetto is a supplement used by clients to elicit which of the following therapeutic effects? A. Urinary health promotion B. Immune system stimulation C. Decreased leg pain from arterial disease D. Prevention of nausea caused by motion sickness

A. Urinary health promotion Saw palmetto is used primarily for manifestations related to prostatic conditions such as benign prostatic hypertrophy (BPH). Its effectiveness has not been scientifically verified, however. The nurse should instruct the client to check with the provider about interactions between saw palmetto and other medications.

A nurse is providing discharge teaching to a client who had a kidney transplant and has a prescription for oral cyclosporine. Which of the following statements by the client indicates an understanding of the teaching? A. "I will be able to stop taking this medication within 6 months after my surgery." B. "I am likely to develop higher blood pressure while taking this medication." c. "I am likely to lose my hair while taking this medication." D. "I am taking this medication to boost my immune system."

B. "I am likely to develop higher blood pressure while taking this medication." Half the clients who take cyclosporine develop a 10% to 15% increase in blood pressure and might need to start antihypertensive therapy.

A nurse is administering a client's first dose of sucralfate. Which of the following explanations should the nurse provide about the action of sucralfate? A. "Sucralfate decreases gastric acid secretions." B. "Sucralfate forms a gel-like substance that protects ulcers." C. "Sucralfate inactivates Helicobacter pylori." D. "Sucralfate inhibits the production of gastric acid."

B. "Sucralfate forms a gel-like substance that protects ulcers." The primary action of sucralfate is the formation of a gel-like protectant that adheres to the ulcer surface. This protective mechanism lasts for 6 hours and allows the ulcer to heal.

A nurse is preparing to administer nitroglycerin topical ointment to a client who has angina. Which of the following actions should the nurse take? A. Cover the applied ointment with cotton gauze B. Apply the ointment using a dose-measuring applicator C. Apply the ointment using the index finger D. Massage the ointment into the client's skin

B. Apply the ointment using a dose-measuring applicator The nurse should apply the ointment using a dose-measuring applicator. This allows the nurse to measure the correct dose the client is to receive.

A nurse is teaching a client who is premenopausal and has a prescription for a combination oral contraceptive. Which of the following findings should the nurse include as an adverse effect of oral contraceptives? A. Bone fractures B. Deep-vein thrombosis C. Increased LDL cholesterol D. Increased risk of breast cancer

B. Deep-vein thrombosis The nurse should include in the teaching that clients who are premenopausal and have a prescription for a combination oral contraceptive containing estrogen are at an increased risk for developing a deep-vein thrombosis, which is an adverse effect of this medication.

A nurse is monitoring a client who has asthma, takes albuterol, and recently started taking propranolol to treat a cardiovascular disorder. The client reports that the albuterol has been less effective. Which of the following factors should the nurse identify as a possible explanation for this change? A. Potentiative interaction B. Detrimental inhibitory interaction C. Increased adverse reaction D. Toxicity-reducing inhibitory interaction

B. Detrimental inhibitory interaction A detrimental inhibitory interaction can occur with the concurrent use of propranolol and albuterol. When a client takes propranolol and albuterol together, propranolol can interfere with albuterol's therapeutic effects.

A nurse is admitting a client who has atrial fibrillation with a heart rate of 155/min. The nurse should anticipate a prescription from the provider for which of the following medications? A. Atropine B. Diltiazem C. Epinephrine D. Vasopressin

B. Diltiazem The nurse should anticipate the provider to prescribe diltiazem for a client who is experiencing atrial fibrillation. Diltiazem is an antiarrhythmic agent that reduces the ventricular rate in atrial fibrillation.

A nurse is caring for a client who has a new prescription for ergotamine. The nurse should recognize that ergotamine is administered to treat which of the following conditions? A. Raynaud's phenomenon B. Migraine headaches c. Ulcerative colitis D. Anemia

B. Migraine headaches Ergotamine prevents or stops a migraine headache by blocking alpha-adrenergic receptors in the cranial peripheral vascular smooth muscle, which causes vasoconstriction of dilated cerebral blood vessels.

A nurse is caring for a client who has been in the PACU for more than 1 hr, has a respiratory rate of 9/min, and is difficult to arouse. The nurse should expect a prescription for which of the following medications? A. Pentazocine B. Naloxone C. Naltrexone D. Butorphanol

B. Naloxone The nurse should expect a prescription for naloxone. This medication displaces opiate medications from receptor sites, reversing the respiratory depression, sedation, and analgesia that opiates cause.

A nurse is caring for a client with chronic obstructive pulmonary disease (COPD) who has been taking tiotropium. Which of the following client statements should indicate to the nurse that the client is experiencing an adverse effect of this medication? A. "My body aches all over." B. "I am urinating more during the day." C. "My mouth feels dry all the time." D. "I have trouble sleeping at night."

C. "My mouth feels dry all the time." The nurse should identify that dry mouth is a common adverse effect of this medication's anticholinergic effects. Tiotropium is a long-acting anticholinergic inhaled medication used for maintenance therapy for clients with COPD.

A nurse is caring for a client who has a prescription for clopidogrel. The nurse should monitor the client for which of the following adverse effects? A. Insomnia B. Hypotension C. Bleeding D. Constipation

C. Bleeding Clopidogrel is an antithrombotic medication that inhibits platelet aggregation. It is used to prevent stenosis of coronary stents, myocardial infarctions, and strokes. The nurse should monitor for coffee-ground emesis, black tarry stools, ecchymosis, or any indication of bleeding.

A nurse is providing teaching to a client who has gout and a new prescription for allopurinol. The nurse should instruct the client to discontinue taking the medication for which of the following adverse effects? A. Nausea B. Metallic taste C. Fever D. Drowsiness

C. Fever A fever can indicate a potentially fatal hypersensitivity reaction. The client should discontinue allopurinol and notify the provider if a fever or rash develops.

