ATI pharm

A primary care provider has prescribed 250 mg PO Q6H of a medication for a client. The label reads 50 mg/mL. How many mL should the client receive in a 24 hr period?

20 mL

The client is to receive 1 L of ringer's lactate (LR) IV over 8 hr. the drip factor on the IV tubing is 10 gtt/ml. what rate should the nurse set the IV to deliver the fluid as prescribed?

21 gtt/min the client needs to receive 1 L over 8 hr. you know that 1 L = 1000 mL. 1,000 mL/8 hr is 125 mL/hr x 10 gtt/ml/by 60 (min/hr) = 20.83. --> 21 gtt/min

A nurse is preparing to administer a morphine sulfate IV to a client for pain. the nurse should expect the onset of pain relief for the client to take place in: A. 10-15 min B. 15-30 min C. 30-60 min D. 60-90 min

A. 10-15 min the IV route is considered to be the fastest

A nurse is providing teaching to the parent of a child with asthma who is prescribed cromolyn sodium (Intal) via metered dose inhaler. Which of the following statements by the child's parent should indicate to the nurse the need for further instruction? A. I will give my child a dose as soon as wheezing starts. B. My child needs to do a mouth rinse after using the inhaler. C. My child should breathe in slowly while depressing the canister. D. If my child has difficulty breathing in the dose, a spacer should be used.

A. I will give my child a dose as soon as wheezing starts a spacer allows clients with difficulty breathing in the entire dose in one inhalation to continue to receive medication in subsequent breaths.

A client who is taking chlorpromazine hydrochloride (Thorazine) is experiencing extreme restlessness and involuntary movements. To treat these side effects, the nurse should anticipate administering which of the following medications? A. amantadine (Symmetrel) B. bupropion (wellbutrin) C. phenelzine (Nardil) D. hydroxyzine (atarax)

A. amatadine (Symmetrel) Rationale: Phenelzine is an MAO inhibitor antidepressant. it is not used to treat extrapyramidal side effects.

A primary care provider prescribes an infusion of a hypertonic solution. which of the following intravenous solutions should the nurse anticipate administering? A. dextrose 5% in lactated ringers B. dextrose 5% in water C. lactated Ringers D. NS

A. dextrose 5% in lactated ringers osmotic pressure is demonstrated when a solvent moves through a semipermeable membrane from a weaker concentration to a stronger concentration. IV solutions are determined by the way their osmotic characteristics affect red blood cells. a hypertonic solution, such as dextrose in LR, exerts greater osmotic pressure than that of the blood serum, thereby causing cells to shrink.

A nurse should recognize that aspirin therapy is contraindicated for children with viral illnesses due to the increased risk of which of the following? A. reyes syndrome B. renal failure C. diabetes mellitus D. wilms' tumor

A. reyes syndrome reyes syndrome has an increased incidence in children or adolescents who take aspirin during a viral illness, such as the flu or chickenpox.

when administering diphenoxylate and atropine (Lomotil) to a client with ulcerative colitis, the nurse should monitor the client for the development of: A. toxic megacolon B. pseudomembranous colitis C. increased bleeding time D. drug addiciton

A. toxic megacolon clients with ulcerative colitis are at risk for developing toxic megacolon, a condition characterized by paralysis of colonic peristalsis resulting in rapid dilatation of the bowel. The nurse should observe for the symptoms of: tachycardia, hypotension, elevated temp, abdominal tenderness or cramping, and a reduction or cessation of diarrhea.

a nurse is caring for a client receiving heparin for deep vein thrombosis (DVT) prophylaxis. the nurse correctly delivers the heparin by: A using the sub cut sites in abdomen B. administering the injection using the Z-track method into the thigh C. massaging the injection site after injection D. administering the injection with a 22 gauge needle.

A. using the subcut sites in abdomen heparin is administered subcut in the fatty layers of the abdomen, not Z-tract into the muscles of the thigh

A nurse is providing teaching to the parents of a child who is prescribed valproic acid (Depakene) for seizures. The nurse instructs the parents that it will be necessary for the child to return to the clinic in 2 weeks to have which of the following diagnostic tests performed? (select all that apply) A. BUN B. platelet count C. Aspartate aminotransferase D. urinalysis E. alanine aminotransferase

B, C, E Valproic acid has no effect on renal function. The major effect on the hematologic system is on the platelet count. valproic acid may cause thrombocytopenia and prolonged bleeding time.

