Rasmussen - Pharmacology Final

5. A Client has an infection caused by pseudomonas aeruginosa, and the prescriber has ordered intravenous piperacillin and tobramycin. Why might the nurse question this combination of antibiotics? A) This combination causes tendon rupture. B) Aminoglycosides are inactivated by penicillins. C) Aminoglycosides alone are adequate against pseudomonas. There is no need to risk penicillin allergy. D) Aminoglycosides increase the risk of penicillin allergy.

B) Aminoglycosides are inactivated by penicillins.

77. What should the nurse advise a client on spironolactone regarding necessary self-care? A) Discontinue taking this medication if you feel well B) Avoid salt substitutes. C) Check your pulse before taking this medication D) Add as many fruits and vegetables to your diet as possible

B) Avoid salt substitutes.

82.Which is a common side effect caused by atenolol? A) Memory loss B) Bradycardia C) Neuropathy D) Hyperglycemia

B) Bradycardia

21. A client who takes 325 mg of aspirin daily is scheduled for major surgery. Which of the following pre-surgical orders would the nurse expect to include in her teaching? A) Take two 81 mg tablets daily until surgery B) Discontinue aspirin 7-19 days before surgery C) Discontinue aspirin three days before surgery D) Continue taking aspirin as scheduled

B) Discontinue aspirin 7-19 days before surgery

45.Which of a client's medications is the most likely cause of a persistent, dry cough? A) Nifedipine B) Enalapril C) Atorvastatin D) Hydrochlorothiazide

B) Enalapril

60. The nurse is scheduled to administer lispro insulin per sliding scale before meals. The serum blood glucose reading before lunch is 280mg/dl. Given the following sliding scale, how much insulin lispro should be given before lunch? SATA A) If 60-124, no coverage B) If 151-120 give 4 unites C) If over 300, notify the provider D) If 125-300 give 2 units E) If 251-300 give 8 units F) If 201-250 give 6 units G) If below 60, notify the provider

E) If 251-300 give 8 units

46. A person with type 2 diabetes is starting metformin therapy. Which comment by the client indicates a need for further teaching? A) "This medication may be hard on my kidneys. I should take it with plenty of water." B) "I should not take metformin on the day I have contrast dye or on the two days after the dye study." C) "This medication makes my pancreas put out more insulin." "D) This medication may bother my stomach."

"D) This medication may bother my stomach."

30. The nurse receives an order to give atropine 300mcg SQ now. The medication is available in 1mg/ml vial. How many mL should the nurse administer?

0.3ml

69. The provider has ordered furosemide 10 mg PO stat. Furosemide is available in 20 mg/tablet. How many tablets should the nurse administer? ( record the answer to the tenth, or one decimal place. Use a leading zero if it applies. Do not use a trailing zero).

0.5

48. A nurse is preparing to administer lisinopril 30mg PO now. Available is lisinopril 20mg/tablet. How many tablets should the nurse administer?

1.5

36. The provider has prescribed digoxin 0.5mg PO stat. Digoxin is available in a 0.25mg tablet. How many tablets should the nurse administer?

2

29. A client weighs 214lbs. What is the client's weight in kg?

97 (round to whole) or 97.3 (round to nearest tenth place)

64. What should the nurse include in a client's discharge teaching when going home with a prescription for digoxin 0.125 mg by mouth once daily? A) " you must be able to check your pulse." B) "Take the digoxin at bedtime." C) "Eat a diet high in bran, fiber, and calcium." D) " don't take digoxin if your heart rate exceeds 90 beats per minute."

A) " you must be able to check your pulse."

65. A client will receive oral ciprofloxacin to treat a urinary tract infection. The nurse provides teaching for this client. Which statement by the client indicated further teaching? A) "I should take this medication with milk to improve absorption." B) " I will need to use sunscreen every time I go outdoors." C) " I should stop taking the medication immediately if I experience heel pain." D) " I may have abdominal pain and nausea, but these are usually mild."

A) "I should take this medication with milk to improve absorption."

2. Which statement by a client indicates an understanding of self-care precautions when taking warfarin? A) "My warfarin dose may need to be readjusted when I take a course of antibiotics." B) "I should expect pink urine due to metabolic bi-products of the dye used in this medication." C) "Herbal remedies are fine, but I shouldn't take aspirin without consulting my provider." D) "I should eat spinach to increase my iron count if my INR goes below two."

A) "My warfarin dose may need to be readjusted when I take a course of antibiotics."

31. A Client presents with tinea corporis, and the prescriber orders itraconazole. When educating the client about this medication, the nurse will include which statement? A) "Use the medication for at least one week after the symptoms have cleared." B) "Apply the medication over the entire body twice daily for two weeks." C) "This drug is effective after a single application." D) "Sun exposure will minimize the drugs' effects."