A nurse is teaching self-administration of NPH insulin to a client who has type 2 diabetes mellitus. Which of the following instructions should the nurse include? A. Alternate injecting doses between the abdomen and the thigh B. Shake the vial before withdrawing the dosage C. Rotate injection sites within the same area D. Discard the vial if the insulin is

C. Rotate injection sites within the same area

A nurse is reviewing the laboratory data for a client who has Alzheimer's disease and a new prescription for memantine. The nurse should identify that which of the following findings increases the client's risk for reduced clearance of the medication? A. Alanine aminotransferase (ALT) 60 international units/L B. Creatinine clearance 35 mL/min C. HbAlc 5% D. BMI 31

Correct Answer: B. Creatinine clearance 35 mL/min Creatinine clearance is an estimate of the glomerular filtration rate (GFR) and the kidneys' ability to filter waste. A creatinine clearance of 35 mL/min is below the expected reference range of 87 to 139 mL/min and indicates moderate renal impairment. Memantine is excreted by the kidneys, and decreased clearance occurs with moderate renal impairment.

A nurse is teaching a client who has a prescription for a combination oral contraceptive (OC) that uses a 28-day cycle. Which of the following instructions should the nurse include in the teaching? A. "If you miss a pill, take the missed pill with your next dose." B. "If you miss 2 pills during the second and third week, discard the inactive placebo pills and begin a new pack." c. "f you miss 3 pills during the second week, take a pill as soon as possible and continue with your scheduled doses." D. "You can miss up to 7 pills with little risk in getting pregnant as long as you have taken the pills regularly for the previous 3 weeks."

D. "You can miss up to 7 pills with little risk in getting pregnant aslong as you have taken the pills regularly for the previous 3 weeks."

A nurse is caring for a client who has a dry nonproductive cough. Which of the following types of medication should the nurse recommend? A. Expectorant B. Mucolytic C. Bronchodilator D. Antitussive

D. Antitussive Antitussives suppress the cough reflex. Incorrect Answers: Expectorants help mobilize secretions. Mucolytics help liquefy secretions. Bronchodilators help open air passages.

A nurse is caring for a client who takes sultasalazine twice daily for rheumatoid arthritis. Which of the following values should the nurse review prior to the administration of the medication? A. Respirations B. Serum creatinine level C. Blood pressure D. Complete blood count

D. Complete blood count The nurse should identify that sulfasalazine can cause bone marrow suppression, which can lead to agranulocytosis, hemolytic anemia, and macrocytic anemia. As a result, the client's complete blood count should be periodically monitored, and the nurse should review it prior to administering this medication.

A nurse is assessing a client who is receiving a continuous morphine IV infusion and finds the client's respiratory rate has decreased from 20/min to 12/min. Which of the following actions should the nurse take? A. Flush the IV line with saline B. Administer flumazenil C. Lower the head of the bed D. Slow the rate of the infusion

D. Slow the rate of the infusion

A nurse is caring for a client who has tuberculosis and is taking rifampin. Which of the following client statements should indicate to the nurse that the client is experiencing an adverse effect of the medication? A. "I have noticed my urine is orange in color." B. "I sleep more than I used to." C. "My tongue and mouth are sore." D. "My voice seems hoarse."

A. "I have noticed my urine is orange in color." The nurse should identify that an adverse effect of rifampin can be red-orange colored urine, saliva, sweat, and tears as the medication is excreted from the body. The nurse should also inform the client that permanent staining of contact lenses can occur. However, this adverse effect is harmless. The client should inform the provider if urine becomes dark in color since this can be an indication of hepatotoxicity.

A nurse is providing teaching about sodium phosphate to a client who has a new prescription for sodium phosphate. The client is scheduled for a colonoscopy and is currently taking furosemide for hypertension. Which of the following client statements should indicate to the nurse that the teaching has been effective? A. "I can take my water pill as prescribed." B." can experience an imbalance in my electrolytes from this medication." C. "I should drink 8 ounces of bowel cleanser every 10 minutes until I drink a total of 4 liters." • D. "I can experience rebound constipation after using this medication."

B." can experience an imbalance in my electrolytes from this medication" Sodium phosphate can cause excess fluid loss as a result of cleansing the bowel of stool. Therefore, the client is at risk for electrolyte imbalance and should be monitored closely.

A nurse is teaching a client who has osteoporosis and a new prescription for alendronate. Which of the following client statements indicates that the teaching was effective? A. "I should take the medication with a glass of orange juice." B. "I will allow the medication to dissolve in my mouth." C." will sit upright for 30 minutes after taking the medication." D. "I should take the medication right after eating breakfast."

C." will sit upright for 30 minutes after taking the medication." The nurse should instruct the client to sit upright or stand for at least 30 minutes after taking the medication to prevent esophagitis.

A nurse is caring for a client who reports crushing chest pain. The nurse reviews the client's ECG results and notes ST changes. Which of the following medications should the nurse administer? A. Simvastatin B. Furosemide C.Nitroglycerin D. Sildenafil

C.Nitroglycerin

A nurse is teaching a female client about vitamin A supplementation. Which of the following client statements indicates an understanding of the teaching? A. "Vitamin A supplements are usually prescribed during pregnancy." B. "Vitamin A can be taken in high doses because it is water-soluble." C. "Vitamin A is encouraged for women who have osteoporosis." D. "A deficiency of vitamin A can cause night blindness."

D. "A deficiency of vitamin A can cause night blindness." The nurse should identify that vitamin A is required for dark light adaptation. When a client has a deficiency of vitamin A, night blindness is often the first sign. As the deficiency continues, other eye conditions can arise such as a dry and thickened conjunctiva and degeneration of the cornea.

