AQ_Pharm 1

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

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

A nurse is caring for a client who is due to receive general anesthesia. The client asks the nurse, "What is the difference between an analgesic and anesthesia? Which of the following statements should the nurse make? A. "Analgesics can cause a lack of sensation." B. "Anesthesia is specifically for eliminating pain perception." C. "Analgesics treat pain without causing sedation." D. "Anesthesia can cause loss of consciousness."

"Anesthesia can cause loss of consciousness." *General anesthesia reduces or causes a complete loss of consciousness.

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

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

A nurse is caring for a client who is pregnant and inquiring about alternative, non-pharmacological therapies for nausea and vomiting of pregnancy (NVP). Which of the following options should the nurse recommend? A. "Be sure to eat at least 3 large meals each day." B. "If you're experiencing nausea when you wake up, wait to eat until lunchtime." C. "You may need to take additional supplements to alleviate nausea." D. "Ginger is effective in the treatment of nausea and vomiting."

"Ginger is effective in the treatment of nausea and vomiting." *The nurse should recommend seasoning foods with ginger to alleviate the client's nausea and vomiting. Ginger is derived from the ginger root and is an alternative treatment to prescribed medication for treating nausea and vomiting during pregnancy

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

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

A nurse is collecting data from a client with rheumatoid arthritis who has been taking high doses of prescribed hydroxychloroquine. Which of the following client statements should indicate to the nurse that the client statements should indicate to the nurse that the client is experiencing an adverse effect of hydroxychloroquine? A. "I have developed sores in my mouth." B. "I often feel like the room is spinning." C. "I noticed that the whites of my eyes look yellow." D. "I have had a change in my vision recently."

"I have had a change in my vision recently." *The nurse should identify that hydrochloroquine is an antimalarial medication used to treat rheumatoid arthritis. Clients who take hydroxychloroquine in high doses are at risk for developing retinopathy, which can be irreversible and cause blindness.

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

"I might feel dizzy at times while taking this medication." *Hypotension and dizziness are potential adverse effects of this medication. The nurse should monitor the client's blood pressure and instruct the client to change positions slowly. ACE inhibitors like captopril can cause severe neutropenia. The client should notify the provider about manifestations of infection such as a sore throat and a fever. The client should take captopril either 1 hour before meals or 2 hours after meals. NSAIDs such as ibuprofen can interfere with the effects of captopril. The client should avoid combining these medications

A nurse is reinforcing teaching with a female client who has a new prescription for misoprostol to treat peptic ulcer disease. Which of the following client statements should indicate to the nurse that the teaching was effective? A. "I should avoid taking NSAIDs while using this medication." B. "Misoprostol is used to treat stress-induced gastric ulcers." C. "I should avoid becoming pregnant while taking this medication." D. "This medication is also used to treat dysmenorrhea."

"I should avoid becoming pregnant while taking this medication." *The nurse should identify that misoprostol is contraindicated during pregnancy and is classified as pregnancy risk category C by the FDA. It has the potential to stimulate uterine contractions, and the use of misoprostol during pregnancy has been known to cause partial or complete expulsion of the developing fetus

A nurse is teaching a client who has a new diagnosis of angina and has a prescription for isosorbide mononitrate 10 mg PO twice daily. Which of the following client statements indicates an understanding of the teaching? A. "I can take my second dose of medication no later than 9:00 PM." B. "I should change positions slowly when getting out of bed." C. "If I miss a dose, I should double the next dose." D. "I should notify my provider if I experience a headache while taking this medication."

"I should change positions slowly when getting out of bed." *The nurse should identify that isosorbide mononitrate is an antianginal medication that producs vasodilation. Therefore, this medication can cause orthostatic hypotension. Clients should change positions slowly upon rising to minimize the effects of orthostatic hypotension

A nurse is reinforcing teaching with a client who will be taking dexamethasone daily for pain due to spinal edema. The nurse should identify which of the following client statements as an indication that the client understands the instructions? A. "I should eat a snack at bedtime to avoid low blood glucose." B. "I should stay away from people who are ill." C. "I should increase my fluid intake to about 3 quarts per day." D. "I'll call my provider if I am experiencing too much sedation"

"I should stay away from people who are ill." *This medication is a glucocorticoid that decreases inflammation by affecting the client's immune system. As a result, the client is suspceptible to infection and should avoid large crowds as well as people who are ill

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

"I should take this medication before bedtime." *The nurse should instruct the client that an adverse effect of amytriptyline is sedation. The nurse should intruct the client to take the medication at bedtime to minimize sedation during waking hours while promoting sleep. The nurse should instruct the client about taking this medication daily as prescribed. The nurse should warn the client not to discontinue this medication abruptly once mood has improved. The nurse should instruct the client that this medication has anticholinergic effects such as dry mouth, blurred vision, urinary retention, and constipation. The nurse should instruct the client that an adverse effect of amitriptyline is weight gain. The nurse should encourage the client to monitor weight routinely during treatment.

A nurse is reinforcing medication teaching with a client who has a new prescription for ribaroxaban for the prevention of deep venous thrombosis (DVT). Which of the following statements by the client indicates an understanding of the teaching? A. "I will be sure to take this medication at the same time every day." B. "I will limit my intake of green leafy vegetables while taking this medication." C. "I will need to come into the office monthly to have my blood tested." D. "I will be sure to take this medication on an empty stomach."

"I will be sure to take this medication at the same time every day." *Rivaroxaban is prescribed for anticoagulation to prevent DVT and pulmonary embolism (PE) and for the prevention of cerebrovascular accident (CVA) in clients who have atrial fibrillation. The medication has a short duration and must be taken at the same time every day

A nurse is reinforcing teaching with a client who has gout and a prescription for allopurinol. Which of the following statements by the client should indicate to the nurse that the teaching was effective? A. "I should start taking this medication at 800 mg daily." B. "I will have an increased risk for diabetes with this medication." C. "I will increase my fluids to at least 2 liters per day." D. "I should take this medication daily."

