Suggested questions from a prior class...

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

2. Tremors

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

3. Fasting blood glucose of 200 mg/dl

A client with tuberculosis is being started on antituberculosis therapy with isoniazid. Before giving the client the first dose, the nurse should ensure that which baseline study has been completed? 1. Electrolytes levels 2. coagulation times 3. liver enzyme levels 4. serum creatinine level

3. liver enzyme levels Isoniazid therapy can cause an elevation of hepatic enzyme levels and hepatitis. Therefore, liver enzymes levels are monitored when therapy is initiated and during the first 3 months of therapy.

A client has a prescription to take guaifenesin. The nurse determines that the client understands the proper administration of this medication if the client states that he or she will perform which action? 1. take an extra dose if fever develops 2. take the medication with meals only 3. take the table with a full glass of water 4. decrease the amount of daily fluids

3. take with full glass of water Guaifenesin is an expectorant and should be taken with full glass of water to decrease the viscosity of secretions . client should call pcp if cough is longer than a week.

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

3.On an empty stomach

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

4. decongestants

A client's medication sheet contains a prescription for sertraline. To ensure safe administration of the medication, how should the nurse administer the dose? a) On an empty stomach b) At the same time each evening c) Evenly spaced around the clock d) As needed when the client complains of depression

b) At the same time each evening Rationale: Sertraline (Zoloft) is classified as an antidepressant. Sertraline (Zoloft) generally is administered once every 24 hours. It may be administered in the morning or evening, but evening administration may be preferable because drowsiness is a side effect. The medication may be administered without food or with food if gastrointestinal distress occurs. Sertraline (Zoloft) is not prescribed for use as needed.

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

1. "I will flush the eyes after instilling the ointment." Rationale: eye prophylaxis protects newborns against gonorrhea and chlamydia. The eyes are not flush after installation of the medication because the flush would wash away the administered medication. Options two, three, and four are correct statements regarding the procedure for administering medication to the new born

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

1. "i will take the cimetidine with my meals" 2. "i'll know the medication is working if my diarrhea stops" 4. "taking the cimetidine with an antacid will increase its effectiveness" Cimetidine, a Histamine (h2) receptor antagonist, helps alleviate the symptom of heartburn, not diarrhea. Because Cimetidine crosses the blood-brain barrier, CNS side and adverse effects, such as mental confusion, agitation, depression, and anxiety can occur. Food reduces the rate of absorption, so if cimetidine is taken with meals, absorption will be slowed. Antacids decrease the absorption of cimetidine and should be taken a t least 1 hour apart. If cimetidine is concomitantly administered with warfarin Therapy, warfarin dose may need to be reduced, so prothrombin and INR results must be followed.

A client is prescribed an eye drop and an eye ointment for the right eye. How should the nurse best administer the medications? 1. Administer the eye drop first, followed by the eye ointment. 2. Administer the eye ointment first, followed by the eye drop. 3. Administer the eye drop, wait 15 minutes, and administer the eye ointment. 4. Administer the eye ointment, wait 15 minutes, and administer the eye drop.

1. Administer the eye drop first, followed by the eye ointment. Rationale: When an eye drop and an eye ointment are scheduled to be administered at the same time, the eye drop is administered first. The instillation of two medications is separated by 3 to 5 minutes.

The nurse is applying a topical corticosteroid to a client with eczema. The nurse apply the medication to which body area? Select all that apply. 1. Back 2. Axilla 3. Eyelids 4. Soles of the feet 5. Palms of the hands

1. Back 4. Soles of the feet 5. Palms of the hands Rationale: topical corticosteroids can be absorbed into the systemic circulation. Absorption is higher from regions where the skin is especially permeable ( scalp, axilla, face, eyelids, neck, perineum, genitalia), and lower from regions where permeability is poor (back, palms, soles). The nurse should avoid areas of higher absorption to prevent systemic absorption.

A client has begun therapy with theophylline. The nurse should plan to teach the client to limit the intake of which items while taking this medication? 1.coffee, cola and chocolate 2. oysters, lobster and shrimp 3. melons, oranges and pineapple 4. cottage cheese, cream cheese and dairy creamers

1. Coffee, cola and chocolate Theophylline is a methylxanthine bronchodilator. the nurse teaches the client to limit the intake of xanthine-containing foods while taking the medication. these foods include coffee, cola and chocolate.

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

1. Continue taking the medication; the brown urine occurs and is not harmful

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

1. Diarrhea may occur secondary to the metformin. 2. The repaglinide is not taken if a meal is skipped. 3. The repaglinide is taken 30 minutes before eating. 4. A simple sugar food item is carried and used to treat mild hypoglycemia episodes. Rationale: Repaglinide, a rapid-acting oral hypoglycemic agent that stimulates pancreatic insulin secretion, should be taken before meals (approximately 30 minutes before meals) and should be withheld if the client does not eat. Hypoglyce- mia is a side effect of repaglinide and the client should always be prepared by carrying a simple sugar at all times. Metformin is an oral hypoglycemic given in combination with repaglinide and works by decreasing hepatic glucose production. A com- mon side effect of metformin is diarrhea. Muscle pain may occur as an adverse effect from metformin but it might signify a more serious condition that warrants health care provider notification, not the use of acetaminophen.