A nurse manager is instructing a newly licensed nurse about routes of medication administration. Which of the following routes involves medication absorption through the mucous membranes under the tongue? A. Oral B. Topical C. Parenteral D. Sublingual

D. Sublingual

A nurse is providing teaching to a client who has cirrhosis and a new prescription for lactulose. The nurse should instruct the client that lactulose has which of the following therapeutic effects? • A. Increases blood pressure • B. Prevents esophageal bleeding • C. Decreases heart rate • D. Reduces ammonia levels

Reduces ammonia levels Lactulose is a laxative that promotes the excretion of ammonia in a client who has hepatic encephalopathy from cirrhosis of the liver.

A nurse is providing teaching to a client with tuberculosis who has prescriptions for rifampin and ethambutol. Which of the following findings is an adverse effect of these medications that the client should report to the provider? A. Red-orange discoloration of urine B. Unexpected weight gain C. Ringing in the ears D. Decreased visual acuity

D. Decreased visual acuity The nurse should identify optic neuritis as an adverse effect of ethambutol. The nurse should instruct the client to monitor for changes in visual acuity or color identification as indications of optic neuritis to report to the provider. This adverse effect necessitates termination of ethambutol therapy because irreversible blindness can result.

A nurse is caring for a client who is 12 hours postoperative following a total hip arthroplasty. Which of following medications should the nurse anticipate administering to this client to prevent deep vein thrombosis (DVT)? A. Aspirin B. Warfarin C. Ticagrelor D. Enoxaparin

D. Enoxaparin The nurse should anticipate the administration of enoxaparin for a client who is 12 hours postoperative following surgery. Enoxaparin is low-molecular-weight (LMW) heparin that is used to prevent a DVT by inhibiting the effects of antithrombin and thrombin.

A nurse is reviewing the laboratory reports of a client who has been taking warfarin for atrial fibrillation. Which of the following results should the nurse report to the provider immediately? A. PT 18 seconds B. Platelet count 160,000/mm^3 C. Hct 43% D. INR 5.5

D. INR 5.5 When using the urgent vs nonurgent approach to client care, the nurse should determine that the priority laboratory result is an INR of 5.5. A client who is taking warfarin for the treatment of atrial fibrillation is expected to have an INR in the range of 2 to 3. A level of 5.5 is considered a critical value and places the client at risk of bleeding; therefore, the nurse should report this result to the provider immediately.

A charge nurse is monitoring a newly licensed nurse who is caring for a postoperative client who is receiving morphine through a PCA pump. Which of the following actions by the newly licensed nurse requires intervention? A. Instructing the client to administer a PCA dose prior to a dressing change B. Providing increased fluids while the client is using the PCA pump C. Informing the client's partner that only the client shouldadminister the PCA doses D. Maintaining the client on bed rest while the PCA pump is in use

D. Maintaining the client on bed rest while the PCA pump is in use Use of a PCA pump does not prevent ambulation following surgery. Early ambulation should be encouraged. The nurse should instruct the client to sit at the side of the bed prior to standing to reduce the risks of orthostatic hypotension and falls.

A nurse is caring for a client who is taking a prescription for glucocorticoid adrenal replacement medication for the long-term treatment of Addison's disease. Which of the following findings indicates that the client is experiencing an adverse effect of the medication? A. Weight loss B. Hypotension C. Lethargy D. Osteoporosis

D. Osteoporosis Long-term use of steroid medications such as glucocorticoid medication can inhibit bone growth and result in the adverse effect of osteoporosis with long-term treatment.

A nurse is caring for a client who is experiencing an acute asthma exacerbation. Which of the following medications should the nurse identify as being contraindicated for this client? A. Dextromethorphan B. Montelukast C. Ciprofloxacin D. Propranolol

D. Propranolol The nurse should identify that a client who is experiencing an acute asthma exacerbation requires the use of a beta2-agonist to alleviate bronchospasm and relax the client's airway. Therefore, propranolol is contraindicated for this client. Propranolol is a beta-blocker that is used to treat cardiac conditions, including hypertension. Blocking the beta receptors prevents the action of beta2-agonists such as albuterol.

A nurse is caring for a female client who has osteoporosis and is taking raloxifene. Which of the following findings should indicate to the nurse that the client is experiencing an adverse effect of this medication? A. Severe leg cramps B. Urinary frequency C. Jaw pain D. Sudden onset of dyspnea

D. Sudden onset of dyspnea The nurse should identify that raloxitene is a selective estrogen receptor modulator (SERM), which can have estrogenic effects in some tissues and anti-estrogenic effect in other tissues. Clients who are taking raloxifene have an increased risk of thromboembolic events such as deep-vein thrombosis, pulmonary embolism, or stroke. Therefore, the nurse should notify the provider if the client is experiencing this adverse effect of raloxifene.

A nurse is planning discharge teaching for a client who has major depressive disorder and a new prescription for phenelzine. Which of the following foods should the nurse include in the plan as safe for the client to consume while taking phenelzine? A. Broiled beef steak B. Macaroni and cheese C. Pepperoni pizza D. Smoked salmon

A. Broiled beef steak Phenelzine, an MAOl, is an antidepressant. This medication interacts with a variety of foods to produce a hypertensive crisis. Beef steak and other meats that are fresh do not interact with phenelzine and are safe to consume.

A nurse is preparing a continuous IV infusion of erythromycin lactobionate for a client who has a Bordetella pertussis infection. Which of the following actions should the nurse take to minimize the risk of thrombophlebitis? A. Infuse the medication slowly B. Administer half the dosage C. Avoid diluting the solution D. Initiate intermittent dosing

A. Infuse the medication slowly The nurse should infuse erythromycin slowly to minimize the risk of thrombophlebitis, which is an inflammatory process resulting from the formation of a blood clot in a vein. These blood clots usually form in the legs.