A client has been taking isoniazid (INH) and rifampin (Rifadin) for 3 weeks after being diagnosed with active pulmonary tuberculosis (TB). The client calls the clinic to report that his urine is a reddish orange color. Which of the following is an appropriate response by the nurse? A. Stop taking the INH for 2 to 3 days, and the discoloration should go away. B. Rifampin may turn all body fluids orange-red. This is a harmless side effect. C. I'll make an appointment for you to see the doctor this afternoon. D. These medications are known to cause bladder irritation when taken together.

B. Rifampin may turn all body fluids orange-red. This is a harmless side effect Rationale: There is no reason for the client to see the physician. This is a harmless side effect of the rifampin.

A nurse is assessing a client who is on tamoxifen (Nolvadex). The nurse should recognize that tamoxifen has which of the following actions? A. antimicrobial B. anti-estrogenic C. androgenic D. anti-inflammatory

B. anti-estrogenic tamoxifen does not have an antimicrobial, androgenic, or anti-inflammatory effect

a nurse is reviewing the admission prescriptions for a client who has just been admitted from the emergency room with a prescription for clopidogrel (plavix). Which of the following precautions should the nurse plan to implement? A. neutropenic B. bleeding C. airborne D. contact

B. bleeding Plavix is an antithrombotic and antiplatelet aggregate used to lesen the chance of heart attack or stroke. bleeding precautions attempt to limit client exposure to injury causing events that may lead to internal or external bleeding

a nurse should be aware that metoclopramide (Reglan) is contraindicated for a client who: A. is receiving chemotherapy B. has an intestinal obstruction C. has glaucoma D. is vomiting after undergoing a colon resection

B. has an intestinal obstruction reglan promotes gastric emptying; it should not be given to a client with an intestinal obstruction

a nurse is caring for an older adult client who has been diagnosed with depression and is prescribed tricyclic antidepressant amitripyline (Elavil). which of the following diagnostic tests should the nurse anticipate will be ordered prior to starting the client on this medication? A. CBC B. EEG C. ECG D. liver function profile

C. ECG EEGs are ordered to assess clients with suspected seizures for the presence of abnormal electrical activity in the brain

when administering the first dose of enalapril maleate (Vasotec) to a client, which of the following should the nurse recognize as the priory assessment? A. urine output B. respiratory rate C. blood pressure D. LOC

C. blood pressure when taking the first dose of enalapril, the greatest risk to the client is orthostatic hypotension. therefore, the priority assessment is BP

a nurse is providing teaching to a client who is to start taking allopurinol (Zyloprim). for which of the following side effects should the nurse instruct the client is discontinue taking the medication? A. nausea B. metallic taste C. fever D. drowsiness

C. fever metallic taste is an expected side effect. clients should be instructed that this may occur and not to discontinue taking meds.

the nurse is caring for a client who has had an acute myocardial infarction. the client is taking chlorothiazide (Diuril) 500 mg and digoxin (Lanoxin) 0.25 mg daily. The nurse should plan to monitor the client for which of the following? A. elevated body temperature B. hyperactive reflexes C. muscle weakness D. weight loss

C. muscle weakness

A nurse is taking a medication history on a client who is to receive a first dose of ceftriaxone (Rocephin). which of the following allergies should the nurse report to the primary care provider? A. gentamicin sulfate (Garamycin) B. clindamycin (Cleocin) C. piperacillin sodium D. sulfamethoxazole-trimethoprim (Bactrim)

C. piperacillin sodium there is no cross-sensitivity between sulfamethoxazole-trimethoprim. an allergy to sulfamethoxazole-trimethoprim does not need to be reported to the primary care provider

When preparing the discharge plan for a client who has been on a long term prednisone (Deltasone) therapy, the nurse should be aware that such clients are at risk for which of the following? A. gingival ulcerations B. orthostatic hypotension C. stress fracture D. weight loss

C. stress fractures

a nurse is caring for a client who is to start epoetin alfa (Epogen) for chronic renal failure. the nurse should recognize that the epoetin alfa is used to do which of the following? A. stabilize electrolyte levels B. prevent fluid retention C. treat anemia D. help lower BUN and creatinine levels