A burn client is receiving treatments of topical mafenide acetate to the site of injury. the nurse monitor the clients, knowing that which finding indicates that a systemic effect has occurred? 1. Hyperventilation 2. Elevated blood pressure 3. Local rash at burn site 4. Local pain at burn site

1. Hyperventilation Rationale: mafenide acetate is a Carbonic anhydrase inhibitor and can suppress renal excretion of acid, thereby causing acidosis. Clients receiving this treatment should be monitored for signs of an acid base imbalance (hyperventilation). if this occurs, the medication will probably be discontinued for one to two days. Options three and four describe local rather than systemic effects. An elevated blood pressure may be expected from the pain that occurs with a burn injury.

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

1. I feel like my heart is racing. Albuterol/ipratropium is a combination agent- one is b2-adrenergic agonist and the other is an anticholinergic medication, in combination they produce an overall bronchodilation effect. common side effects include headache, dizziness, dry mouth, tremors, nervousness and tachycardia.

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

1. Insomnia 2. Weight loss 5. Mild heat intolerance Rationale: Insomnia, weight loss, and mild heat intolerance are side effects of levothyroxine sodium. Bradycardia and con- stipation are not side effects associated with this medication, and rather are associated with hypothyroidism, which is the disorder that this medication is prescribed to treat.

The nurse is preparing to administer eye drops. Which interventions should the nurse take to administer the drops? Select all that apply. 1. Wash hands 2. Put gloves on. 3. Place the drop in the conjunctival sac. 4. Pull the lower lid down against the cheekbone. 5. Instruct the client to squeeze the eyes shut after instilling the eye drop. 6. Instruct the client to tilt the head forward, open the eyes, and look down.

1. Wash hands. 2. Put gloves on. 3. Place the drop in the conjunctival sac. 4. Pull the lower lid down against the cheekbone .Rationale: To administer eye medications, the nurse should wash hands and put gloves on. The client is instructed to tilt the head backward, open the eyes, and look up. The nurse pulls the lower lid down against the cheekbone and holds the bottle like a pencil with the tip downward. Holding the bottle, the nurse gently rests the wrist of the hand on the client's cheek and squeezes the bottle gently to allow the drop to fall into the conjunctival sac. The client is instructed to close the eyes gently and not to squeeze the eyes shut to prevent the loss of medication.

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

1. Withdraws the NPH insulin first (Remember RN—draw up the Regular (short-acting) insulin before the NPH insulin.)

Rifabutin is prescribed for a client with active Mycobacterium avium complex (MAC) disease and tuberculosis. For which side and adverse effects of the medication should the nurse monitor? Select all that apply. 1. signs of hepatitis 2. flu like symptoms 3. low neutrophil count 4. vitamin b6 deficiency 5. ocular pain or blurred vision 6. tingling and numbness of fingers.

1. signs of hepatitis 2. flu like symptoms 3. low neutrophil count 5. ocular pain or blurred vision rifabutin may be prescribed for client with active MAC disease and TB. it inhibits mycobacterial DNA-dependent RNA polymerase and suppress protein synthesis. side and adverse effects include rash, GI disturbances, neutropenia (low neutrophil count), red-orange colored body secretions, uveitis (blurred vision and eye pain), myositis, arthralgia, hepatitis, chest pain with dyspnea and flu like symptoms.

A client receiving thrombolytic therapy with a continuous infusion of alteplase suddenly becomes extremely anxious and complains of itching; The nurse hears stridor and notes generalized urticaria and hypotension. Which interventions should the nurse anticipate Select all that apply. 1. Stop the infusion 2. Raise the head of the bed 3. Administer protamine sulfate 4. Administer diphenhydramine 5. Call for the rapid response team (RRT)

1. stop the infusion 4.administer diphenhydramine 5. all for rapid response team. Rationale- the client is experiencing an anaphylactic reaction, therefor, the priority action is to the stop the infusion and notify the RRT. The client may be treated with antihistamines. Raising the head of the bed would not be helpful, as that may exacerbate the hypotension. Protamine sulfate is the antidote for heparin, so it is not helpful for a client receiving alteplase.

The nurse is planning to administer hydrochlorothiazide to a client. The nurse understands that which is a concern related to the administration of this medication? 1. Sulfa allergy 2. Osteoporosis 3. Hypokalemia 4. Hypouricemia 5. Hyperglycemia 6. Hypercalcemia

1.sulfa allergy 3..Hypokalemia, 5 Hyperglycemia, 6..Hypercalcemia Rationale: Thiazide diuretics such as term-42hydrochlorothiazide are sulfa-based medications, and a client with a sulfa allergy is at risk for an allergic reaction. Also, clients are at risk for hypokalemia, hyperglycemia, hypercalcemia, hyperlipidemia, and hyperuricemia.