A nurse is caring for a client who has schizophrenia and a prescription for chlorpromazine. For which of the following adverse effects should the nurse monitor? A. Orthostatic hypotension B. Diarrhea C. Urinary frequency D. Bradycardia

A. Orthostatic hypotension Orthostatic hypotension is an adverse effect of chlorpromazine. Other adverse effects include palpitations, tachycardia, constipation, sedation, and photosensitivity.

A nurse is caring for a client who was recently diagnosed with rheumatoid arthritis. The nurse should expect the provider to prescribe methotrexate at which of the following times? A. Within 3 months of the initial diagnosis B. When NSAIDs have not provided pain relief C. During an exacerbation of symptoms D. Once bone degeneration progresses

A. Within 3 months of the initial diagnosis The nurse should identify that current guidelines recommend starting a disease-modifying antirheumatic drug (DMARD) such as methotrexate within 3 months of a diagnosis of rheumatoid arthritis to prevent or delay joint degeneration.

A nurse is teaching a client who has allergic rhinitis about a new prescription for brompheniramine. Which of the following pieces of information should the nurse include in the teaching? • A. "Report gastrointestinal disturbances immediately." B. "You might find that you develop a dry mouth." C. "You should not experience any central nervous system alterations." D. "Increased urinary frequency is an expected effect."

B. "You might find that you develop a dry mouth." A client who takes a first-generation antihistamine such as brompheniramine can experience cholinergic blockade effects that can cause drying of mucous membranes in the mouth, nasal passages, and throat. Taking frequent sips of liquid or sucking on a hard, sugarless candy can help relieve dry mouth.

A nurse is providing teaching about antiretroviral medication therapy to a client who has a new diagnosis of AIDS. Which of the following statements should the nurse include in the teaching? A. "Your provider will prescribe a single antiretroviral medication at a time." B. "You should take antiretroviral medications on a routine schedule." c. "You should increase your intake of raw fruits and vegetables while taking antiretroviral medications." D. "Your provider will prescribe antiretroviral therapy to kill the HIV."

B. "You should take antiretroviral medications on a routine schedule." The nurse should inform the client of the need to take antiretroviral therapy exactly as prescribed and to avoid delaying or skipping any doses, which can result in medication resistance. Incorrect Answers: A. The nurse should inform the client that the provider will prescribe multiple antiretroviral medications at a time. This approach, called highly active antiretroviral therapy (HAART), improves the effectiveness of treatment. A prescription for a single antiretroviral medication at a time promotes medication resistance. The nurse should inform the client of the need to avoid raw fruits and vegetables to reduce the risk of infection due to immunosuppression. The nurse should inform the client that antiretroviral therapy does not kill the HIV virus but inhibits viral replication

A nurse is reviewing the medication history of a client who has mild intermittent asthma. The nurse should anticipate a prescription for which of the following inhalers for the client? A. Ipratropium B. Albuterol sulfate C. Tiotropium D. Budesonide

B. Albuterol sulfate The nurse should anticipate a client who has mild intermittent asthma to be prescribed albuterol sulfate. Albuterol sulfate is a short-acting beta2-agonist that activates beta2-receptors in the smooth muscle of the lung allowing the client's airway and lungs to dilate, thereby relieving bronchospasm and allowing the client to breathe.

A nurse in a provider's office is reviewing a client's medication history. Th client asks the nurse if she should begin taking high-dose vitamins as she ages. Which of the following pieces of information should the nurse provide about high doses of vitamin supplements? A. High doses of water-soluble vitamins enhance their therapeuticactions. B. High doses of water-soluble vitamins can have adverse effects. C. High doses of vitamin supplements are restricted to use duringpregnancy. D. Tolerance might develop, resulting in an increased vitamin need.

B. High doses of water-soluble vitamins can have adverse effects. High doses of vitamins can cause harm to the body. Any vitamin supplements consumed should not exceed the recommended dietary allowance. Elevated levels of vitamin A can increase the risk of developing osteoporosis and cause birth defects when taken during pregnancy. Excessive intake of beta-carotene can increase the risk of lung cancer in clients who smoke. In addition, increased doses of vitamin E can increase the risk of death in clients who have chronic illnesses.

A nurse is reviewing the medical record of a client who has postmenopausal osteoporosis and a prescription for raloxifene. Which of the following findings in the client's medical record should the nurse identify as a contraindication to receiving this medication? A. Breast cancer B. History of deep-vein thrombosis (DVT) C. Allergy to calcitonin D. Current diagnosis of cholecystitis

B. History of deep-vein thrombosis (DVT) The nurse should identify that a history of DVT is a contraindication for receiving raloxifene because this medication can cause DVT in clients who have a prior history. Therefore, the nurse should notify the provider of this finding and request an alternative medication prescription for the client.

A nurse is providing teaching to a newly licensed nurse about metoclopramide. The nurse should highlight that which of the following conditions is a contraindication to this medication? A. Hyperthyroidism B. Intestinal obstruction C. Glaucoma D. Low blood pressure

B. Intestinal obstruction Metoclopramide reduces nausea and vomiting by increasing gastric motility and promoting gastric emptying. It is contraindicated for a client who has an intestinal obstruction or perforation.

A nurse is reviewing the medical record for a client who has a migraine and a prescription for sumatriptan. Which of the following factors in the client's medical history should the nurse identify as a contraindication to receiving sumatriptan? A. Renal impairment B. Ischemic heart disease C. Severe osteoporosis D. Cirrhosis

B. Ischemic heart disease The nurse should identify that ischemic heart disease is a contraindication to receiving sumatriptan. Sumatriptan is a serotonin receptor agonist that can cause vasoconstriction and coronary vasospasm. This medication is also contraindicated in clients who had a myocardial infarction or clients who have coronary artery disease, uncontrolled hypertension, or other types of heart disease.