C. treat anemia

a nurse is caring for a client with peptic ulcer disease. which of the following medications should the nurse expect to administer for a headache? A. ibuprofen (Advil) B. Naproxen (Naprosyn) C. aspirin (Ecotrin) D. acetaminophen (Tylenol)

D. acetaminophen ibuprofen, naproxen, and aspirin are all NSAIDs that are hard on the GI and contraindicated for clients with peptic ulcer disease due to the increased risk of bleeding.

a nurse is caring for an older adult client who is prescribed zolpidem (Ambien) at bedtime to help promote sleep. the nurse should plan to monitor the client for which of the following? A. ecchymosis B. decreased urine output C. increased blood pressure D. confusion

D. confusion an older adult client prescribed zolpidem is at risk for developing confusion

A nurse is providing teaching a client who is prescribed hydrochlorothiazide (Oretic) for hypertension. The nurse should instruct the client to take the medication: A. when edema is present B. at bedtime C. on an empty stomach D. in the morning

D. in the morning clients should be instructed to take hydrochlorothiazide, a diuretic, in the morning to allow for diuresis during the day without interfering sleep.

a nurse is caring for a pregnant client who is scheduled to have a contraction stress test (CST). The nurse should anticipate administering which of the following medications? A. oxytocin (Pitocin) B. Nifedipine (procardia) C. betamethasone (Celestone) D. rho (D) immune globulin (RhoGAM)

oxytocin (Pitocin) oxytocin is administered to stimulate contractions during a CST

The nurse must calculate the daily dosage of a new medication for a child weighing 69 lb. The primary care provider has prescribed 10 mcg/kg per day PO in three divided doses. The nurse has on hand 0.1 mg tablets. Which of the following should the nurse calculate to be the daily dosage in milligrams?

0.31 mg First, convert pounds to kg. 69/2.2=31.4 kg. Determine the total daily dose based on the order of 10 mcg/kg per day. 10 mcg x 31.4kg/day = 314 mcg/day. Finally, convert the dose from mcg to mg. 1000 mcg = 1 mg so 314 mcg = 0.314 mg. Again using rounding rules, this is equal to 0.31 mg.

The primary care provider has prescribed a continuous enteral feeding of half strength Ensure, which comes in eight ounce cans, to begin infusing at 75 mL/hr. How much water should the nurse add to the can of Ensure to complete the health care provider's prescription?

240 ml must be added. in order to deliver a half-strength concentration, the feeding must be diluted with equal amounts of water. Consequently, for 240 mL (8oz x 30ml/oz) of formula, 240 mL of water would be added.

The health care provider prescribes IV therapy for a client with deep vein thrombosis (DVT). The prescription states: heparin sodium 20,000 units in 1000 ml 0.9% sodium chloride IV to infuse at 1,000 units/hr va IV pump. How any mL per hr should be administered by the nurse to give the dose prescribed?

50 mL/hr Dose needed = 1000 units/hr; dose available = 20,000 units (in 1000 mL). 20,000 u/1,000 = x/mL x = 20 u/mL have/quantity = desire/x 20 u/1mL = 1000 u/x cross multiply and solve for x 20X = 1000; x = 50 mL/hr

A nurse receives a precription to increase a procainamide (Pronestyl) IV infusion to 4 mg/min. The IV bag is labeled Pronestyl 2 g in 500 mL D5W. The nurse will adjust the IV pump to what rate?

60 mL/hr Dose needed = 4 mg/min; dose available = 2 g (in 500 mL). Determine how many g in 1 mL by setting up an equation: 2 g/500 = x g/1 mL x = 0.004 g/mL, convert g to mg, 1 g = 1000 mg, therefore, 0.004 g = 4 mg have/quantity = desire (60 min)/x 4 mg/1 mL = 4 mg (60 min per hr) 4X = 4(60) x = 60 mL/hr

A nurse is caring for a client who is prescribed ergotamine tartrate (Ergomar). The nurse should recognize that ergotamine tartrate is indicated for which of the following? A. hypertension B. migraine headaches C. ulcerative colitis D. Anemia

B. migraine headaches ergotamine tartrate blocks alpha-adrenergic receptors in the cranial peripheral vascular smooth muscle to cause vasoconstriction of dilated cerebral blood vessels.