A) "Use the medication for at least one week after the symptoms have cleared.""

87. A client is taking oral itraconazole for a systemic fungal infection. The nurse reviews the medication record and notes that the client is also taking cimetidine for reflux disease. Which action should the nurse take? A) Administer the cimetidine at least two hours after the itraconazole. B) Don't give the cimetidine to a client receiving itraconazole. C) Administer the cimetidine with the itraconazole. D) Confer with the prescriber about a potentially hazardous interaction.

A) Administer the cimetidine at least two hours after the itraconazole.

13. A client will begin taking fexofenadine for hay fever. What education should be included regarding the use of this second-generation antihistamine? A) Citrus fruit juices can inactivate this class of medications. B) Fexofenadine has cholinergic side effects. It causes excessive salivation. C) Fexofenadine must be taken at bedtime. D) Fexofenadine must be taken apart from food

A) Citrus fruit juices can inactivate this class of medications.

79. A client receiving a cephalosporin develops a secondary intestinal infection caused by Clostridium difficile. What treatment plan would the nurse advocate for? A) Discontinue the cephalosporin and begin metronidazole or oral vancomycin as ordered B) Increase the dose of the cephalosporin and provide isolation measures C) Stop all antibiotics and probiotics D) Add an antibiotic, such as tobramycin, to the client's regimen

A) Discontinue the cephalosporin and begin metronidazole or oral vancomycin as ordered

89. The diabetic client is scheduled for a computer tomography (CT) scan with intravenous contrast. What education will the nurse provide? (SATA) A) Hold metformin 24 hours to 48 hours before the CT B) Resume metformin at half dose after the CT C) Double the metformin dose after the CT D) Hold Metformin 48 hours after the CT E) Take Metformin as scheduled the day of the CT

A) Hold metformin 24 hours to 48 hours before the CT D) Hold Metformin 48 hours after the CT

11. A client taking warfarin presents with bruises, dark tarry stools, and an international normalized ratio (INR) of 4.3. What is the nurse's action? A) Hold the warfarin and consult the provider regarding the next steps. B) Give an ampule of vitamin K, then call the physician to report client status. C) Explain to the client the nurse may ask the provider to order a test for leukemia. D) Give the warfarin with a dark green salad and check the next stool for blood.

A) Hold the warfarin and consult the provider regarding the next steps.

62. A client with type 1 diabetes is eating breakfast at 7:30 am. Blood sugars are on a sliding scale and are ordered before a meal and at bedtime. The client's blood sugar level is 317 mg/dL. Which insulin should the nurse prepare to administer? A) Insulin aspart protamine suspension 70%, insulin aspart 30% B) No insulin should be administered C) Insulin lispro D) NPH

A) Insulin aspart protamine suspension 70%, insulin aspart 30%

71. A client taking warfarin develops hyperuricemia, and the provider order's prednisone for a flare-up of gout. What priority follow-up lab should the nurse seek from the provider? A) International normalized ratio (INR) B) C-reactive protein C) Creatinine clearance D) Hepatic enzymes

A) International normalized ratio (INR)

90. A client is taking a drug that has potential toxic side effects. What will the nurse do? A) Monitor the function of all organs potentially affected by the drug B) Continue the drug even if the client has signs of toxicity C) Teach the client how to treat the symptoms if they develop D) Discontinue the drug even if the client does no have signs of toxicity

A) Monitor the function of all organs potentially affected by the drug

25. The nurse is caring for a pregnant client recently diagnosed with hypothyroidism. The client tells the nurse she does not want to take medications while she is pregnant. A) Neuropsychological deficits in the fetus can occur if the condition is not treated. B) No treatment is required if the client is experiencing symptoms. C) No danger to the fetus exists until the third trimester. D) Hypothyroidism is a normal effect of pregnancy and usually is of no consequence.

A) Neuropsychological deficits in the fetus can occur if the condition is not treated.

47. A nurse is caring for a client and her newborn immediately after delivery. The client's medication history includes prenatal vitamins throughout pregnancy, one or two glasses of wine before knowing she is pregnant, occasional use of an albuterol inhaler in her last trimester, and intravenous morphine during labor. What is the nurse's most appropriate action? A) Note a high-pitched cry and irritability in the infant and observe for seizures. B) Administer opioids to the infant to prevent withdrawal syndrome. C) Monitor the infants' respiration and prepare to administer naloxone if needed. D) Prepare the client for motor delays in the infant caused by alcohol use.

A) Note a high-pitched cry and irritability in the infant and observe for seizures.