A nurse is caring for a client who is taking glucocorticoids. The nurse should monitor the client for which of the following adverse effects of the medication? A. Weight loss B. Peptic ulcer C. Hyperkalemia D. Diplopia

B. Peptic ulcer The nurse should monitor this client who is taking glucocorticoids for peptic ulcer disease due to irritation of the gastric mucosa. The nurse should periodically check the client's stool for occult blood and instruct the client to contact the provider if any black or tarry stools occur.

A nurse is caring for a client who has rheumatoid arthritis and a new prescription for etanercept. Which of the following values should the nurse review prior to the administration of the medication? A. Ability to swallow B. Results of last purified protein derivative (PPD) test C. Serum creatinine level D. Blood glucose level

B. Results of last purified protein derivative (PPD) test The nurse should identify that a client who is taking etanercept is at risk for infections such as tuberculosis (TB). To reduce this risk, the client should be tested for latent TB; if the test is positive, the client should undergo TB treatment before receiving etanercept. During treatment with etanercept, the client should be monitored closely for the development of TB.

A nurse is assessing a client who takes oral theophylline for chronic bronchitis relief. The nurse should recognize that which of the following findings indicates toxicity to theophylline? A. Constipation B. Tremors C. Fatigue D. Bradycardia

B. Tremors Theophylline is a xanthine-derivative bronchodilator. An early manifestation of toxicity is CNS stimulation, often seen as tremors. Seizures can occur if blood levels continue to rise.

A nurse is teaching a client who has a new prescription for enteric-coated aspirin as stroke prophylaxis. The client asks the nurse why the provider prescribed an enteric-coated medication. Which of the following responses should the nurse give? A. "The enteric coating allows a lower dosage to be given." B. "Enteric-coated medications have better absorption in the body." C. "Enteric-coated medications cause less gastric irritation." O D. "The enteric coating provides a steady release of the medication over time."

C. "Enteric-coated medications cause less gastric irritation." Enteric-coated medications do not dissolve until they reach the small intestine, which reduces the risk of gastric irritation.

A nurse is teaching a client who has diabetes mellitus about a new prescription for pioglitazone. Which of the following statements should the nurse include in the teaching? A. Monitor for hypoglycemia 6 hours after taking the medication." B. "This medication cannot be taken if you have a sulfa allergy." C. "This medication can be taken when using insulin." D. "This medication is effective for people with type 1 diabetes mellitus."

C. "This medication can be taken when using insulin."

A nurse is providing teaching to a client who has tuberculosis (TB) and a prescription for isoniazid. Which of the following instructions should the nurse include? A. "You'll need to take this medication for the rest of your life to prevent recurrence." B. "Your provider will monitor your thyroid function while you are taking this medication." C. "You should take this medication on an empty stomach." • D. "You should take this medication with an antacid."

C. "You should take this medication on an empty stomach." The nurse should instruct the client to take isoniazid on an empty stomach to improve absorption of the medication. To ensure the stomach is empty, the client should take the medication either 1 hour before or 2 hours after a meal.

A nurse is caring for a client who has osteoporosis and has been taking a vitamin D supplement. The nurse notes that the client reports also taking a multivitamin daily. Which of the following findings should indicate to the nurse that the client might be experiencing vitamin D toxicity? A. Hyperkalemia B. Hypermagnesemia C. Hypercalcemia D. Hypernatremia

C. Hypercalcemia The nurse should identify that vitamin D increases plasma calcium levels by increasing reabsorption from bone, decreasing excretion by the kidneys and increasing absorption from the intestines. Clients who take a vitamin D supplement along with a multivitamin daily might be taking too much calcium.

A nurse is teaching a client who has type 2 diabetes mellitus about a prescription for insulin lispro. Which of the following statements should the nurse include in the teaching? A. "The effects of the insulin lispro can last for 8 to 12 hours." B. "Administer insulin lispro 30 to 60 minutes before eating." C. Insulin lispro has an onset of about 15 minutes." D. "This insulin can be given as a continuous intravenous bolus."

C. Insulin lispro has an onset of about 15 minutes." Insulin lispro is a rapid-acting insulin and has an onset of 15 to 30 minutes.

A nurse is teaching a client who is about to start taking propylthiouracil to treat hyperthyroidism. Which of the following statements should the nurse identify as an indication that the teaching has been effective? A. "I will need laboratory tests to check my liver function." B. "' should take this medication once daily." C. "IfI get a rash, I am probably having an allergic reaction." D. "If I have difficulty sleeping, it is probably because of this medication."

A. "I will need laboratory tests to check my liver function." Propylthiouracil is hepatotoxic and can cause severe liver injury. The nurse should instruct the client to report dark urine and yellowing of the eyes, which can indicate an injury to the liver.

A nurse is teaching a client who has dyspepsia about prescribed antacids Which of the following statements should the nurse include in the teaching? A. "Take antacids 1 hour apart from other medications." B. "Increase your sodium intake to avoid hyponatremia." C. "Avoid combining antacids due to an increased risk of adverse effects." D. "Antacids are taken 3 times daily."

A. "Take antacids 1 hour apart from other medications." The nurse should include in the teaching that antacids increase gastric pH, which causes an interference with the absorption of various medications. To help minimize these interactions, the client should take the antacids at least 1 hour apart from other medications.