A nurse is caring for a client taking filgrastim (Neupogen) and is reviewing the client's morning CBC and differential. in evaluating the client's response to filgrastim, the nurse should review the: A. erythrocyte count B. neutrophil count C. lympocyte count D. thrombocyte count

B. neutrophil count the purpose of filgrastim is to raise the client's absolute neutrophil count. filgrastim is a glycoprotein that specifically stimulates the proliferation of neutrophils. it is used for clients who have a decreased neutrophil count as a result of chemotherapy or other causes of neutropenia

A client is being treated with a 10-day course of gentamicin sulfate (Garamycin). which of the following findings should indicate to the nurse that the client is experiencing an adverse effect of this medication? A. hypoglycemia B. proteinuria C. elevated temperature D. visual disturbances

B. proteinuria

after taking erythromycin (Erythrocin) PO for 7 days, a client develops oral candidiasis. the nurse should recognize that this is most likely due to which of the following? A. allergic response B. superinfection C. synergistic reaction D. eythromycin toxicity

B. superinfection

a nurse is caring for a client who is receiving heparin IV therapy. the morning a PTT is 90 seconds (control of 26). which of the following actions should the nurse take first? A. administer protamine sulfate B. turn off the infusion C. contact the primary care provider D. request a repeat blood test

B. turn off the infusion an aPTT of 90 seconds is 1 and a 1/2 to 2 times the normal value. the greatest risk to the client is hemorrhage, therefore, the first action the nurse should take is to turn off the IV infusion to prevent the client from receiving any more heparin

A client with a urinary tract infection (UTI) is being discharged on phenazopyridine (Pyridium) and ciprofloxacin hydrochloride (Cipro). Which of the following statements by the client should indicate to the nurse a need for futher teaching? A if the pyridium upsets my stomach, i can take it with meals B the pyridium will relieve my discomfort, but the Cipro will get rid of the infection. C. i need to drink about 2-3 liters of fluid a day while I am taking the pyridium. D. I should notify the health car provider immediately if my urine turns a red or orange color.

D. I should notify the health care provider immediately if my urine turns a red or orange color. Rationale: pyridium is for short-term relief of UTI manifestations, but ciprofloxacin hydrochloride is necessary to treat the causative organism.

A nurse is providing teaching to a client receiving gemfibrozil (Lopid). The nurse evaluates effectiveness of the teaching when the client states he will have which of the following evaluated periodically. A. platelet count B. serum electrolyte levels C. thyroid function D. liver function

D. liver function Gemfibrozil (lopid) is converted by te liver to activate metabolites, and therefore, it is necessary to undergo periodic liver function studies to monitor for active hepatic disease or elevated transaminase levels

A nurse is caring for a client with a pregnancy induced hypertension (PIH) who is started on a magnesium sulfate IV. Which of the following should the nurse recognize as the priority assessment finding? A. blood pressure: 134/82 B. urine output: 45/hr C. deep tendon reflexes: +2 D. respiratory rate: 10 breaths/min

D. respiratory rate: 10 breaths/min Rationale: urine output in an adult client should be a minimum of 30 mL per hour. this is not a priority finding.

a nurse is caring for a client prescribed amphotericin B (Fungizone). Which of he following should the nurse recognize as the best indicator of renal function? A. serum potassium levels B. daily weights C. intake and output D. serum creatinine levels

D. serum creatinine levels intake and output may reflect renal function but it is not the best indicator of impairment

A nurse i caring for a preschool-age child in the emergency department who has dyspnea, wheezing, and a history of severe asthma. The healthcare provider prescribes epinephrine hydrochloride (Adrenalin) subcut. stat. After the drug is administered, the nurse should assess the client for: A. hypotension B. hyperthermia C. hypoglycemia D. tachycardia

D. tachycardia Rationale: epinephrine hydrochloride stimulates the central nervous system (CNS). Adverse effects of epinephrine hydrochloride include rapid heart rate and high blood pressure

A client who is admitted with cirrhosis is prescribed lactulose (Cephulac) PO. For which of the following actions should the nurse administer lactulose? A. to increase blood pressure B. to prevent bleeding from esophageal varices C. To derease heart rate D. to reduce serum ammoia levels

D. to reduce serum ammonia levels cephulac is a laxative that is given to promote the excretion of ammonia. Ammonia levels are increased in lever failure, producing hepatic encephalopathy or coma. cephalic discourages the growth of bacteria, traps ammonia in the gut, and expels ammonia from the colon.