67. A client with no known drug allergies is receiving amoxicillin PO twice daily. Twenty minutes after being given a dose, the client complains shortness of breath with a blood pressure of 100/58 mm Hg. what will the nurse do? A) Notify the provider if the client develops a rash. B) Withhold the next dose until symptoms subside C) Contact the provider and prepare to administer epinephrine as ordered D) Request an order for a skin test to evaluate possible penicillin allergy

A) Notify the provider if the client develops a rash.

95. A client who has erectile dysfunction asks a nurse whether sildenafil would be a suitable medication. Which aspect of this client's history would be of most concern? A) Occasional use of nitroglycerin B) Mild hypertension C) Benign prostatic hypertrophy D) Taking finasteride

A) Occasional use of nitroglycerin

15. Naloxone is effective because of which action? A) Preventing activation of opioid receptors through antagonist actions B) Regulating the sensitivity of opioid receptors by neurochemical alterations C) Increasing the excretion of morphine sulfate by altering serum ph D) Countering the effects of morphine sulfate by agonist actions

A) Preventing activation of opioid receptors through antagonist actions

96.The nurse is caring for a client who is receiving vancomycin. The nurse notes the client is experiencing flushing, rash, pruritus, and urticaria. The client's heart rate is 120 beats/min, and blood pressure is 92/57 mm Hg. What complication is the client experiencing? A) Red man syndrome B) Rhabdomyolysis C) Side effects D) Stevens-Johnson syndrome

A) Red man syndrome

92. A pregnant client stopped using a prescription medication she takes for asthma because she doesn't want to harm her baby. What will the nurse tell the client? A) Stopping medications for asthma doubles the chances of stillbirth B) Resume the medicines in her second trimester C) Avoid taking medications during her pregnancy D) Asthma medications will not affect the fetus.

A) Stopping medications for asthma doubles the chances of stillbirth

20. The nurse is providing client education for a postmenopausal client; which risks associated with estrogen/progestin therapy should the nurse discuss with the client? (SATA) A) Stroke B) Deep vein thrombosis C) Decreased bone density D) Increased colon cancer E) Ovarian Cancer

A) Stroke B) Deep vein thrombosis E) Ovarian Cancer

33. Which of these findings, from a client taking steroids, should the nurse report immediately? A) Temperature of 101.2 degrees F B) Glucose 128mg/dl C) Blood pressure of 144/68 mm Hg D) Heart rate of 102 beats per minute

A) Temperature of 101.2 degrees F

70. The nurse will include which information when teaching a client about hydroxyzine? A) The client should avoid drinking alcohol while taking the drug. B) The drug will reduce redness and itching but not edema. C) The client should report nausea while taking the medication. D) This medication is not likely to cause sedation.

A) The client should avoid drinking alcohol while taking the drug.

73. Which actions occur in fatal medication errors? SATA A) confusing drugs with similar packaging B) Complicated drugs with names that look or sound alike C) Giving a drug intravenously instead of intramuscularly D) Using barcode scanning to very client's name and birthdate E) Writing a prescription that is unreadable

A) confusing drugs with similar packaging B) Complicated drugs with names that look or sound alike C) Giving a drug intravenously instead of intramuscularly E) Writing a prescription that is unreadable

7. A client with cancer has been taking an opioid analgesic four times daily for chronic pain and reports needing increased doses for pain. What will the nurse tell the client? A- Over time, people can develop tolerance to opioids. We can discuss increasing your dose with the provider. B- Take your medication more often to help control the pain C- You are addicted and should take a different medication. We can discuss this with your provider. D- The risk of respiratory depression increases over time

A- Over time, people can develop tolerance to opioids. We can discuss increasing your dose with the provider.

66. A client who has type 2 diabetes begins taking glipizide. Which statement by the client indicates a need for further education? A) " I will begin by taking this once daily with breakfast." B) " I may continue to have a glass of wine with dinner." C) " I will need to check my blood sugar once daily or more." D) " I should not take this medication if I have a sulfa allergy."

B) " I may continue to have a glass of wine with dinner."

61. Which of these statements indicates the client's understanding of nitroglycerin self-care practices? A) " I can take nitroglycerin three times, but I need to space them three minutes apart." B) " I should stop what I am doing and sit down before I take nitroglycerin for chest pain." C) " I should keep unopened bottles of nitroglycerin in the freezer." D) "I should wait until I have taken three nitroglycerin tablets before I call for help."

B) " I should stop what I am doing and sit down before I take nitroglycerin for chest pain."