A nurse is caring for a client who is experiencing an acute gout attack. The nurse should anticipate a prescription from the provider for which of the following medications? A. Naproxen B. Pegloticase C. Probenecid D. Allopurinol

A. Naproxen The nurse should anticipate that the provider will prescribe an NSAID such as naproxen. This type of medication is recommended as the first choice of treatment for relieving the manifestations of an acute gout attack. NO: Allopurinol is the medication of choice for clients who have chronic tophaceous gout. Allopurinol acts by lowering uric acid levels in the blood and reducing the development of new tophus formation, which are nodular masses created as a result of increased uric acid levels producing uric crystals. However, this medication is not used for the treatment of an acute gout attack.

A nurse is teaching a client with type 2 diabetes mellitus about self-administration of a new prescription for acarbose. Which of the following pieces of information should the nurse include in the teaching? A. Tell the client to take the medication with food B. Show the client how to perform an intramuscular injection C. Advise the client to avoid taking this medication with insulin D. Warn the client against exercising while taking this medication

A. Tell the client to take the medication with food

A nurse is assessing a client who has cystic fibrosis. Which of the following pieces of information indicates a therapeutic response to pancreatic enzyme replacement? A. The client is having 1-2 bowel movements per day. B. The client's glucose level is elevated. C. The client has experienced weight loss. D. The client has abdominal distention.

A. The client is having 1-2 bowel movements per day. One to two bowel movements per day indicates adequate absorption of food and a therapeutic response to pancreatic enzyme replacement for clients who have cystic fibrosis. Frequent stooling, defined as more than one to two bowel movements per day, indicates inadequate replacement.

A nurse is caring for a client who has a suspected adrenal insufficiency. Which of the following medications should the nurse anticipate the provider using to determine the presence of adrenal insufficiency? A. Prednisone B. Cosyntropin C. Dexamethasone D. Ketoconazole

B. Cosyntropin The nurse should expect the provider to use cosyntropin to determine if the client has adrenal insufficiency. The client is monitored after the provider injects cosyntropin to see if the cortisol level rises above 20 mcg/dL. If the adrenal response causes the cortisol level to elevate, the response is considered to be within the expected reference range. If the cortisol level does not elevate, the provider should determine that the client has adrenal insufficiency.

A nurse is caring for a client who has acute glomerulonephritis and a prescription for furosemide. The nurse should monitor the client for which of the following therapeutic effects of this medication? A. Hypotension B. Diuresis C. Increased blood glucose level D. Weight gain

B. Diuresis The nurse should identify that furosemide is a high-ceiling loop diuretic indicated for the treatment of clients who have severe renal impairment such as acute glomerulonephritis. Furosemide blocks the reabsorption of sodium and chloride, thereby preventing the reabsorption of water. Diuresis is a therapeutic response to the administration of furosemide.

A nurse is performing a preoperative assessment of a client who is about to undergo an aneurysm clipping. The nurse should identify a risk for increased bleeding when the client reports taking which of the following dietary supplements? A. Soy B. Garlic C. Black cohosh D. Green tea

B. Garlic Many dietary supplements can affect clotting or interact with other medications that affect clotting, thereby increasing the client's risk of bleeding. Examples of these dietary supplements include garlic, ginger, and ginkgo biloba. The nurse should notify the provider immediately about this potential risk.

A nurse is preparing to administer meperidine to a client who is postoperative and reports a pain level of 8 on a scale of 0 to 10. Which of the following routes of administration will deliver the medication with the shortest time of onset? A. Oral B. Intravenous Intramuscular Subcutaneous

B. Intravenous

A nurse is caring for a client who has asthma and is prescribed a short-acting beta2-agonist. Which of the following should the nurse identify as the expected outcome of this medication? A. Reduces the frequency of attacks B. Reverses bronchospasm C. Prevents inflammation D. Decreases chronic manifestations

B. Reverses bronchospasm

A nurse is teaching a client who has a new prescription for amitriptyline to treat depression. Which of the following client statements indicates an understanding of the teaching? A. "I should take this medication when I experience active symptoms." B."I should take this medication before bedtime." C. "This medication may cause excess salivation." D. "I might experience weight loss while taking this medication."

B."I should take this medication before bedtime." The nurse should instruct the client that an adverse effect of amitriptyline is sedation. The nurse should instruct the client to take the medication at bedtime to minimize sedation during waking hours while promoting sleep.

A nurse is caring for a client who is receiving chlorpromazine to treat schizophrenia. Which of the following statements by the client should prompt the nurse to notify the provider immediately? A. "My last bowel movement was 2 days ago." B. "My tongue keeps moving like a worm." c. "I feel dizzy when I stand up too quickly." D. "I can't stop blinking when I'm in the sun."

B."My tongue keeps moving like a worm." Involuntary tongue movement indicates that this client is at greatest risk for tardive dyskinesia, which is a rare neurological syndrome that has no cure. Therefore, this is the priority statement.

A nurse is providing teaching to a client about a new prescription for captopril to treat hypertension. Which of the following client statements indicates an understanding of the teaching? A. "I might have a sore throat that will go away after a few days." B. "I will take this medication with food to avoid getting an upset stomach." C. "I might feel dizzy at times while taking this medication." • D. "I will take ibuprofen if I get a fever while taking this medication."

C. "I might feel dizzy at times while taking this medication." Hypotension and dizziness are potential adverse effects of this medication. The nurse should monitor the client's blood pressure and instruct the client to change positions slowly.

A nurse is teaching a client who has a new prescription for sucralfate for a duodenal ulcer. Which of the following client statements indicates an understanding of the teaching? A. "I should take this medication with my meals and at bedtime." B. "I should only have to take this medication for about 2 weeks." C. "I should wait at least 30 minutes before taking this medication after I take an antacid." D. "I should swallow these tablets whole."

C. "I should wait at least 30 minutes before taking this medication after I take an antacid." The nurse should recognize that antacids can raise the gastric pH above 4, which can interfere with the effects of sucralfate. To minimize these interactions, sucralfate should be taken at least 30 minutes apart from antacids.