"I will increase my fluids to at least 2 liters per day." *The nurse should identify that an adverse effect of allopurinol is renal injury. Therefore, clients encouraged to drink at least 2,000 mL/day to maintain a urine output of at least 2 L/day

A nurse is reinforcing teaching with a client who has a new prescription for nitroglycerin sublingual tablets. Which of the following client statements indicates an understanding of the teaching? A. "I will not eat or drink anything for 1 hour after taking the medication." B. "I will keep the pills in my plastic pill box when traveling." C. "I will contact my doctor if the medication gives me a headache." D. "I will sit down when I take this medication."

"I will sit down when I take this medication." *The nurse should reinforce with the client the need to sit down when taking this medication to prevent orthostatic hypotension. The client should change positions slowly after taking this medication

A nurse is reinforcing teaching with a client who has severe chronic gout and a new prescription for pegloticase. The client has been taking allopurinol for 1 month. Which of the following instructions should the nurse include about pegloticase? A. "You will take this medication along with allopurinol." B. "You will take this medication by mouth." C. "There are very few adverse effects of this medication." D. "If you experience a flare-up, you can take an NSAID while receiving this medication."

"If you experience a flare-up, you can take an NSAID while receiving this medication." *The nurse should instruct this client who has chronic gout that, during the first few months of treatment, an increase in gout manifestations is expected. To reduce the intensity of these manifestions, clients are instructed to take an NSAID such as Naproxen. Allupurinol is the first medication of choice when a client is initially diagnosed with chronic gout. Pegloticase can be prescribed if treatment with allopurinol has been unsuccessful. Pegloticase is administered intravenously. It is a recombinant form of uric oxidase that inhibts the reabsorption of uric acid in clients who have chronic gout. Pegloticase has several adverse effects sch as anaphylaxis. Manifestations include diffculty breathing, periorbital edema, wheezing, and a rash. Therefore, precautions should be taking such as pre-medicating the client with an antihistamine and reducing the rate of the infusion if necessary.

A nurse is reinforcing teaching with a client who has a prescription for chenodiol for the treatment of gallstones. Which of the following client statements indicates an understanding of the teaching? A. "Treatment should last for a couple of months." B. "Liver function tests are required while taking this medication." C. "I should contact my provider if I experience diarrhea." D. "I can continue taking this medication if I become pregnant."

"Liver function tests are required while taking this medication." *The nurse should identify that chenodiol is hepatotoxc and can injure the liver. Periodic liver function tests are required during treatment. This medication is contraindicated in clients who have a preexisting liver condition. Treatment with chenodiol usually lasts for 2 years. The nurse should instruct the client to take the medication as prescribed by the provider. Chendiol can cause dose-dependent diarrhea. This is an adverse effect and does not need to be reported to the provider. Chenodiol is classified by the FDA as pregnancy risk category X. It is contraindicated during pregnancy

A nurse is caring for a client who has multiple sclerosis and is receiving interferon beta-1a. The nurse should identify that which of the following client statements indicates a potential adverse effect of the medication? A. "My body aches all over." B. "I have abdominal cramping." C. "My hair seems to be thinning." D. "It hurts when I urinate."

"My body aches all over." *The adverse effects of interferon beta-1a can include flu-like symptoms such as general body and muscle aches.

A nurse is reinforcing teaching with a client who has asthma and a prescription for a fluticasone dry powder inhaler (DPI). Which of the following instructions should the nurse include in the teaching? A. "This medication should be taken at the start of your symptoms." B. "Rinse your mouth after administering this medication." C. "Shake the canister prior to administer this medication." D. "This medication relaxes your airways to decrease your symptoms."

"Rinse your mouth after administering this medication." *The nurse should include in the teaching that this medication is an oral corticosteroid. Oral corticosteroids increase the risk of the development of oral candidiasis, also known as thrush. In order to prevent this effect, the nurse should advise the client to rinse the mouth after the administration of this medication

A nurse is reinforcing teaching with the guardian of an infant about the diptheria, tetanus, and pertussis (DTaP) vaccine. Which of the following pieces of information should the nurse include in the teaching? A. "Routine immunization for DTaP consists of 3 injections." B. "The first immunization for DTaP in the series is given at 2 months." C. "DTaP has been replaced with DTP." D. "This immunization is administered subcutaneously."

"The first immunization for DTaP in the series is given at 2 months." *The nurse should tell the guardian that the first immunization of DTaP is given at 2 months, with the rest of the vaccinations occurring at 4 months, 6 months, 15 to 18 months, and 4 to 6 years of age

A nurse is reinforcing teaching with a client who has chronic asthma and a new prescription for cromolyn. Which of the following instructions should the nurse include in the teaching? A. "Use the inhaler just before exercise." B. "The medication's therapeutic effects can take up to several weeks to develop." C. "You will shake the medication container for 3 seconds." D. "You wil need to exhale slowly after you inhale."

"The medication's therapeutic effects can take up to several weeks to develop." *The nurse should include in the teaching that the therapeutic effects of cromolyn can take up to several weeks to develop

A nurse is reinforcing teaching with a client who is scheduled to start taking hydrochlorothiazide for hypertension. The nurse instructs the client to eat foods that are rich in potassium. Which of the following statements by the client indicates an understanding of the teaching? A. "This medication will not work unless I have enough potassium." B. "This medication can cause a loss of potassium." C. "Potassium will lower my blood pressure." D. "Potassium will increase the therapeutic effect of my blood pressure medication."

"This medication can cause a loss of potassium." *Hydrochlorothiazide can result in hypokalemia caused by excessive potassium excretion from the kidneys. The client should supplement the diet with potassium-rich foods to avoid hypokalemia. Foods that are high in postassium include bananas, raisins, baked potatoes, pumpkins, and milk.

A nurse is reinforcing teaching with a client who has a new diagnosis of peptic ulcer disease (PUD) and a prescription for bismuth subsalicylate. The client asks the nurse, "How will this medication hep my ulcer?" Which of the following statements should the nurse make? A. "This medcation will decrease prostaglandins." B. "The amount of bicarbonate in your body will be increased." C. "This medication can decrease bacteria in the gastrintestinal tract." D. "This medication acts by increasing blood flow to the stomach."