76. A client is starting to take furosemide and asks the nurse. " When is the best time to take this medication?" What is the nurse's response? A) 1600 B) 0800 C) 2200 D) 1900

B) 0800

19. Which factors can alter a client's physiologic response to a medication? (SATA) A) Height B) Age C) Liver disease D) Genetic Factors E) Gender

B) Age C) Liver disease D) Genetic Factors E) Gender

8) A client who is suffering from an acute gout attack wants to know how colchicine differs from probenecid and allopurinol in its actions. Which of these statements shows the need for further teaching regarding purpose and use of medications? A- Allopurinol prevents the synthesis of uric acid. B- All of these medications should be taken concurrently during an acute attack, and NSAIDS should be added for pain control. C- Colchicine reduces inflammation caused by uric acid D- Probenecid facilitates the elimination of uric acid in the nephrons

B) All of these medications should be taken concurrently during an acute attack, and NSAIDS should be added for pain control.

26. A client who is receiving a final dose of intravenous cephalosporin complains of pain and irritation at the infusion site. The nurse observes signs or redness at the intravenous. What is the nurse's action? A) Apply warm packs to the arm and infuse the medication at a slower rate. B) Immediately stop the infusion and select an alternate intravenous site. C) Request central venous access. D) Continue the infusion while elevating the arm.

B) Immediately stop the infusion and select an alternate intravenous site.

24. When administering medications to infants, it is essential to remember which of the following? SATA A) Oral medications are contraindicated in infants. B) Infants are more sensitive to medications that act on the CNS C) Immaturity of renal function in infancy causes infants to excrete drugs less efficiently. D) Infants have immature livers, which slow drug metabolism. E) Breastfeeding infants are more likely to develop toxicity when given lipid-soluble drugs.

B) Infants are more sensitive to medications that act on the CNS C) Immaturity of renal function in infancy causes infants to excrete drugs less efficiently. E) Breastfeeding infants are more likely to develop toxicity when given lipid-soluble drugs.

49. A nurse is reviewing the chart of an adult male client- who has been taking oral androgens. Which assessment would warrant notifying the provider? A) Increased facial hair B) Jaundice C) Acne D) Increased libido

B) Jaundice

17. Insulin glargine is prescribed for a hospitalized client who has diabetes. When will the nurse expect to administer this drug? A) After meals and at bedtime. B) Once-daily at the same time every day. C) With meals. D) Approximately 15 to 30 minutes before each meal.

B) Once-daily at the same time every day.

27. A client on a morphine PCA pump is noted to be drowsy and lethargic with pinpoint pupils and the following vitals; pulse 84 beats/min, respiratory rate 10 breaths/min, bp 90/50 mm hg. What are the nurse's best actions? A) Discuss possible opiate dependence with the client's provider. B) Prepare to administer naloxone and provide respiratory support. C) Note the effectiveness of the analgesia in the client's chart. D) Encourage the client to turn over, and cough and take deep breaths.

B) Prepare to administer naloxone and provide respiratory support.

34. A nurse is concerned about renal function in an 84-year-old client who is taking several medications. What is a priority for the nurse to assess? A) Sodium levels B) Serum Creatinine C) Specific gravity D) Troponin levels.

B) Serum Creatinine

80. A client who has been taking a glucocorticoid for several months arrives in the clinic. The nurse notes the client's cheeks appear full, and a prominent hump of fat is present on the upper back. The nurse will ask the provider to order which of these laboratory tests? A) Vitamin D levels B) Serum electrolytes C) Liver function tests D) Tuberculin skin test

B) Serum electrolytes

41. A third grader is starting methylphenidate. What counseling should the nurse provide for the child's parents? A) Give the medication at bedtime. B) Store the medicine in a safe palace; it is a controlled substance. C) Give the medication as needed D) If you notice weight loss, switch dosing to every other day

B) Store the medicine in a safe palace; it is a controlled substance.

40. A client who is taking calcium supplements receives a prescription for ciprofloxacin for a respiratory infection. What must the nurse include in client teaching? A) Consume extra fluids while taking the ciprofloxacin to prevent hypercalciuria. B) Take the calcium either six hours before or two hours after taking the ciprofloxacin. C) Stop taking the calcium supplements while taking the ciprofloxacin. D) Take the two medications together to increase the absorption of both.

B) Take the calcium either six hours before or two hours after taking the ciprofloxacin.

86. A Client who is taking warfarin has started on cephalexin. What are the nursing implications of this medication change? (SATA) A) The provider should be asked to consider increasing the client's dose of cephalexin B) The provider should be reminded to recheck the client's international normalized ratio (INR) C) The client should not be allowed to eat leafy greens. D) The client should be assessed for bruising. E) The provider should be asked to consider increasing the client's dose of warfarin.

B) The provider should be reminded to recheck the client's international normalized ratio (INR) C) The client should not be allowed to eat leafy greens. D) The client should be assessed for bruising.

4.A 50-year-old postmenopausal cleint who has had a hysterectomy has moderate to severe hot flashes and is discussing estrogen therapy with the nurse. What will the nurse tell the client regarding the side effect of estrogen therapy? A) An estrogen progesterone product will increase side effects B) Transdermal preparations of estrogen therapy have reduced side effects. C) Side effects of estrogen therapy are uncommon among women of her age. D) An intravaginal preparation may be best.