Bethanechol chloride is prescribed for a client with urinary retention. Which disorder would be a contraindication to the administration of this medication? 1. Gastric atony 2. Urinary strictures 3. Neurogenic atony 4. Gastroesophageal reflux

2 urinary strictures

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

2. "I should decrease my oral fluids when I start this medication." 5. "I should report headache and drowsiness to my HCP since these symptoms could be related to my desmopressin."

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

2. "Take your prescribed pills 1 hour before or 2 hours after the injection."

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

2. Betamethasone Rationale: betamethasone, a glucocorticoid, is given to increase the production of surfactant to stimulate fetal lung maturation. It is administered to clients in preterm labor at 28 to 32 weeks of gestation if labor can be inhibited for 48 hours. Now Buford is an opioid analgesic. Rho immune globulin is given to rh- clients to prevent sensitization. Dinoprostone vaginal insert is a prostaglandin given to ripen and soften the cervix and to stimulate uterine contractions.

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

2. Intratracheal Rationale: respiratory distress syndrome is a serious lung disorder caused by immaturity and the inability to produce surfactant, resulting in hypoxia and acidosis. It is common in premature infants and may be due to lung immaturity as a result of surfactant deficiency. The Mainstay of treatment is the administration of exogenous surfactant, which is administered by the intratracheal route. Options 1, 3, and 4 are not routes of administration for this medication

The nurse is caring for a client with chronic back pain. Codeine has been prescribed for the client. Specific to this medication, which intervention should the nurse include in the plan of care while the client is taking this medication? 1. monitor radial pulse 2. monitor bowel activity 3. monitor apical heart rate 4. monitor peripheral pulses

2. Monitor Bowel activity. Med can cause constipation. Nurse should monitor for hypotension, urine retention, bowel sounds, monitor the pattern of bowel movements. and monitor resp status and how effective the med is for pain reduction.

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

2. Prednisone prednisone may decrease the effect of oral hypoglycemics, insulin, diuretics and potassium supplements.

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

2. Protamine sulfate rationale- The antidote for heparin is protamine sulfate; it should be readily available for use if excessive bleeding or hemorrhage should occur. vitamin K is an antidote for warfarin sodium. Potassium Chloride is administered for a potassium deficit. Aminocaproic acid is the antidote for thrombolytic therapy.

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

2. Red meats 3. Whole-grain cereals 5. Carbonated beverages 2, 3, 5 Rationale: When alcohol is combined with glimepiride, a disulfiram-like reaction may occur. This syndrome includes flushing, palpitations, and nausea. Alcohol can also poten- tiate the hypoglycemic effects of the medication. Clients need to be instructed to avoid alcohol consumption while taking this medication. Low-calorie desserts should also be avoided. Even though the calorie content may be low, carbohydrate content is most likely high and can affect the blood glucose. The items in options 2, 3, and 5 are acceptable to consume.

A client who uses NSAIDs has been taking misoprostol. The nurse determines that the misoprostol is having the intended therapeutic effect if which finding is noted? 1. resolved diarrhea 2. relief of epigastric painterm-30 3. decreased platelet count 4. decreased WBC count

2. Relief of epigastric pain Clients who use NSAIDs are prone to gastric mucosal injury. Misoprostol is a gastric protectant and is given specifically to prevent this occurrence in clients taken NSAIDs frequently. Diarrhea can be a side effect of the medication but is not an intended effect.

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

2. Respirations of 10 breaths/minute& 4. Urine output of 20 mL in an hour Rationale: magnesium toxicity can occur from magnesium sulfate therapy. signs of magnesium sulfate toxicity relate to the central nervous system depressant effects of the medication and include respiratory depression, loss of deep tendon reflexes, and a sudden decline in fetal heart rate and maternal heart rate and blood pressure. Respiratory rate below 12 breaths per minute is a sign of toxicity. Urine output should be at least 25 to 30 milliliters per hour. Proteinuria of 3 + is an expected finding in a client with pre-eclampsia. Presence of deep tendon reflexes is normal and expected finding. Therapeutic serum levels of magnesium are for 27.5 mEq per liter

The nurse in monitoring a client with hypertension who is taking propranolol. Which assessment data indicates a potential adverse complication associated with this medication? 1. The development of complaints of insomnia 2. The development of audible expiratory wheezes 3. A baseline BP of 150/80mmHg followed by a BP of 138/72mmHg after two doses of the medication 4. A baseline resting HR of 88bpm followed by a resting HR of 72bmp after two doses of the medication

2. The development of audible expiratory wheezes Rationale: Audible expiratory wheezes may indicate a serious adverse reaction, bronchospasm. B-blockers may induce this reaction, particularly in clients with chronic obstructive pulmonary disease or asthma. Normal decreases in BP and heart rate are expected. Insomnia is a frequent mild side effect and should be monitored.