"This medication can decrease bacteria in the gastrintestinal tract." *The nurse should include in the teaching that bismuth subsalicylate can assist by eliminating the bacterial Helicobacter pylori, which can cause PUD

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

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

A nurse is reinforcing discharge teaching wth a client who has a new prescription for sildenafl to treat erectile dysfunction. Which of the following pieces of information should the nurse include? A. "Take this medication 10 minutes before sexual activity." B. "If you experience chest pain after taking this medication, take a sublingual nitroglycerin." C. "This medication offers protection against HIV infection." D. "This medication should not be taken more than once per day."

"This medication should not be taken more than once per day." *The nurse should reinforce with the client that sildenafil should only be taken once daily

A nurse is reinforcing teaching with a client who has a new prescription for ferrous sulfate syrup to treat iron-deficiency anemia. Which of the following statements should the nurse make? A. "You should dilute this medication in water and drink it through a straw." B. "You might notice your stool turning dark orange in color while taking this medication." C. "A fever and stomach pain are common during the first few days of taking this medication." D. "Taking this medicaion with an antacid can decrease stomach upset."

"You should dilute this medication in water and drink it through a straw." *The nurse should reinforce with the client that ferrous sulfate can stain the teeth. For this reason, it is best to dilute liquid sulfate in a full glass of water or juice and take the medication through a straw. Drops can also be administered to the back of the throat

A nurse is reinforcing teaching about how to take donepezil with a client who was recently diagnosed with early Alzheimer's disease. Which of the following instructions should the nurse include? A. "You should chew the medication thoroughly prior to swallowing." B. "You should take this medication late in the evening." C. "You should take this medication with food." D. "If you miss taking a dose for day, take 2 doses the following day."

"You should take this medication late in the evening." *The nurse should instruct the client to take donepezil late in the evening, just before going to bed.

A nurse is caring for a client who is taking diphenhydramine for allergies. The client reports, "I feel sleepy during the day." Which of the following responses should the nurse make? A. "You will find that all antihistamines cause sedation." B. "You should avoid taking the antihisamine with food." C. "The effects of sedation will occur with each dose." D. "You should try antihistamines with non-sedative effects."

"You should try antihistamines with non-sedative effects." *The nurse should tell the client to try second-generation antihistamines that have no sedatve effect, as these are large molecules with low lipid solubility that cannot cross the blood-brain barrier. Diphenhydramine is a first-generation antihistamine and has a common adverse effect of sedation

A nurse is reinforcing teaching with a client who has tuberculosis and a prescription for isoniazid. Which of the following instructions should the nurse include? A. "You'll need to take this medication for the rest of your life to prevent recurrence." B. "Your provider will monitor your liver function while you are taking this medication." C. "Limit your alcohol intake to 2 drinks per day." D. "You should take this medication with a meal to increase absorption."

"Your provider will monitor your liver function while you are taking this medication." *The provider will monitor the client's liver function while taking isoniazid due to the risk of hepatotoxicity.

A nurse is administering insulin glulisine 10 units subcutaneously at 0730 to an adolescent client who has type 1 diabetes mellitus. The nurse should anticipate the insulin's onset of action at which of the following times? A. 0800 B. 0745 C. 0900 D. 1030

0745 *Insulin glulisine has a very short onset of action of 15 minutes. The nurse should expect the onset of action around 0745 and ensure the client eats breakfast immediately following the administration of the insulin

A nurse is preparing to administer meperidine 50 mg IM for pain. Meperidine is available for injection at 25 mg/0.5 mL. How many mL should the nurse administer Round to the nearest tenth.

1

A nurse is preparing to administer atropine 0.6 mg IM preoperatively to a client. The amount available is atropine 0.4 mg/1 mL. How many mL should the nurse plan to administer? Round to the nearest tenth

1.5

A nurse is preparing to administer benztropine 8 mg PO daily in 2 divided doses to a client who has Parkinson's disease. The amount available is benztropine 2 mg tablets. How many tablets should the nurse administer with each dose?

2

A nurse is preparing to administer metoclopramide 10 mg IM to a client who is postoperative and nauseated. The amount available is metoclopramide 5 mg/1 mL. How many mL should the nurse administer?

2

A nurse is preparig to administer lactated Ringer's (LR) 1,000 mL IV infused over 8 hours. The drop factor of the manual IV tubing is 10 gtt/mL. The nurse should set the manual IV infusion deliver how many gtt/min? Round to the nearest whole number

21

A nurse is preparing to administer acetaminophen 1 g PO 3 times per day PRN to a client who has a fever. The amount available is acetaminophen 325 mg/1 tablet. How many tablets should the nurse administer per dose? (Round to the nearest whole number)

3

A nurse is preparing to administer magnesium hydroxide 1.5 oz PO to a client who has constipation. How many mL should the nurse adminster?

45

A nurse is preparing to adminster an enteral tube feeding through an NG tube at 250 mL over 4 hours. The nurse should set the pump to deliver how many mL/hr? (Round to the nearest whole number)

63 ml/hr

A nurse is preparing to administer amipicillin 50 mg/kg/day PO divided into 4 equal doses for a toddler who weights 33 lb. Ampicillin 125 mg/5 mL oral solution is available. How many mL should the nurse administer per dose? Round to the nearest tenth.

7.5

A nurse is evaluating how a client who is pregnant is responding to a medication. Which of the following physiological effects of pregnancy should the nurse take into consideration? A. Increased intestinal transit rate B. Accelerated excretion of fluids C. Reduced renal blood flow D. Decreased hepatic metabolism

Accelerated excretion of fluids *There are physiological changes in the kidneys with pregnancy, including accelerated excretion from increased renal blood flow. This results in increased glumerular filtration. To compensate for accelerated excretion, dosages of medications that glomerular filtration eliminates must be increased to achieve a comparable therapeutic effect

A nurse is reinforcing discharge teaching with a 6-year-old client who has asthma ad several prescription medications using a metered-dose inhaler (MDI). Which of the following instructions should the nurse include in the teaching? A. Add a spacer to each MDI B. Instruct the child to inhale more rapidly than usual when using an MDI C. Ask the provider to change the child's medications from inhaled to oral formulations D. Administer oxygen by facemask along with the MDI

Add a spacer to each MDI *MDIs are difficult to use correctly; even when properly used, only a portion of the medication is delivered to the lungs. A spacer applied to an MDI can make up for a lack of hand-lung coordination by increasing the amount of medication delivered to the lungs