B) Transdermal preparations of estrogen therapy have reduced side effects.

37. In Which situation would the nurse hold digoxin? A) When the client is pacing and very thirsty B) When the client complains of seeing yellow-green halos C) When the lab reports a digoxin level 1.2 ng/ml D) When the client is edematous

B) When the client complains of seeing yellow-green halos

28. What must a nurse include in client education for an arthritic client taking high doses of aspirin? SATA A) Aspirin is preferred to acetaminophen in the control of fevers in children. B) Call your provider for ringing in the ears C) Aspirin is nephrotoxic. D) Report bruises bleeding gums, tarry stools, and pink urine.

B) all your provider for ringing in the ears C) Aspirin is nephrotoxic. D) Report bruises bleeding gums, tarry stools, and pink urine.

55, A nurse is teaching a group of nursing students about administering medications to older adult clients. Which statement by a student indicates a need for further teaching? A- "Nonadherence for medications among older adult clients is due to the cost of medications" B- "Changes in gastrointestinal function in older adult clients lead to an increase in serum drug levels" C- "Most adverse drug reactions in older adult clients are related to altered renal function" D- "Alteration in hepatic function requires more frequent drug dosing"

B- "Changes in gastrointestinal function in older adult clients lead to an increase in serum drug levels"

52, A pregnant client asks the nurse if she can take antihistamines for seasonal allergies during her pregnancy. What will the nurse tell the client? A-The margin of safety for antihistamines is clearly understood for pregnant clients. B- Antihistamines should be avoided in pregnancy unless necessary C- Second generation antihistamines are completely safe to take during the first trimester D- Antihistamines are safe to take during breastfeeding, but can cause spina bifida in pregnancy

B- Antihistamines should be avoided in pregnancy unless necessary

10. The parents of a child with asthma ask the nurse why their child cannot use oral corticosteroids more often because they are so effective. What is the correct response by the nurse? A- Frequent use of this drug may lead to a decreased response. B- Chronic steroid use can show growth C- A hypersensitivity reaction to this drug may occur. D- systemic steroids are more toxic in children

B- Chronic steroid use can show growth

58, A client with a new diagnosis of atrial fibrillation is receiving a continuous infusion of heparin. Which finding will the nurse report immediately? A- The most recent lab results indicate that the client has an international normalized ratio (INR) of 0.8 B- The client reports dark, tarry stools C- The client states that they have been taking acetaminophen for pain. D- The most recent lab results indicate that

B- The client reports dark, tarry stools

32. A nurse is talking to the client who wants to stop taking glucocorticoids after taking them for 3 months. Which statement by the client indicates a good understanding of the teaching about withdrawal? A) "Once I am off of the steroids, I should never take them again." B) "I should monitor for Cushing's symptoms during the withdrawal process." C) "I should not try to taper off the medication without consulting my provider." B) "I should reduce the dose by half each day until I am at 5mg, then I can stop the medication."

C) "I should not try to taper off the medication without consulting my provider."

16. Parents ask the nurse why an over-the-counter cough suppressant with sedative side effects is not recommended for infants. Which response by the nurse is correct? A) "Cough medicine tastes bad, and infants usually won't take it," B) "Babies have a more rapid gastric emptying time and don't absorb drugs well." C) "Infants are more susceptible to central nervous system effects than adults are." D) "Infants metabolize drugs too rapidly, so drugs aren't as effective."

C) "Infants are more susceptible to central nervous system effects than adults are."

98. A nurse is administering morphine sulfate to a postoperative client. Which are appropriate routine nursing actions when giving this drug? (SATA) A) Requesting an order for methylnaltrexone to prevent constipation B) Evaluating for urinary retention every 4-6 hours C) Counting respirations before and after giving the medication D) Assist with ambulation E) Monitoring the client's bp closely for hypertension

C) Counting respirations before and after giving the medication

35. Which side effect of clindamycin causes the most concern? A) Vomiting B) Headache C) Diarrhea D) Nausea

C) Diarrhea

12. The nurse will caution a client taking immunosuppressant drugs to avoid which dietary supplement? A) Glucosamine B) Feverfew C) Echinacea D) Black cohosh

C) Echinacea

1. The nurse is talking with a new mother about medications that can be safely resumed now that she is no longer pregnant. All the following medications are contraindicated during pregnancy, but which one may be ingested while breastfeeding without causing known infant harm? A) Lithium B) Methotrexate C) Ibuprofen D) Nicotine