Isotretinoin is prescribed for a client with severe acne. Before the administration of this medication, the nurse anticipates that which Laboratory test will be prescribed? 1. Potassium level 2. Triglyceride level 3. Hemoglobin A1C 4. Total cholesterol level

2. Triglyceride level Rationale: isotretinoin can Elevate triglyceride levels period blood triglyceride levels should be measured before treatment and periodically thereafter until the effect on triglycerides has been evaluated. There is no indication that isotretinoin effects potassium, hemoglobin A1c, or total cholesterol levels.

The health education nurse provides instructions to a group of clients regarding measures that will assist with preventing skin cancer. Which instructions should the nurse provide? Select all that apply. 1. Sunscreen should be applied every 8 hrs 2. Use sunscreen when participating in outdoor activities. 3. Wear a hat, opaque clothing, and sunglasses when in the sun. 4. Avoid sun exposure in the late afternoon and early evening hours. 5. Examine your body monthly for any lesions that may be suspicious.

2. Use sunscreen when participating in outdoor activities. 3. Wear a hat, opaque clothing, and sunglasses when in the sun. 5. Examine your body monthly for any lesions that may be suspicious. Rationale: the client should be instructed to avoid sun exposure between the hours of brightest sunlight: 10 a.m. and 4 p.m. Sunscreen, a hat, opaque clothing, and sunglasses should be warm for outdoor activities. The client should be instructed to examine the body monthly for appearances of any cancerous or pre-cancerous lesions. Sunscreen should be reapplied every 2 to 3 hours and after swimming or sweating; otherwise, the duration of protection is reduced.

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

2. peripheral neuritis isoniazid is an antitubercular medication. common side effects are peripheral neuritis, manifested by numbness tingling and paresthesia in the extremities. this can be minimized with pyridozine b6 intake.

A client is to begin a 6-month course of therapy with isoniazid. The nurse should plan to teach the client to take which action? 1. use alcohol in small amounts only. 2. report yellow eyes or skin immediately 3. increase intake of swiss and aged cheeses 4. avoid vitamin supplements during therapy.

2. report yellow eyes and skin immediately med is hepatotoxic ..

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

2.Checking the frequency and consistency of bowel movements Rationale: The principal manifestations of Crohn's disease are diarrhea and abdominal pain. Infliximab (Remicade) is an immunomodulator that reduces the degree of inflammation in the colon, thereby reducing the diarrhea.

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

3. Blood urea nitrogen level of 25 mg/dl

The Nurse is administering an IV dose of Methocarbamol to a client with muscle skeletal injury. For which adverse effect should the nurse Monitor? 1. tachycardia 2. Rapid Pulse 3. Bradycardia 4. Hypertension

3. Bradycardia IV administration of methocarbamol can cause hypotension and bradycardia. The nurse needs to monitor for those adverse effects. 1, 3, 4 are not effects of this drug.

An older client recently has been taking cimetidine. The nurse monitors the client for which most frequent central nervous system side effect of this medication? 1. tremors 2. dizziness 3. confusion 4. hallucinations

3. Confusion Cimetidine is an Histamine (h2)-receptor antagonist. Older clients are especially susceptible to CNS side effects from cimetidine. Most frequently Confusion. . less common CNS side effects include headaches, dizziness, drowsiness and hallucinations.

Terbutaline is prescribed for a client with bronchitis. The nurse checks the client's medical history for which disorder in which the medication should be used with caution? 1.osteoarthritis 2. hypothyroidism 3. diabetes mellitus 4. polycystic disease

3. Diabetes mellitus is contraindicated in client with hypersensitivity to sympathomimetics. it should be used with caution in clients with impaired cardiac function, Diabetes mellitus, hypertension, hyperthyroidism, or history of seizures.

Betaxolol hydrochloride eye drops have been prescribed for a client with glaucoma. Which nursing action is most appropriate related to monitoring for side and adverse effects of this medication? 1. Assessing for edema 2. Monitoring temperature 3. Monitoring blood pressure 4. Assessing blood glucose level

3. Monitoring blood pressure Rationale: Hypotension, dizziness, nausea, diaphoresis, headache, fatigue, constipation, and diarrhea are side and adverse effects of the medication. Nursing interventions include monitoring the blood pressure for hypotension and assessing the pulse for strength, weakness, irregular rate, and bradycardia. Options 1, 2, and 4 are not specifically associated with this medication.

A client is taking the prescribed dose of phenytoin to control seizures. Results of a phenytoin blood level study reveal a level of 35 mcg/mL. Which finding would be expected as a result of this lab result? 1. hypotension 2. tachycardia 3. slurred speech 4. no abnormal finding

3. Slurred Speech Rationale- Therapuetic Phenytoin level is 10 to 20mcg/ml (40 to 79 mcmol/L). Ata a level higher than 20mcg/ml, involuntary movements of the eyeballs )nystagmus) occurs. At levels higher than 30mcg/ml, ataxia and slurred speech occur.