A nurse is caring for a client who is receiving a medication parenterally. Which of the following techniques should the nurse identify as effective in reducing fluctuations in plasma medication level? A. Gradually increasing the dose with the dosing interval B. Administering a single loading IM dose C. Using a large-fluid volume IV dose D. Administering a continuous infusion of the dose

Administering a continuous infusion of the dose *By administering a medication by continuous infusion, plasma levels stay nearly constant, thus reducing fluctuations in plasma levels

A nurse is caring for a client who has asthma and a prescription for zileuton. Which of the following laboratory values should the nurse monitor while the client is taking this medication? A. Alanine amiotransferase (ALT) B. WBC count C. Potassium D. Chloride

Alanine amiotransferase (ALT) *The nurse should identify that ALT is a liver function test. Zileuton is a leukotriene modifier that can affect the liver, causing increased ALT levels. The nurse should monitor this laboratory value closely while the client is taking the medication

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

Antitussive *Anitussives suppress the cough reflex. Expectorants help mobiize secretions; Mucolytics help liquefy secretions. Bronchodilators help open air passages.

A nurse is preparing to administer timolol eye drops to a client who has primary open-angle glaucoma (POAG). Prior to administering the medication, the nurse should recognize that which of the following conditions in the client's medical history is a contraindication to receiving this medication? A. Hypertension B. Peripheral vision loss C. Asthma D. Increased intraocular pressure

Asthma *The nurse should identify that astham is a contraindication to receiving timolol. Timolol is a beta-blocker that can cause blocking of the beta2-receptors, causing bronchospasm. A client who has a history of asthma is a candidate for an alternate medication to treat this condition such as betaxolol

A nurse is collecting data from a client who i to receive the hepatitis B vaccine. Which of the following allergies is a contraindication to receiving this vaccine? A. Shellfish B. Gelatin C. Baker's yeast D. Eggs

Baker's yeast *An allergy to baker's yeast is a contraindication to receiving the hepatitis B vaccine. The nurse should notify the client's provider

A nurse is caring for a client who has a pseudomonas infection for a new prescription for ticarcillin-clavulanate. Which of the following should the nurse collect before administering this medication? A. Indications of superinfection B. Peak and trough C. Baseline BUN and creatinine D. History of allergy to aminoglycoside antibiotics

Baseline BUN and creatinine *Ticarcillin-clavulanate is a penicillin antiobiotic and is excreted by the kidneys. Therefore, any renal impairment could result in a toxic level of the medication. The nurse should assess the client's baseline BUN and creatinine levels and monitor these values throughout therapy. Peak and trough level are not monitoted for penicilling antibiotics but are monitored for aminoglycoside antibiotics

A nurse in a provider's office is collecting data from a client who reports taking a dietary supplement to reduce hot flashes related to menopause. Which of the following supplements is this client probably taking? A. Flaxseed B. Ginkgo biloba C. Black cohosh D. St. John's wort

Black cohosh *Black cohosh is an herb that is used for the treatment of menopausal symptoms such as hot flashes, vaginal dryness, and sleep disturbance. Flaxseed is used for constipation and to reduce high cholesterol. Ginkgo biloba improves blood flow and can reduce pain related to peripheral arterial disease. St. John's wort is used to treat mild to moderate depression.

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

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

A nurse is caring for a client who is receiving IV famotidine. Which of the following adverse effects should the nurse report to the provider immediately? A. Nausea B. Bloody stools C. Drowsiness D. Headache

Bloody stools *When using the urgent vs. nonurgent approach to client care, the nurse should determine that the priority finding is bloody stools. Adverse effects of treatment with famotidine might include blood dyscrasias such as thrombocytopenia, which can lead to bleeding. This finding should be reported to the provider immediately

A nurse is reviewing the medical history of a client who has a respiratory infection. The nurse notes the client has a severe penicillin allergy. Which of the following class of antibiotics is also contraindicated for this client? A. Carbapenems B. Cephalosporins C. Aminoglycosides D. Fluoroquinolones

Cephalosporins *Cephalosporins such as cefazolin, cefaclor, and cefepime should not be prescribed to clients who have a severe allergy to penicillins as fatal anaphylaxis can occur. Cephalosporins can be prescribed to clients who have a mild penicillin allergy

A urse is reinforcing teaching with an assistve personnel (AP) about dietary restrictions for a client who is taking phenelzine to treat depression. The AP's depression. The AP's selection of which of the following foods for the client's lunch indicates an understanding of the instructions? A. Bologna on wheat bread B. Chicken salad C. Cheddar cheese and crackers D. Pizza with pepperoni

Chicken salad *Phenelzine is an MAOI. Clients taking MAOIs must avoid foods that contain tyramine due to a dangerous food-drug interaction. Foods high in tyramine include those that are processed and aged such as lunchmeats and cheeses. This menu selection does not contain foods high in tyramine; therefore, it is the best choice

A nurse is preparing to administer medications to a group of clients. Which of the following actions should the nurse take to verify the right medication is administered? A. Compare the provider's initial prescription with the medication administration record (MAR) B. Ask each client to list the medications he or she is currently taking while in the facility C. For unmarked medication containers, check the client's MAR 3 times while preparing the medication D. Have a second nurse verify the MAR at the client's bedside

Compare the provider's initial prescription with the medication administration record (MAR) *To verify the right medication, the nurse should compare the provider's prescription with the client's MAR when the prescription is first received

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

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

A nurse is caring for a client who has diabetes insipidus. Which of the following values should the nurse identify as reflecting a contraindication to receiving vasopressin to treat this disorder? A. Sodium 152 mEq/L B. Potassium 6.0 mEq/L C. Creatinine clearance 50 mL/min D. Aspartate aminotransferase (AST) 52 units/L

Creatinine clearance 50 mL/min *Creatinine clearance should be above 87 mL/min for female clients and above 107 mL/min for male clients. A creatinine clearance of 50 mL/min indicates renal impairment and is a contraindication to receiving vasopressing. Renal impairment increases the likelihood of the life-threatening adverse effect of water intoxication.