C) Ibuprofen

99. A client has had emergency surgery for a ruptured appendix. Before surgery, the client was taking dexamethasone for three years. With the client's steroid use history, for which complication will the nurse monitor in the recovery phase? A) Postoperative blood clots B) Bradycardia C) Impaired wound healing D) Pre-surgical dehydration

C) Impaired wound healing

84. A client with an infection is being treated with vancomycin. The nurse providing care reviews the client's laboratory reports and notes that the client's blood urea nitrogen (BUN) and serum creatinine levels are newly elevated. What would be the appropriate nursing intervention? A) Consult the provider about the need for a less nephrotoxic medication. B) Assess the client's urine output C) Interpret the peak and trough levels D) Instruct the client to notify the nurse if they have any tingling in their toes

C) Interpret the peak and trough levels

23. Which of these statements best describes the concept of half-life? A) It is time it takes for half of the medication to be distributed to receptors. B) It is time it takes for half of the medicinal effect to be achieved. C) It is time it takes for half of the medication to be metabolized for elimination. D) The term refers to the shelf life of the drug.

C) It is time it takes for half of the medication to be metabolized for elimination.

85. A nurse is caring for a client who was recently started on lithium and is training a new nurse. What comment by the new nurse would require further teaching? A) Lithium is used to treat bipolar depression B) Lithium is used to reduce manic episodes C) Lithium is contraindicated with antidepressant use D) Lithium reduces hyperactivity

C) Lithium is contraindicated with antidepressant use

88. A nurse is teaching a client who has asthma the appropriate use of inhaled fluticasone. What advice should the nurse give to help the client avoid complications with the use of inhaled steroids? A) Limit your caffeine intake. B) Check the pulse after the medication C) Rinse your mouth after inhaling the medicine. D) Take the medication before eating

C) Rinse your mouth after inhaling the medicine.

43. A client with type 1 diabetes who takes insulin reports taking propranolol for hypertension. Why is the nurse concerned? A) Propranolol increases insulin requirements because of receptor blocking. B) Using the two agents together increases the risk of ketoacidosis. C) The beta-blocker can mask the symptoms of hypoglycemia. D) The beta-blocker can cause insulin resistance.

C) The beta-blocker can mask the symptoms of hypoglycemia.

91.The nurse working on a high-acuity medical-surgical unit is prioritizing care for four clients who were just admitted. Which client should the nurse assess first? A) The client with a blood pressure of 136/92 mm Hg, who complains of having a headache. B) The NPO client with a blood glucose level of 80 mg/dl who just received 20 units of 70/30 insulin aspart. C) The client with an allergy to penicillin who is receiving an infusion of vancomycin. D) The client with a pulse of 62 beats/min, about to receive digoxin.

C) The client with an allergy to penicillin who is receiving an infusion of vancomycin.

39. A nurse is performing a preoperative drug history on a client who is admitted to the hospital for surgery. What dietary supplement contributes to the risk of bleeding? A) Probiotics B) Coenzyme Q-10 C) Ma Huang D) Ginkgo biloba

D) Ginkgo biloba

59. A nurse is providing teaching for an adult client with arthritis who has been instructed to take ibuprofen for discomfort. Which statement by the client indicates a need for further education? A) " I may experience tinnitus with higher dose of this medications." B) " I will take this medication with meals to help prevent stomach upset." C) " I may take up to 1000 mg four times daily for pain." D) "Should stop drinking alcohol"

C) " I may take up to 1000 mg four times daily for pain."

68. Which of these comments by a client taking a calcium channel blocker would indicate the need for additional teaching? A) " I will elevate my legs if edema occurs." B) " I can limit my risk for constipation by increasing fluid and biber." C) " I will take the medication with grapefruit juice." D) " I will rise slowly from lying to sitting, to standing."

C) " I will take the medication with grapefruit juice."

63. Which statement indicates an asthmatic client understands discharge teaching regarding leukotriene blocker? A) " This medication could cause me to develop a thrush infection." B) " I should take this medication whenever I suddenly have difficulty breathing." C) " This medication is taken once daily for the prevention of asthma." D) " I should expect this medication will make me agitated, but I don't need to report that effect."

C) " This medication is taken once daily for the prevention of asthma."

6. A client with bronchitis is taking trimethoprim/sulfamethoxazole 160/800 mg orally, twice daily. Before administering the third dose, the nurse observes the client has a widespread rash, a temperature and a heart rate of 100 beats/min. The client looks ill and reports not feeling well. What is the nurse's response? A) Request an order for intravenous trimethoprim/ sulfamethoxazole. B) Initiate probiotics. C) Withhold the treatment and notify the provider of the symptoms. D) Administer the dose and request an order for an antipyretic medication.

C) Withhold the treatment and notify the provider of the symptoms.