Zafirlukast is prescribed for a client with bronchial asthma. Which laboratory test does the nurse expect to be prescribed before the administration of this medication? 1. platelet count 2. neutrophil count 3. liver function test 4. complete blood count

3. liver function test zafirlukast is a leukotriene receptor antagonist used in the prophylaxis and long term treatment of bronchial asthma. zafirlukast should with caution in clients with impaired hepatic function.

A client has begun medication therapy with pancrelipase. The nurse evaluates that the medication is having the optimal intended benefit if which effect is observed? 1. weight loss 2. relief of heartburn 3. reduction of steatorrhea 4. absence of abdominal pain

3. reduction of steatorrhea Pancrelipase is a pancreatic enzyme use in clients with pancreatitis as an digestive aid. This medication should reduce the amount of fatty stools (steatorrhea). Another intended effect could be improved nutritional status. Its use could result in weight gain.

Silver sulfadiazine is prescribed for a client with a partial thickness burn and the nurse provides teaching about the medication. Which statement made by the client indicates a need for further teaching about the treatments? 1. "The medication is an antibacterial." 2. "The medication will help heal the burn." 3. "The medication should be applied directly to the wound." 4."The medication is likely to cause stinging every time it is applied."

4. "The medication is likely to cause stinging every time it is applied." Rationale: silver sulfadiazine is an antibacterial that has a broad spectrum of activity against gram-negative bacteria gram positive bacteria, and yeast. It is applied directly to the wound to assistant healing. It does not cause stinging when applied.

A client with trigeminal neuralgia tells the nurse that acetaminophen is taken daily for the relief of generalized discomfort. Which lab value would indicate toxicity associated with the medication? 1. sodium level of 140 mEq/L 2. platelet count of 400,000 mm3 3. prothrombin time of 12 seconds 4. direct bilirubin level of 2 mg/dL

4. Direct Bilirubin of 2mg/dL in Adults, overdose of acetaminophen causes liver damage. The correct option is an indicator of liver function and is the only option that indicates an abnormal lab value. The normal Direct Bilirubin level is 0.1 to 0.3mg/dl.

Carbidopa-levodopa is prescribed for a client with Parkinson's disease, and the nurse monitors the client for adverse effects of the medication. Which sign/symptom indicates the client is experiencing an adverse effect? 1. Pruritis 2. Tachycardia 3. Hypertension 4. Impaired Voluntary Movement

4. Impaired Voluntary Movement Dyskinesia and impaired voluntary movements may occur with high Carbidopa-levodopa dosages. Nausea, anorexia , dizziness, orthostatic hypotension, bradycardia, and akinesia are frequent side effects of this medication.

The nurse is providing instructions to a client who will be self-administering eye drops. To minimize systemic absorption of the eye drops, the nurse should instruct the client to take which action? 1. Eat before instilling the drops. 2. Swallow several times after instilling the drops. 3. Blink vigorously to encourage tearing after instilling the drops. 4. Occlude the nasolacrimal duct with a finger after instilling the drops.

4. Occlude the nasolacrimal duct with a finger after instilling the drops. Rationale: Applying pressure on the nasolacrimal duct prevents systemic absorption of the medication. Options 1, 2, and 3 will not prevent systemic absorption.

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

4. One hour before meals and at bedtime. Sucralfate is a gastric protectant. The medication should be scheduled for administration 1 hr before meals and at bedtime. The medication is timed to allow it to form a protective coating over the ulcer before food intake stimulates gastric acid production and mechanical irritation.

Silver sulfadiazine is prescribed for a client with a burn injury. Which laboratory finding requires the need for follow-up by the nurse? 1. Glucose level of 99 mg/dL2. 2. Platelet level of 300,000. 3. Magnesium level of 1.5 mEq/L 4. White blood cell count of 3000

4. White blood cell count of 3000 Rationale: silver sulfadiazine is used for the treatment of burn injuries. Adverse effects of this medication include rash and itching, blue green or gray skin discoloration, leukopenia, and interstitial nephritis. The nurse should monitor a complete blood count, particularly the white blood cells, frequently for the client taking this medication. If leukopenia develops, the healthcare provider is notified and the medication is usually discontinued. The white blood cell count noted an option for is indicative of leukopenia. The other laboratory values are not specific to this medication, and are also within normal limits.

In monitoring a client's response to disease-modifying antirheumatic drugs (DMARDs), which findings should the nurse interpret as acceptable responses? Select all that apply. A. Control of symptoms during periods of emotional stress B. Normal white blood cell, platelet, and neutrophil counts C. Radiological findings that show nonprogression of joint degeneration D. An increased range of motion in the affected joints 3 months into therapy E. Inflammation and irritation at the injection site 3 days after injection is given F. A low-grade temperature upon rising in the morning that remains throughout the day

A. control of symptoms during periods of emotional stress B. Normal white blood cell, platelet, and neutrophil counts C. Radiological findings that show nonprogression of joint degeneration D. An increased range of motion in the affected joints 3 months into therapy Because emotional stress frequently exacerbates the symptoms of rheumatoid arthritis, the absence of symptoms is a positive finding. DMARDs are given to slow progression of joint degeneration. In addition, the improvement in the range of motion after 3 months of therapy with normal blood work is a positive finding. Temperature elevation and inflammation and irritation at the medication injection site could indicate signs of infection.