A nurse is collecting data from a client who has taken methimazole for a thyroid disorder over the past month. Which of the following finding demonstrates an expected response to methimazole? A. Decreased body temperature B. Increased pulse rate C. Weight loss of 3 lb (1.4 kg) D. Increased urine output

Decreased body temperature *Methimazole inhibits thyroid production for clients with hyperthyroidism. Increased body temperature with warm, moist skin is a manifestation of hyerthyroidism; therefore, a decreased body temperature is an expected response to the medication. Other findings demonstrating the effectiveness of the medication include a decreased pulse rate and a decreased metabolic rate, which allows the client to maintain a healthy body weight.

A nurse is reviewing the laboratory results for a client who is receiving allopurinol. Whch of the following findings should indicate to the nurse that the medication is having a therapeutic effect? A. Increased hematocrity level B. Decreased serum alkaline phosphatase C. Decreased urinary uric acid D. Increased platelet levels

Decreased urinary uric acid *The nurse should identify that a decrease in both serum and urinary uric acid levels indicates a therapeutic effect of allopurinol. Clinical improvement findings can take 2 to 6 weeks for the nurse to observe

A nurse is reviewing the medical record of a client who has diabetes insipidus and has been taking desmopressin. Which of the following findings indicates the client is having a therapeutic response to the medication? A. Decreased urine output B. Weight gain C. Serum glucose level withing the expected reference range D. Increase in heart rate

Decreased urine output *Diabetes insipidus causes a large output of dilute urine to be excreted due to a deficiency of antidiuretic hormone or its release by the hypothalamus. Urine output can range from 4 to 30 L/day, and manifestations of dehydration are present (hypotension, tachycardia, dry mucous membranes, increased thirst, low urine specific gravity).

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

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

A nurse is reviewing the medical record of a client who is receiving hydrochlorothiazide (HCTZ). The nurse should expect to find an improvement in which of the following conditions as a result of this medication? A. Gouty arthritis B. Dehydration C. Diabetes Insipidus D. Hypokalemia

Diabetes Insipidus *A thiazide diuretic such as HCTZ is administered to treat diabetes insipidus. Diabetes insipidus is a condition in which there is an overproducton of urine. Thiazides reduce urine production by 30% to 50%

A nurse is caring for a client for which of the following findings as an adverse effect of selegiline and notify the provider? A. Bruising B. Drowsiness C. Coughing D. Constipation

Drowsiness *Drowsiness can be an adverse effect of selegiline, which can also be a manifestation of serotonin syndrome. The nurse should notify the provider of this finding immediately

A nurse is caring for an older adult client who has a new prescription for amitripyline to treat depression. Which of the following diagnostic tests should the nurse plan to obtain prior to administering the medication? A. Hearing examination B. Glucose tolerance test C. Electrocardiogram D. Pulmonary function tests

Electrocardiogram *Amytriptyline can cause tachycardia and ECG changes. An older adult client is at risk for cardiovascular effects while taking amitriptyline; therefore, an ECG should be performed prior to the start of therapy to obtain a baseline of the client's cardiovascular status

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

Enoxaparin *The nurse should anticipate the administration of enoxaparin for a client who is 12 hours postoperative following surgery. Enoxaparin is low-molecular-weight (LMW) heparin that is used to prevent a DVT by inhibiting the effects of antithrombin and thrombin. Aspirin is an aspirin is an antipyretic and a nonopioid analgesic that suppresses platelet aggregation, not anticoagulation. Aspiring can be used as a prophylactic therapry for ischemic stroke, transient ischemic attack, chronic stable angina, and coronary stenting. Warfarin is an anticoagulant that is indicated to prevent thrombosis. However, it has a delayed onset and is prescribed for long-term prophylaxis. Ticagrelor is an antiplatelet agent indicated to prevent thrombotic events in clients who have acute coronar syndrome by inhibiting platelet aggregation

A nurse is collecting data from a client who is taking varenicline for smoking cessation. Which of the following findings is nurse's priority? A. Erratic behavior B. Nausea C. Altered sense of taste D. Skin rash

Erratic behavior *The nurse should apply the safety and risk reduction priority-setting framework, which assigns priority to the factor of situation posing the greatest safety risk to the client. For this client, the development of neuropsychiatric effects could progress to depression and suicide. Therefore, the highest priority in terms of findings is erratic behavior

A nurse is caring for a client who has chronic renal failure and has developed anemia. Which of the following medications should the nurse expect the provider to prescribe? A. Calcium acetate B. Vitamin D C. Erythropoietin D. Diphenhydramine

Erythropoietin *Erythopoietin is a hormone produced by the kidneys that stimulates the priduction of red blood cells. When levels are lowm the kidneys increase the level of erythropoietin production. This homeostatic mechanism falls in a client who has chronic renal failure, and exogenous erythropoietin is prescribed. Administering erythropoietin to a client who has chronic renal failure can reduce the need for blood transfusions

A nurse is caring for a client who takes scheduled morphine for cancer pain. The client reports experiencing breakthrough pain. The nurse should anticipate a prescription from the provider for which of the following medications to treat breakthrough pain? A. Meperidine B. Buprenorphine C. Methadone D. Fentanyl

Fentanyl *The nurse should expect a prescription for fentanyl transmucosal (nasal spray) to treat breakthrough pain. Fentanyl is an opioid agonist with a rapid onset and a duration of 2 to 4 hours. Fentanyl should not interfere with the client's long-term opioid medication but should relieve breakthrough pain

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

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

A nurse is reviewing the medical record of a client who is experiencing an acute migraine attack and has a new prescription for sumatriptan. Which of the following findings indicates a contraindication to the administration of this medication? A. History of uncontrolled hypertension B. Currently taking metformin for type 2 diabetes mellitus C. Currently taking an oral contraceptive D. History of recurrent urinary tract infections

History of uncontrolled hypertension *Sumatriptan can cause coronary vasospasm; therefore, it is contraindicated for a client who has a history of a myocardial infarction, heart disease, or uncontrolled hypertension

A nurse is caring for a client who is experiencing severe cancer pain. Which of the following medications should the nurse expect the provider to prescribe? A. Buprenorphine B. Tramadol C. Hydromorhone D. Oxycodone

Hydromorphone *The nurse should expect the provider to prescribe hydromorphone, an opioid agonist. Hydromorphone is used for the treatment of moderate to severe pain management in clients who have cancer.