53, Insulin lispro was given to a client at 0700 by a night nurse who needed to leave early. At 0730 the client is clammy and refuses breakfast, stating, "I don't feel well. I need to lie down." What is the nurse's action? A- Document the refusal and let the client sleep since the insulin lispro will not peak until later in the morning. B- Wait to offer breakfast until the client feels better. C- Check the blood sugar and convince the client to drink juice if possible. D- Call the night nurse at home and tell her to come back and deal with the situation.

C- Check the blood sugar and convince the client to drink juice if possible.

56, What should the nurse include in discharge teaching regarding self care for a client taking loop or thiazide diuretics? A- Take the medication after supper to avoid mid-day urgency. B- Walk at least a mile a day C- Weigh daily and report any loss or gain exceeding two pounds in 24 hours to your provider. D- Avoid fruits and potatoes

C- Weigh daily and report any loss or gain exceeding two pounds in 24 hours to your provider.

75. The nurse is educating a client regarding the use of omeprazole. What statement by the client shows a proper understanding of how to take this medication? A) " I should plan to take this medication for the rest of my life." B) " I should take this medication with an antacid to maximize its effects." C) " I should chew the medication when my heartburn is bad, so it absorbs more rapidly." D) " I should take this medication on an empty stomach before I eat."

D) " I should take this medication on an empty stomach before I eat."

78. A client who reports routine consumption of more than 3 alcoholic beverages per day asks about taking acetaminophen when needed for occasional recurrent pain. What will the nurse tell the client? A) "Do not take more than 4gm of acetaminophen a day. " B) " do not take a scheduled-dose preparation of acetaminophen with opioid analgesics." C) " do not take more than 3 gm of acetaminophen a day." D) " do not take more than 2 gm of acetaminophen a day."

D) " do not take more than 2 gm of acetaminophen a day."

38. A nurse tells a nursing student glucocorticoids given for rheumatoid arthritis are nearly identical to substances produced naturally by the body. The student remarks that the drug must be very safe. Which response by the nurse is correct? A) "Side effects can occur and are dependent on the dose and duration of treatment." B) "By interrupting the inflammatory process, these drugs inhibit side effects." C) "The negative feedback loop prevents side effects." D) "As long as the drug is taken as prescribed, side effects usually do not occur."

D) "As long as the drug is taken as prescribed, side effects usually do not occur."

44. A nurse is providing education to a client who is beginning therapy with testosterone gel 1%. What statement made by the client demonstrates a need for additional teaching? A) "I should avoid direct skin-to-skin contact with my spouse where the medication was applied." B) "I should not shower or swim for at least five to six hours after application." C) "I should have my blood drawn for laboratory tests in 14days." D) "I should apply the medication to my genitals for the best results."

D) "I should apply the medication to my genitals for the best results."

93. A nurse is preparing discharge teaching for a client who will be going home on warfarin. Which of these statements indicates the need for further instruction? A) "I should avoid alcohol and herbal remedies while I am taking warfarin." B) "I should have my bleeding time checked when I am taking antibiotics." C) "I should stop taking my warfarin if I get bruises or black stools." D) "I should be consistent with my intake of leafy greens because they reverse warfarin effects."

D) "I should be consistent with my intake of leafy greens because they reverse warfarin effects."

97. Which statement by the client shows a correct understanding of how they should take their levothyroxine? A) "I should take it after my noon meal." B) "I should stop taking it if my thyroid-stimulating hormone (TSH) level is high." C) "My dose should skip the next dose if the medication makes me sleepy." D) "I should take it before breakfast on an empty stomach."

D) "I should take it before breakfast on an empty stomach."

42. A client who is recovering from total knee surgery is preparing for discharge. Which of these statements indicates the client needs further teaching? A) "I can rotate acetaminophen with ibuprofen if needed for pain control, so I don't take too much of either one." B) "Taking more than 4000mg of acetaminophen in a day can cause liver problems." C) "Taking acetaminophen often could mask any infection-related fevers I might have." D) "If I still have pain 10 minutes after taking 1000mg of acetaminophen, I should take two of oxycodone-acetaminophen.

D) "If I still have pain 10 minutes after taking 1000mg of acetaminophen, I should take two of oxycodone-acetaminophen.