The nurse is preparing discharge instructions to a client who sustained a skeletal muscle injury and receiving baclofen. Which should the nurse include in the instructions? A. Restrict fluid intake. B. Avoid the use of alcohol. C. Stop the medication if diarrhea occurs. D. Notify the health care provider if fatigue occurs.

B. Avoid the use of alcohol. Baclofen is a central nervous system (CNS) depressant. The client should be cautioned against the use of alcohol and other CNS depressants because baclofen potentiates the depressant activity of these agents. It is not necessary to restrict fluids, but the client should be warned that urinary retention can occur. Constipation rather than diarrhea is an adverse effect of baclofen. Fatigue is related to a CNS effect that is most intense during the early phase of therapy and diminishes with continued medication use. It is not necessary that the client notify the health care provider if fatigue occurs.

Colchicine is prescribed for a client with a diagnosis of gout. The nurse reviews the client's medical history in the health record, knowing that the medication would be used with caution in which disorder? A. Myxedema B. Kidney Disease C. Hypothyroidism D. Diabetes mellitus

B. Kidney Disease Colchicine is used with caution in older clients, debilitated clients, and clients with cardiac, kidney, or GI disease. disorders 1, 3, 4 are not concerns with this med

The client has been on treatment for rheumatoid arthritis for 3 weeks. During the administration of etanercept, it is most important for the nurse to collect which data? A. The injection site for itching and edema B. The white blood cell counts and platelet counts c. Whether the client is experiencing fatigue and joint pain D. A metallic taste in the mouth, with a loss of appetite

B. The white blood cell counts and platelet counts Infection and pancytopenia can occur as a result of etanercept. Laboratory studies are performed before and during medication treatment. The appearance of abnormal white blood cell counts and abnormal platelet counts can alert the nurse to a potentially life-threatening infection or potential bleeding. Injection site itching and edema are common occurrences following administration. A metallic taste and loss of appetite are not associated with this medication. Fatigue and joint pain occur with rheumatoid arthritis.

Alendronate is prescribed for a client with osteoporosis and the nurse is providing instructions on administration of the medication. Which instruction should the nurse reinforce? A. Take the medication at bedtime. B. Take the medication in the morning with breakfast. C. Lie down for 30 minutes after taking the medication. D. Take the medication with a full glass of water after rising in the morning.

D. Take the medication with a full glass of water after rising in the morning.

the nurse is preparing to administer a dose of naloxone intravenously to a client with an opioid overdose. Which supportive medical equipment should the nurse plan to have at the client's bedside if needed? 1. nasogastric tube 2. paracentesis tray 3. resuscitation equipment 4. central line insertion tray.

Resuscitation equipment the nurse administering naloxone for suspected opioid overdose should have the resuscitation equipment readily available to support naloxone therapy if needed.

Salicylic acid is prescribed for a client whit a diagnosis of psoriasis. The nurse monitors the client, knowing that which finding indicates the presence of systemic Toxicity from this medication? 1. Tinnitus 2. Diarrhea 3. Constipation 4. Decreased respirations

Tinnitus Rationale: salicylic acid is absorbed readily through the skin, and systemic toxicity can result period symptoms include tinnitus, dizziness, hyperpnea comma and psychological disturbances period constipation and diarrhea are not associated with salicylism.

A client who is human immunodeficiency virus seropositive has been taking stavudine . The nurse should monitor which most closely while the client is taking this medication? a) Gait b) Appetite c) Level of consciousness d) Gastrointestinal function

a) Gait Rationale: Stavudine is an antiretroviral used to manage human immunodeficiency virus infection in clients who do not respond to or who cannot tolerate conventional therapy. The medication can cause peripheral neuropathy, and the nurse should monitor the client's gait closely and ask the client about paresthesia. Options 2, 3, and 4 are unrelated to this medication.

The nurse is reviewing the history and physical examination of a client who will be receiving asparaginase, an antineoplastic agent. The nurse contacts the health care provider before administering the medication if which disorder is documented in the client's history? a) Pancreatitis b) Diabetes mellitus c) Myocardial infarction d) Chronic obstructive pulmonary disease

a) Pancreatitis Rationale: Asparaginase (Elspar) is contraindicated if hypersensitivity exists, in pancreatitis, or if the client has a history of pancreatitis. The medication impairs pancreatic function and pancreatic function tests should be performed before therapy begins and when a week or more has elapsed between dose administrations. The client needs to be monitored for signs of pancreatitis, which include nausea, vomiting, and abdominal pain. The conditions noted in options 2, 3, and 4 are not contraindicated with this medication.