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

Hypercalcemia *The nurse should identify that vitamin D increases plasma calcium levels by increasing reabsorption from the intestines. Clients who take a vitamin D supplement along with a multivitamin daily might be taking too much calcium

A nurse is caring for a client who is taking fludrocortisone. Which of the following findings indicates to the nurse that the client is experiencing an adverse effect of the medication? A. Hypotension B. Weight loss C. Hypokalemia D. Anorexia

Hypokalemia *The nurse should identify that hypokalemia is an adverse effect of fludrocortisone due to excessive sodium and water retention, resulting in the loss of excessive amounts of potassium

A nurse is caring for a client who has a new prescription for enalapril. The nurse should monitor the client for which of the following adverse effects of this medication? A. Ecchymosis B. Jaundice C. Hypotension D. Hypokalemia

Hypotension *Enalapril, an angiotensin-converting enzyme (ACE) inhibitor, can cause hypotension and postural hypotension, especially during the first 3 hours following the initial dosage

A nurse is caring for a client who has benign prostatic hyperplasia and a new prescription for doxazosin. Which of the following manifestations should the nurse monitor for as an adverse effect of doxazosin? A. Seizures B. Tachycardia C. Bronchodilation D. Hypotension

Hypotension *Nonselective alpah1-adrenergic antagonists such as doxazosin block sympathetic receptors in the blood vessels as well as receptors in the bladder. These agents promote vasodilation, which can cause decreased blood pressure

A nurse is reviewing the laboratory reports for a client who has been taking warfarin for atrial fibrillation. Which of the following results should the nurse report to the provider immediately? A. PT 18 seconds B. Platelet count 160,000/mm3 C. Hct 43% D. INR 5.5

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

A nurse is assisting with the care of a client who is postoperative. The client reports a pain level of 8 on a scale of 0 to 10 and has a prescription for meperidine. Which of the following routes of administration will deliver the medication with the shortest time of onset? A. Oral B. Intravenous C. Intramuscular D. Subcutaneous

Intravenous *The nurse should identify that meperidine given intraveously has no barriers to absorption because it is deposited directly into the circulatory system. An instantaneous time of onset and absorption gives the client immediate relief

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

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

A nurse is reinforcing teaching with a client who has cirrhosis and a new prescription for lactulose. The nurse should inform the client that lactulose has which of the following therapeutic effects? A. Increases blood pressure B. Prevents esophageal C. Decreases heart rate D. Lactulose does not decrease heart rate

Lactulose does not decrease heart rate *Lactulose is a laxative that promotes the excretion of ammonia in a client who has hepatic encephalopathy from cirrhosis of the liver

A nurse is monitoring a client with pneumonia who has received penicillin G intramuscularly (IM). Which of the following findings should the nurse plan to evalute first? A. Pain at the injection site B. Prolonged motor dysfunction C. Laryngeal edema D. Temperature 37.6°C (99.7°F)

Laryngeal edema *When using the urgent vs nonurgent approach to client care, the nurse should determine that the priority finding is laryngeal edema, which can indicate the client is experiencing an allergic reaction to penicillin G. The nurse should also consider that the client is experiencing an anaphylactic reaction, which can be life-threatining. Anaphylaxis is an immediate hypersensitivity reaction that requires the primary treatment of epinephrine in addition to respiratory support

A nurse is administering a medication to a client. The nurse should identify that which of the following medication distribution factors facilitates the effective passage of the medication across the client's cell membranes? A. Protein-binding ability B. Lipid solubility C. Hepatic metabolism D. Slow dissolution

Lipid solubility *A medication being lipid soluble and the presence of a transport system both facilitate the ability of a medication to cross cell membranes that separate the medicaition from the blood

A nurse is monitoring a client who is receiving terbutaline to suppress preterm labor. Which of the following findings should indicate to the nurse that the client is experiencing an adverse effect of the medication? A. BP 132/84 mmHg B. Blood glucose 106 mg/dL C. Decreased deep tendon reflexes D. Maternal heart rate >120/min

Maternal heart rate >120/min *A client who is receiving terbutaline can experience tachycardia, which poses a significant risk to the mother. Therefore, when the maternal heart rate exceeds 120/min, the medication should be stopped. Adverse effects results from activating beta1 receptors as well as beta2 receptors.

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

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

A nurse is collecting data from a client who is receiving ropinirole to treat restless leg syndrome. Which of the following findings should indicate that the client is having a potential allergic reaction to the medication? A. Dizziness B. Dry mouth C. Sweating D. Mild rash

Mild rash *The nurse should identify that has indicates a potential allergic reaction to the medication. An allergic reaction requires prior sensitization to a medication and is an immune response. This can include reactions that range from a mild rash to anaphylaxis. Less than 10% of adverse drug reactions are allergic reactions

A nurse is caring for a client who was recetly diagnosed with Addison's disease and placed on long-term mineralocorticoid therapry with fludrocortisone. Which of the following pieces of information should the nurse provide when explaining the purpose of this therapy? A. Mineralocorticoids help the body metabolize carbohydrates, fats, and proteins B. Mineralocorticoids support sexual development C. Mineralocorticoids maintain electrolyte and fluid balance D. Mineralocorticoids reduce the risk of cardiac dysrthymias

Mineralocorticoids maintain electrolyte and fluid balance *Mineralocorticoids, specifically aldosterone, are necessary for the regulation of fluid and electrolyte balance, particularly of sodium, potassium, and water. Addison's disease results in a deficiency of cortisol and aldosterone production and requires supplementation with glucocorticoids and mineralocorticoids. Fludrocortisone is the only mineralocorticoid available.