94. The nurse reinforces instructions regarding when to take levothyroxine and determines teaching was effective when the client states the medication should be taken in which manner? A) When they feel fatigued B) At bedtime C) With an antacid D) 30- 60 minutes before breakfast

D) 30- 60 minutes before breakfast

100.Which of these findings would cause the nurse to hold the administration of oral metoprolol 25mg? A) Respiratory rate of 26 breaths per minute B) Heart rate of 92 beats per minute C) Oxygen saturation level of 95% ON room air D) Blood pressure of 92/44 mm Hg

D) Blood pressure of 92/44 mm Hg

83. Which of these self-care measures should be emphasized in client education regarding phenytoin? A) Gradually reduce prescribed dose if seizures do not occur for one month. B) Instill mineral oil into both ears once a week C) Expect green urine due to medication metabolites D) Brush after every meal and floss teeth daily

D) Brush after every meal and floss teeth daily

18. A client who just took his first dose of glipizide, is now experiencing tremors, pallor, and agitation. How should the nurse respond? A) Ask the client's family to come to sit with him until the client's panic attack subsides. B) Give diphenhydramine per standing order for this allergic reaction. C) Acknowledge how hard a diagnosis of diabetes can be and offer to listen. D) Check the blood glucose and give carbohydrates if the client is hypoglycemic

D) Check the blood glucose and give carbohydrates if the client is hypoglycemic

3. Male client tells the nurse he awakens once or twice each night to video and has difficulty starting his stream of urine. He describes these symptoms as " annoying." The client provider examines him and notes that the prostate is moderately enlarged. The client is sexually active and tells the nurse that he doesn't want to take any medication that will interfere with sexual function. THe nurse anticipates the provider will order which of the following? A) Silodosin B) A transurethral prostatectomy C) Finasteride D) Doxazosin

D) Doxazosin

14. A client is discharged from the hospital with a prescription for trimethoprim/sulfamethoxazole. What must the nurse include in the discharge teaching? A) Take folic acid supplements. B) Eat foods that are high in potassium. C) Take the medication with food. D) Drink eight to ten glasses of water each day.

D) Drink eight to ten glasses of water each day.

50, The nurse is caring for a client receiving intravenous acyclovir. To prevent nephrotoxicity, what is the nurse's action? A- Provide a low- protein diet for one day before and two days after the acyclovir infusion B- increase the client's intake of food rich in vitamin C C- Monitor urinary output every 30 min D-Encourage PO fluid intake during the infusion and for 2 hours after the infusion.

D) Encourage PO fluid intake during the infusion and for 2 hours after the infusion.

74. The nurse is doing discharge teaching with the parent of an asthmatic child who will be going home on steroids. Which of these comments by the parent would indicate accurate understanding of discharge teaching these medications? A) Prolonged steroid use causes children to grow prematurely tall because they enhance growth B) Steroids cause weight loss and dehydration in children because they cause type 1 diabetes C) Prolonged steroid use may lead to addiction D) My child may need to take a gastric acid suppressant while taking steroids

D) My child may need to take a gastric acid suppressant while taking steroids

22. A Prescriber has ordered medication for a newborn that is eliminated primarily by hepatic Metabolism. What would the nurse expect the prescriber to order? A) Order a dose that is higher than an adult dose. B) Discontinue the drug after one or two treatments. C) Increase the frequency of medication dosing. D) Order a dose that is lower than an adult dose.

D) Order a dose that is lower than an adult dose.

72. A nurse is giving discharge instructions sto a client who is beginning theophylline. The nurse tell the client that this medication might cause the following adverse effects? A) Oliguria B) Constipation C) Drowsiness D) Tachycardia

D) Tachycardia

81. A nurse is talking with a client who has peptic ulcer disease and starting therapy with sucralfate. What must the nurse include in the client's education? A) Take it whenever indigestion occurs. B) Take it immediately after meals. C) Take it with an antacid. D) Take it 30-60 minutes before meals.

D) Take it 30-60 minutes before meals.

54, A client who is pregnant has a history of recurrent genital herpes virus. The client asks the nurse what will be done to suppress an outbreak when she is near term. What is the nurse's response? A- "Topical acyclovir must be used to control outbreaks" B- "Intravenous antiviral agents will be used if an outbreak occurs" C- "Antiviral medications are not safe during pregnancy" D- "Oral acyclovir may be used during pregnancy"

D- "Oral acyclovir may be used during pregnancy"

51) The diabetic client receives an injection of insulin glargine. What is the duration of insulin glargine? A- 6 to 14 hours B- 15 min C- 2 to 4 hours D- 18 to 24 hours

D- 18 to 24 hours

57, Which of these situations would cause the nurse to hold a dose of morphine? A- The temperature is above 38 degrees celsius. B- The heart rate is above 90 bpm. C- The blood pressure is above 140 mm hg systolic. D- Respiratory rate of 10 breaths per min with an oxygen saturation level of 86%

D- Respiratory rate of 10 breaths per min with an oxygen saturation level of 86%

9. The nurse understands that a bronchodilator would be most therapeutic in which situation? A- Irregular respiration, snoring, and intermittent episodes of apnea B- fine, scattered crackles heard bilaterally in the bases C- course crackles in the right lower lobe D- Shallow breath sounds with wheezing sounds in the upper lobes

D- Shallow breath sounds with wheezing sounds in the upper lobes