A nurse is providing teaching to a client who has a prescription for famotidine to treat a gastric ulcer. Which of the following statements should the nurse include in the teaching? A. "This medication is more effective when taken on an empty stomach." B. "You should take this medication with an antacid for pain control." C. "This medication is less effective for people who smoke." D. "You should expect to experience dizziness when taking this medication."

C. "This medication is less effective for people who smoke." The nurse should instruct the client that smoking interferes with the effectiveness of famotidine. If a client taking famotidine smokes, the nurse should encourage the client to quit smoking or, if unable quit, to avoid smoking after the last dose of the day.

A nurse is caring for a client who has cancer involving the lumbar vertebrae and has been prescribed gabapentin. Which of the following therapeutic effects should the nurse identify for the client when taking this medication? A. Reduced cancer-related bone pain B. Decreased anxiety and insomnia C. Decreased inflammatory response to cancer tumors D. Reduced cramping, aching, and burning neuropathic pain

D. Reduced cramping, aching, and burning neuropathic pain The nurse should identify that gabapentin is administered to treat neuropathic pain that is sharp and darting. The medication can also decrease cramping, aching, and burning pain and suppress spontaneous neuronal firing that causes pain.

A nurse is caring for a female adult client who is experiencing menopause and has a prescription for estrogen along with progestin. The nurse should identify that the provider has prescribed these medications for which of the following reasons? A. Long-term use to reduce the risk of breast cancer B. Short-term use to stimulate the endometrium C. Long-term use to prevent osteoporosis D. Short-term use to control urogenital atrophy

D. Short-term use to control urogenital atrophy The nurse should identify that estrogen, along with progestin, can be prescribed for a client who is experiencing menopause for hormonal therapy (HT). The use of short-term HT can assist with managing the manifestations of menopause like urogenital atrophy.

A nurse is providing discharge teaching about lithium toxicity to a client who has a new prescription for lithium. Which of the following statements by the client indicates an understanding of the teaching? A. "I should take naproxen if I have a headache because aspirin can cause lithium toxicity." B. "I can develop lithium toxicity if I eat foods with lots of sodium." c. I can develop lithium toxicity if I experience vomiting ordiarrhea." D. "' might need to take a daily diuretic along with my lithium to prevent lithium toxicity."

c. I can develop lithium toxicity if I experience vomiting or diarrhea." Vomiting or diarrhea can cause electrolyte imbalances. If serum sodium decreases, lithium is retained by the kidneys, and the risk of lithium toxicity increases.

A nurse is caring for a client at 39 weeks of gestation who has gestational hypertension. The client has a new prescription for misoprostol for cervical ripening and induction of labor. Which of the following findings in the client's medical history should the nurse identify as increasing the client's risk of complications due to the use of this medication? A. Positive bacterial vaginosis culture B. History of failure to progress c. Previous cesarean delivery D. Positive serum Rh sensitization

c. Previous cesarean delivery The nurse should identify that misoprostol is a prostaglandin that promotes cervical ripening. An adverse effect of misoprostol is uterine tachysystole (excessively frequent uterine contractions). Therefore, this medication should be used with extreme caution and is contraindicated in clients who have experienced a previous cesarean delivery.

A nurse is preparing to administer an epinephrine IV bolus to a client. Which of the following should the nurse verify before initiating the IV medication? A. Concentration of the formulation B. Reversibility of the medication C. Potential barriers to absorption D. Gastric emptying time

A. Concentration of the formulation The nurse should verify the concentration of the formulation of the medication prior to administration. Epinephrine can be injected through several routes, and a solution prepared for use by a certain route can differ in concentration from others. Solutions intended for subcutaneous administration are generally concentrated, whereas solutions intended for intravenous use are dilute. If a solution prepared for subcutaneous administration is administered intravenously, the result could be fatal because intravenous administration of concentrated epinephrine can overstimulate the heart and blood vessels, causing severe hypertension, cerebral hemorrhage, stroke, and death.

A charge nurse is teaching a newly licensed nurse about a client who has severe allergy-related asthma and a new prescription for omalizumab. Which of the following pieces of information should the charge nurse include to describe the medication's mechanism of action? A. It reduces the number of immunoglobulin E (IgE) molecules on mast cells. B. It stabilizes the cellular membrane of mast cells. C. It decreases the synthesis and release of inflammatory mediators. D. It relaxes the smooth muscles by blocking adenosine receptors.

A. It reduces the number of immunoglobulin E (IgE) molecules on mast cells. The charge nurse should include in the teaching that the mechanism of action of omalizumab reduces the number of IgE molecules on mast cells. This limits the ability of allergens to trigger immune mediators that cause bronchospasm.

A nurse is assessing a client who is taking varenicline for smoking cessation. Which of the following findings is the nurse's priority? A. Mood changes B. Nausea C. Altered sense of taste D. Skin rash

A. Mood changes The nurse should apply the safety and risk-reduction priority-setting framework, which assigns priority to the factor or situation posing the greatest safety risk to the client. When there are several risks to client safety, the one posing the greatest threat is the highest priority. The nurse should use Maslow's hierarchy of needs, the ABC priority-setting framework, and/or nursing knowledge to identify which risk poses the greatest threat to the client. The greatest risk to the client is the development of neuropsychiatric effects that can progress to depression and suicide. Therefore, the highest priority is a change in the client's mood.

A nurse is caring for a client with diabetic ketoacidosis who has a prescription for an intravenous infusion of insulin. The nurse should document that which of the following types of insulin was administered intravenously to treat ketoacidosis? A. Regular insulin B. Insulin lispro C. Insulin aspart D. Insulin glargine

A. Regular insulin Treatment for diabetic ketoacidosis is directed at correcting hyperglycemia and acidosis. Therefore, the client's insulin levels are restored with an initial IV bolus of regular insulin followed by continuous infusion.