A nurse in a provider's office is collecting data from a client who reports dysmenorrhea. Which of the following over-the-counter prescriptions should the nurse expect the provider to suggest? A. Acetaminophen B. Naproxen C. Diphenhydramine D. Caffeine citrate

Naproxen *Naproxen is considered first-line therapy for dysmenorrhea. This NSAID can reduce bleeding and painful cramping. It should be administed at the onset of menses rather than taken for prophylactic use

A nurse in a provider's office is reinforcing teaching for a client who has type 2 diabetes mellitus and a new prescription for dulaglutide. Which of the following instructions should the nurse include? A. Administer the medication once daily at any time B. Swallow the medication whole C. Use this medication instead of insulin D. Nausea is an adverse effect that decreases over time

Nausea is an adverse effect that decreases over time *Dulaglutide is a glucogon-like peptide 1 receptor agonist that is used for the treatment of type 2 diabetes mellitus. The most common adverse effect is nausea that usually decreases over time. Pancreatitis is another adverse effect. The client should be instruced to notify the provider if abdominal pain and nausea with vomiting occur

A nurse is reinforcing teaching with a client who has asthma and a new prescription for a short-acting beta2 agonist (SABA) bronchodilator. Which of the following pieces of information should the nurse provide in the nursing? A. The SABA will provide prolonged control of asthma attacks B. SABAs are also available in an oral form C. The SABA will have to be taken with an inhaled glucorticoid D. Notify the provider if the SABA is needed more than twice per week

Notify the provider if the SABA is needed more than twice per week *SABA bronchodilators are used as a PRN rescue medication to stop an ongoing asthma attack. If the client requires the SABA more than twice per week, the provider should be notified because a prescription for a long-acting beta2 agonist (LABA) might be required. Using a SABA more than twice per week can lead to serious adverse effects

A nurse is performing a reconciliation of a client's medications. Which of the following actions should the nurse take first? A. Review the medications the client is taking at home and compare the list with the medications the client is taking in the facility B. Compare any new medication prescriptions with the client's current list of medications C. Obtain a list of the client's current medications, including those that are over-the-counter D. Provide the current and accurate medication list to all of the client's health care providers

Obtain a list of the client's current medications, including those that are over-the-counter *According to evidence-based practice, when completing a medication reconciliation, then nurse should first obtain a current, complete, and accurate list of any medications the client is taking. This should include over-thec-counter medications and herbal supplements

A nurse is reinforcing teaching about glucocorticoid therapy with the parent of a child who has severe reaction airway disease. The parent asks why her child has to inhale the medication instead of taking it orally. Which of the following pieces of information should the nurse provide the parent? A. Inhaled glucocorticoids are less likely to cause thrush B. Oral glucocorticoids are hazardous during times of stress C. Oral glucocorticoids are more likely to slow linear growth in children D. Inhaled glucocorticoids are more effective for acute bronchospasm

Oral glucocorticoids are more likely to slow linear growth in children *Chronic use of oral glucocorticoids in high doses by children can result in decreased linear growth. Inhaled glucocorticoids deliver the anti-inflammatory agent directly to the local target area (i.e. the client's airways), decreasing the risk for adrenal suppression

A nurse is reinforcing teaching a client who has ADHD and is starting therapy with amphetamine/dextroamphetamine mixture. Which of the following manifestations should the nurse instruct the client to identify as an adverse effect and report to the provider? A. Restlessness B. Insomnia C. Palpitations D. Weight loss

Palpitations *The nurse should instruct the client that palpitations can be a sign of a cardiovascular adverse reaction and require immediate attention. The nurse should instruct the client to contact the provider if palpitations develop

A nurse is assessing a client who was recently admitted and has a history of alcohol use disorder. The client displays ataxia, an altered level of consiousness, and nystagmus. Which of the following medications should the nurse anticipate administering to the client? A. Parenteral thiamine B. Niacin extended-release capsules C. Parenteral pyridoxine D. Riboflavin tablets

Parenteral thiamine *The nurse should identify that a client who has a history of alcohol use disorder and displays ataxia, an altered level of consciousness, and nystagmus is exhibiting manifestations of Wernicke-Korsakoff syndrome due to a thiamine deficiency. Therefore, the nurse should anticipate administering parenteral thiamine

A nurse is caring for a client who received spinal anesthesia 30 minutes ago. The client reports feeling dizzy, and the nurse notes that the client's blood pressure is 84/54 mmHg. Which of the following actions should the nurse take? A. Place the client in the head-down position B. Assess the placement of the catheter C. Prepare to administer an IV reversal agent D. Assist the client in passive range of motion movements

Place the client in the head-down position *The nurse should identify the client is experiencing an adverse effect from receiving the spinal anesthesia. Hypotension is the common adverse effect of spinal anesthesia due to the loss of venous tone and decreased venous return to the heart. Therefore, the nurse should position the client in a 10° to 15°, head-down position to rapidly promote venous return to the heart, which increases the client's blood pressure

A nurse is teachig a client who has type 1 diabetes mellitus about a new subcutaneous insulin infusion pump. Which of the following pieces of information should the nurse reinforce in the teaching? A. Plan to use a type of short-duration insulin in the infusion pump B. Replace the infusion pump set every 4 days C. Turn off the infusion pump for at least 3 hours D. Move the infusion pump catheter 1.27 cm (0.5 in) away from the old site

Plan to use a type of short-duration insulin in the infusion pump *The client should plan to use short-duration insulin such as regular, lispro, aspart, or glulisine insulin in the infusion pump to deliver a baseline infusion of insulin. The client should also administer bolus doses of insulin before each meal

A nurse is reinforcing teaching with a female client who has a new prescription for pravastatin to treat hyperlipidemia. Which of the following pieces of information should the nurse include in the teaching? A. Pravastatin can be taken with grapefruit juice B. Pravastatin can be continued during pregnancy C. Pravastatin should be taken with the morning meal D. Laboratory testing to monitor WBC count is required

Pravastatin can be taken with grapefruit juice *Pravastatin, unlike other statins, such as lovastatin, simvastatin, and atorvastatin, is not affected by CYP3A4 inhibitors. It is safe for th client to consume grapefruit juice if desired

A nurse is caring for a client who is at 6 weeks of gestation and has just received a diagnosis of hyperthyroidism. The nurse should anticipate a prescription from the provider for which of the following medications? A. Propylthiouracil B. Liothyronine C. Methimazole D. Iodine-131

Propylthiouracil *This medicaton is used to treate hyperthyroidism during the first trimester of pregnancy because it does not cross the placental barrier well, posing little risk to the fetus. However, methimazole is the preferred medication in the second and third trimesters of pregnancy. Liothyronine is a synthetic thyroid hormone preparation that treates HYPOthyroidism, not HYPERthyroidism. Methimazole poses several risks to the fetus during the first trimester, including neonatal and congenital hypothyroidism as well as goiter. Iodine-131 is a radioactive medication and is pregnancy risk category X. Pregnancy is a contraindication for receiving this medication.