A client taking lithium carbonate reports vomiting, abdominal pain, diarrhea, blurred vision, tinnitus, and tremors. The lithium level is 2.5 mEq/L. This level is indicative of which finding? a) Toxic b) Normal c) Slightly above normal d) Excessively below normal

a) Toxic Rationale: Maintenance serum levels of lithium are 0.6 to 1.2 mEq/L. Symptoms of toxicity begin to appear at levels of 1.5 to 2 mEq/L. Lithium toxicity requires immediate medical attention with lavage and possible peritoneal dialysis or hemodialysis.

A hospitalized client has begun taking bupropion as an antidepressant agent. The nurse understands that which is an adverse effect, indicating that the client is taking an excessive amount of medication? a) Constipation b) Seizure activity c) Increased weight d) Dizziness when getting upright

b) Seizure activity Rationale: Seizure activity can occur in clients taking bupropion (Wellbutrin) dosages greater than 450 mg daily. Weight gain is an occasional side effect, whereas constipation is a common side effect of this medication. This medication does not cause significant orthostatic blood pressure changes.

The nurse notes that a client with schizophrenia and receiving an antipsychotic medication is moving her mouth, protruding her tongue, and grimacing as she watches television. The nurse determines that the client is experiencing which medication complication? a) Parkinsonism b) Tardive dyskinesia c) Hypertensive crisis d) Neuroleptic malignant syndrome

b) Tardive dyskinesia Rationale: Tardive dyskinesia is a reaction that can occur from antipsychotic medication. It is characterized by uncontrollable involuntary movements of the body and extremities, particularly the tongue. Parkinsonism is characterized by tremors, masklike facies, rigidity, and a shuffling gait. Hypertensive crisis can occur from the use of monoamine oxidase inhibitors and is characterized by hypertension, occipital headache radiating frontally, neck stiffness and soreness, nausea, and vomiting. Neuroleptic malignant syndrome is a potentially fatal syndrome that may occur at any time during therapy with neuroleptic (antipsychotic) medications. It is characterized by dyspnea or tachypnea, tachycardia or irregular pulse rate, fever, blood pressure changes, increased sweating, loss of bladder control, and skeletal muscle rigidity.

The nurse caring for a client who is taking an aminoglycoside should monitor the client for which adverse effects of the medication? Select all that apply. a) Seizures b) Ototoxicity c) Renal toxicity d) Dysrhythmias e) Hepatotoxicity

b. Ototoxicity c. Renal Toxicity d. Dysrhythmias Rationale: Aminoglycosides are administered to inhibit the growth of bacteria. Adverse effects of this medication include confusion, ototoxicity, renal toxicity, gastrointestinal irritation, palpitations (dysrhythmias), blood pressure changes, and hypersensitivity reactions. Therefore, the remaining options are incorrect.

A clinic nurse prepares a teaching plan for a client receiving an antineoplastic medication. When implementing the plan, the nurse should make which statement to the client? a) "You can take aspirin (acetylsalicylic acid) as needed for headache." b) "You can drink beverages containing alcohol in moderate amounts each evening." c) "You need to consult with the health care provider (HCP) before receiving immunizations." d) "It is fine to receive a flu vaccine at the local health fair without HCP approval because the flu is so contagious."

c) "You need to consult with the health care provider (HCP) before receiving immunizations." Rationale: Because antineoplastic medications lower the resistance of the body, clients must be informed not to receive immunizations without an HCP's approval. Clients also need to avoid contact with individuals who have recently received a live virus vaccine. Clients need to avoid aspirin and aspirin-containing products to minimize the risk of bleeding, and they need to avoid alcohol to minimize the risk of toxicity and side/adverse effects.

The nurse is monitoring the laboratory results of a client receiving an antineoplastic medication by the intravenous route. The nurse plans to initiate bleeding precautions if which laboratory result is noted? a) A clotting time of 10 minutes b) An ammonia level of 20 mcg/dL c) A platelet count of 50,000 cells/mm3 d) A white blood cell count of 5000 cells/mm3

c) A platelet count of 50,000 cells/mm3 Rationale: Bleeding precautions need to be initiated when the platelet count decreases. The normal platelet count is 150,000 to 450,000 cells/mmc) When the platelet count decreases, the client is at risk for bleeding. The normal white blood cell count is 4500 to 11,000 cells/mmc) When the white blood cell count drops, neutropenic precautions need to be implemented. The normal clotting time is 8 to 15 minutes. The normal ammonia value is 10 to 80 mcg/dL.

The nurse is caring for a postrenal transplantation client taking cyclosporine . The nurse notes an increase in one of the client's vital signs and the client is complaining of a headache. What vital sign is most likely increased? a) Pulse b) Respirations c) Blood pressure d) Pulse oximetry

c) Blood pressure Rationale: Hypertension can occur in a client taking cyclosporine (Sandimmune) and, because this client is also complaining of a headache, the blood pressure is the vital sign to be monitored most closely. Other adverse effects include infection, nephrotoxicity, and hirsutism. Options 1, 2, and 4 are unrelated to the use of this medication.