A nurse is evaluating a 20-month-old child who received a hepatitis A immunization 3 days ago. The parent reports that the child has exhibited a loss of appetite following the immunization. Which of the following actions should the nurse take? A. Tell the parent that this reaction should only last for a couple of days B. Notify the provider immediately C. Prepare an antidote to administer to the child D. Request that the provider order a serum titer level

A. Tell the parent that this reaction should only last for a couple of days The nurse should tell the parent that a loss of appetite is a mild reaction in response to the hepatitis A vaccine and will usually last 1 to 2 days.

A nurse is teaching a client about taking tetracycline PO. Which of the following statements should the nurse include in the teaching? A. "Take this medication on a full stomach." B. "Limit your consumption of dairy products while taking this medicine." C. Take the medication with your regular iron supplement." D. "Take antacids if you have an upset stomach from using tetracycline."

B. "Limit your consumption of dairy products while taking this medicine." The nurse should tell the client to avoid or limit the consumption of dairy products while taking tetracycline. An interval of at least 2 hours should separate tetracycline ingestion and the ingestion of products that can chelate this medication such as milk or calcium.

A nurse is providing teaching for a client who has received a liver transplant and has a prescription to transition from cyclosporine to tacrolimus. Which of the following instructions should the nurse include in the teaching? A. "Take both medications together for 72 hr and then stop taking the cyclosporine." B. "Stop taking the cyclosporine for 24 hr and then begin taking the tacrolimus." C. "Alternate taking the medications for 48 hr and then take only the tacrolimus." D. "If adverse reactions to the tacrolimus occur, stop taking it and restart the cyclosporine."

B. "Stop taking the cyclosporine for 24 hr and then begin taking the tacrolimus." The nurse should instruct the client that these medications should not be taken concurrently due to the increased risk of developing nephrotoxicity. The client should stop cyclosporine for 24 hours prior to beginning the tacrolimus prescription.

A nurse is providing discharge teaching to a client who has venous thrombosis and a prescription for warfarin. Which of the following instructions should the nurse include in the teaching? A. Take ibuprofen as needed for headaches or other minor pains B. Carry a medical alert ID card C. Report to the laboratory weekly to have blood drawn for aPTT D. Increase intake of dark green vegetables

B. Carry a medical alert ID card A client who is taking warfarin is at increased risk for bleeding. In the case of an emergency, any medical personnel must be aware of the client's medication history.

A nurse is caring for a client who is experiencing acute alcohol withdrawal. The nurse should expect to administer which of the following medications? A. Disulfiram B. Chlordiazepoxide C. Methadone D. Varenicline

B. Chlordiazepoxide The nurse should expect to administer chlordiazepoxide to a client who is experiencing manifestations of acute alcohol withdrawal. Chlordiazepoxide is a benzodiazepine; this class of medications is often used to facilitate withdrawal. Chlordiazepoxide assists with decreasing withdrawal manifestations, stabilizing vital signs, and preventing seizures and delirium tremens.

A nurse is caring for a client who has cystic fibrosis (CF) and has a prescription for high-dose ibuprofen daily. The nurse should identify that which of the following is an expected outcome for the client receiving this medication? A. Thinned pulmonary secretions that are retained in the airways B. Slowed progression of pulmonary damage C. Potentiated action of bronchodilator therapy D. Decreased risk of fevers associated with CF

B. Slowed progression of pulmonary damage The nurse should identify that clients who have CF are prescribed high-dose Ibuprofen, which is an NSAID, to slow the progression of pulmonary damage by suppressing the inflammatory response that causes pulmonary damage. CF is a genetic disorder that primarily affects the lungs, pancreas, and sweat glands.

A nurse is teaching a client who has primary adrenal insufficiency (Addison's disease) and a prescription for hydrocortisone. Which of the following statements should the nurse include in the teaching about this medication? A. "You may need to take a lower dosage when you are ill or experiencing stress." B. "Take this medication before going to bed because it will make you tired." C. "Carry a supply of pills and a single-use injectable preparation with you at all times." • D. "You will need to stop this medication before routine procedures such as a colonoscopy."

C. "Carry a supply of pills and a single-use injectable preparation with you at all times." The nurse should tell the client to carry an emergency supply of the medication to take during times of unexpected stress. The client should carry an adequate supply at all times, which should include an injectable preparation plus a supply equal to the regular oral dosage. The single-use injectable preparation should be administered IM if the client has an emergency and needs an extra dose of the glucocorticoid.

A nurse is reviewing the laboratory results of a client who is taking a medication and notes that the client's blood tests show an elevated level of the enzymes aspartate aminotransferase (AST) and alanine aminotransferase (ALT). The nurse should recognize that these findings are potential indications of which of the following conditions? A. Renal dysfunction B. Myelotoxicity C. Hepatic toxicity D. Cardiac dysrhythmia

C. Hepatic toxicity The nurse should identify that elevated levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) are indications the client might be at risk for hepatic toxicity. AST and ALT are enzymes that test liver function. Therefore, this should indicate to the nurse that the medication the client is taking is damaging to the liver. The client should undergo liver function tests, and the nurse should notify the provider of this finding.

A nurse is preparing to administer warfarin to a client who has a new onset of atrial fibrillation. The client asks the nurse, "What should this medication do?" Which of the following responses should the nurse make? A. "It helps your heart return to a normal rhythm." B. "It dissolves blood clots." C. It can reduce your risk of having a stroke." D. "It helps to prevent bleeding in atrial fibrillation."

C. It can reduce your risk of having a stroke."