A nurse is preparing to administer an otic medication to an adult client. Which of the following actions should the nurse take? A. Place the client leaning forward in a chair B. Hold the medication dropper 2.5 cm (1 in) C. Pull the pinna of the client's ear upward and outward D. Have the client to remain still for 30 seconds after the medication is administered

Pull the pinna of the client's ear upward and outward *The nurse should pull the pinna of the client's ear upward and outward so the nurse can instill the medication into the client's ear canal

A nurse is reviewing the medical record of a client. The medication administraton record shows the client is taking clopidogrel. Which of the following events should the nurse expect to be reported in the client's medical history? A. Recent myocardial infarction B. History of hemorrhagic stroke C. Current outbreak of psoriasis D. History of hypertension

Recent myocardial infarction *The nurse should expect the client's medical record to indicate a history of an atherosclerotic event such as myocardial infarction, ischemic stroke, or peripheral vascular disease. Clopidogrel is an antiplatelet mediacation that inhibits the aggregation of platelets to prevent such thrombotic events

A nurse is caring for a client with asthma who has been taking an inhaled glucocorticoid and long-acting beta2-agonist combination dry-powdered inhaler (DPI) for maintenance therapy. The nurse should identify that which of the following is a disadvantage of this medication? A. Restricted dosage flexibility B. Complicated delivery device C. Serious systemic effects D. Limited efficacy over time

Restricted dosage flexibility *The nurse should identify that a disadvantage of an inhaled glucocorticoid and a long-acting beta2-agonist being combined is that the dosages of these medications are fixed, so the dose cannot be adjusted

A nurse is preparing to administer an initial dose of etanercept for a client who has rheumatoid arthritis. For which of the following manifestions should the nurse monitor as a potential adverse effect of the medication? A. Blurred vision B. Rhinitis C. Urinary retention D. Anorexia

Rihinitis *he nurse should monitor the client for rhinitis as an adverse effect of etanercept. Other manifestations the nurse should monitor for include an upper respiratory infection, pharyngitis, and a cough

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

Rotate injection site within the same area *To prevent lipodystrophy, the client should rotate injection sites, making them about 2.5 cm (1 in) apart, within the same anatomical area

A nurse is reinforcing teaching with a client who has type 2 diabetes mellitus about storing unopened vials of insulin. Which of the following pieces of information should the nurse include in the teaching? A. Store the vials in the freezer B. Store the vials at room temperature C. Store the vials by a window D. Store the vials in the refrigerator

Store the vials in the refrigerator *The nurse should tell the client to store unopened vials of insulin in the refrigerator. The client can use the unopened vials of insulin up the printed expiration date. The nurse should tell the client not to store unopened vials of insulin in the freezer because the viability of the insulin can become compromised when frozen. The nurse should tell the client to store a vial that in current use, once opened, at room temperature for up to 1 month from the expiration date. The nurse should tell the client not to store vials of insulin in direct sunlight or allow them to come in contact with extreme heat because these conditions can alter the potency and viability of the product

A nurse is preparing to administer metoclopramide to a client who has GERD. For which of the following manifestations should the nurse monitor as an adverse effect of the medication? A. Urinary retention B. Tardive dyskinesia C. Blurred vision D. Photosensitivity

Tardive dyskinesia *The nurse should monitor the client for tardive dyskinesia, which includes involuntary or repetitive movements of the arms, legs, and facial muscles. Clients who are on long-term, high-dose therapy are at greatest risk of developing this adverse effect

A nurse is collecting data from a client who is receiving clozapine to treat schizophrenia. The nurse should identify that an increase in which of the following parameters is an early indication of agranulocytosis? A. Urine specific gravity B. Urine output C. Blood pressure D. Temperature

Temperature *Antipsychotic medications such as clozapine can cause agranulocytosis, which is the depletion of WBCs. This increases the client's risk of infection. A fever is an early indication that the client should have a WBC count check to detect agranulocytosis

A nurse is preparing to administer an IM injection for a client. Which of the following factors should the nurse identify as a potential contraindication to administering the medication via the IM route? A. The medication is a depot preparation. B. The client is taking an anticoagulant C. The medication is a particulate suspension D. The client has been vomiting

The client is taking an anticoagulant *Because of the risk of bleeding from the injection site, anticoagulant therapy (e.g. warfarin) is a contraindication to receiving medications via the IM route

A nurse is caring for a client who is experiencing acute pain and is receiving morphine. Which of the findings should indicate to the nurse the need to withhold the client's next dose of morphine? A. The client reports an inability to void B. The client's respiratory rate is 10/min C. The client has hypoactive bowel sounds D. The client has vomited once in the last 4 hours.

The client's respiratory rate is 10/min *The nurse should identify that morphine can cause respiratory depression. Therefore, if the client's respiratory rate is less than 12/min, the nurse should withhold the next dose of morphine and notify the provider

A nurse is caring for a client who takes warfarin 2.5 mg PO daily and has an INR of 6.2. The nurse should anticipate a prescription from the provider for which of the following medications? A. Protamine sulfate B. Fondaparinux C. Vitamin K D. Bivalirudin

Vitamin K *The nurse should anticipate the provider to prescribe vitamin K for a client who has an INR of 6.2. Vitamin K antagonizes warfarin's actions, which can revere warfarin-induced inhibition of clotting factor synthesis. Protamine sulfate is an antidote that is administered for severe heparin overdoses. Fondaparinux and Bivalidurin are anticoagulant medications. they would not be administered to a cliet who is hypercoagulated

A nurse is preparing to administer medication to a preschooler. The nurse should use which of the following measurements to calculate the medication for this client? A. Body mass index B. Height C. Weight D. Rule of 9s

Weight *The nurse should use the child's weight to calculate the medication dose for this child. Children's doses are generally written in units of measure per body weight such as mg/kg