Amikacin is prescribed for a client with a bacterial infection. The nurse instructs the client to contact the health care provider (HCP) immediately if which occurs? a) Nausea b) Lethargy c) Hearing loss d) Muscle aches

c) Hearing loss Rationale: Amikacin is an aminoglycoside. Side/adverse effects of aminoglycosides include ototoxicity (hearing problems), confusion, disorientation, gastrointestinal irritation, palpitations, blood pressure changes, nephrotoxicity, and hypersensitivity. The nurse instructs the client to report hearing loss to the HCP immediately. Lethargy and muscle aches are not associated with the use of this medication. It is not necessary to contact the HCP immediately if nausea occurs. If nausea persists or results in vomiting, the HCP should be notified.

The nurse is reviewing the results of serum laboratory studies drawn on a client with acquired immunodeficiency syndrome who is receiving didanosine . The nurse interprets that the client may have the medication discontinued by the health care provider if which elevated result is noted? a) Serum protein level b) Blood glucose level c) Serum amylase level d) Serum creatinine level

c) Serum amylase level Rationale: Didanosine can cause pancreatitis. A serum amylase level that is increased to a)5 to 2 times normal may signify pancreatitis in the client with acquired immunodeficiency syndrome and is potentially fatal. The medication may have to be discontinued. The medication is also hepatotoxic and can result in liver failure.

A hospitalized client is started on a monoamine oxidase inhibitor (MAOI) for the treatment of depression. The nurse should instruct the client that which foods are acceptable to consume while taking this medication? Select all that apply. a) Figs b) Yogurt c) Crackers d) Aged cheese e) Tossed salad f) Oatmeal raisin cookies

c. Crackers E. Tossed Salad Rationale: Phenelzine is a monoamine oxidase inhibitor (MAOI). The client should avoid ingesting foods that are high in tyramine. Ingestion of these foods could trigger a potentially fatal hypertensive crisis. Foods to avoid include yogurt; aged cheeses; smoked or processed meats; red wines; and fruits such as avocados, raisins, or figs.

A client with non-Hodgkin's lymphoma is receiving daunorubicin (DaunoXome). Which finding would indicate to the nurse that the client is experiencing an adverse effect related to the medication? a) Fever b) Sores in the mouth and throat c) Complaints of nausea and vomiting d) Crackles on auscultation of the lungs

d) Crackles on auscultation of the lungs Rationale: Cardiotoxicity noted by abnormal electrocardiographic findings or cardiomyopathy manifested as heart failure (lung crackles) is an adverse effect of daunorubicin. Bone marrow depression is also an adverse effect. Fever is a frequent side effect and sores in the mouth and throat can occur occasionally. Nausea and vomiting is a frequent side effect associated with the medication that begins a few hours after administration and lasts 24 to 48 hours. Options 1, 2, and 3 are not adverse effects.

The nurse is administering risperidone to a client who is scheduled to be discharged. Before discharge, which instruction should the nurse provide to the client? a) Get adequate sunlight. b) Continue driving as usual. c) Avoid foods rich in potassium. d) Get up slowly when changing positions.

d) Get up slowly when changing positions. Rationale: Risperidone (Risperdal) can cause orthostatic hypotension. Sunlight should be avoided by the client taking this medication. With any psychotropic medication, caution needs to be taken (such as with driving or other activities requiring alertness) until the individual can determine whether his or her level of alertness is affected. Food interaction is not a concern.

Chemotherapy dosage is frequently based on total body surface area (BSA), so it is important for the nurse to perform which assessment before administering chemotherapy? a) Measure the client's abdominal girth. b) Calculate the client's body mass index. c) Ask the client about his or her weight and height. d) Measure the client's current weight and height.

d) Measure the client's current weight and height. Rationale: To ensure that the client receives optimal doses of chemotherapy, dosing is usually based on the total body surface area (BSA), which requires a current accurate height and weight for BSA calculation (before each medication administration). Asking the client about his or her height and weight may lead to inaccuracies in determining a true BSA and dosage. Calculating body mass index and measuring abdominal girth will not provide the data needed.

The client with acquired immunodeficiency syndrome and Pneumocystis jiroveci infection has been receiving pentamidine (Pentam 300). The client develops a temperature of 101° F. The nurse continues to assess the client, knowing that this sign most likely indicates which condition? a) That the dose of the medication is too low b) That the client is experiencing toxic effects of the medication c) That the client has developed inadequacy of thermoregulation d) That the client has developed another infection caused by leukopenic effects of the medication

d) That the client has developed another infection caused by leukopenic effects of the medication Rationale: Frequent side/adverse effects of this medication include leukopenia, thrombocytopenia, and anemia. The client should be monitored routinely for signs and symptoms of infection. Options 1, 2, and 3 are inaccurate interpretations.