ATI Pharmacology - All questions Part 1

A nurse is caring for a client who is experiencing cyclopegia following the administration of atropine eye drops during an eye examination. Which of the following findings should the nurse expect as a result of cyclopegia?

Blurred vision Assessment findings of cyclopegia include blurred vision because focusing for near vision is impaired. This action occurs following the administration of atropine because the paralysis of the ciliary muscle prevents near-vision focus. Accommodation, or looking from far to near and vice-versa, is also temporarily impaired.

A nurse is caring for a client who has a new diagnosis of rheumatoid arthritis. The nurse should anticipate a prescription from the provider for which of the following medications for daily management of this condition?

Celecoxib The nurse should anticipate that the provider will prescribe celecoxib, which is an NSAID. This medication or another NSAID should be initiated for a client who has a new diagnosis of rheumatoid arthritis.

A nurse is checking a client who is receiving an IV infusion of telavancin for Streptococcus pyogenes. Which of the following actions should the nurse include?

Check the client for pruritus The nurse should monitor a client who receives telavancin for pruritus, which can occur if the client develops generalized exfoliative dermatitis from infusing the medication too rapidly. Manifestations of this condition can include flushing, rash, pruritus, urticaria, tachycardia, and hypotension.

A nurse is caring for a client who is experiencing acute alcohol withdrawal. The nurse should expect to administer which of the following medications?

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

A nurse is caring for a client who take sulfasalazine twice daily for rheumatoid arthritis. Which of the following values should the nurse review prior to administration of the medication?

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 given this medication.

A nurse is caring for a client who has diabetes insipidus. Which of the following lab values should the nurse identify as reflecting a contraindication to receiving vasopressin to treat this disorder?

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 vasopressin. Renal impairment increases the likelihood of the life-threatening adverse reaction of water intoxication.

A nurse is monitoring a client who has asthma, takes albuterol, and recently started taking propranolol to treat a cardiovascular disorder. The client reports that the albuterol has been less effective. Which of the following facotrs should the nurse identify as a possible explanation for this change?

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

A nurse is caring for a client who is taking selegiline. The nurse should monitor the client for which of the following adverse effects of selegiline and notify the provider if it occurs?

Drowsiness Drowsiness can be an adverse effect of selegiline and a manifestation of serotonin syndrome.

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?

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 often an alternative treatment to prescribed medication for treating nausea and vomiting during pregnancy.

A nurse is caring for a client who has hyperlipidemia and is receiving simvastatin 40 mg PO daily. Which of the following items should the nurse remove from the client's breakfast tray before delivering it to the room?

Grapefruit juice Grapefruit juice is contraindicated for a client who is taking simvastatin because it raises blood levels of the medication significantly by inactivating a liver enzyme that is responsible for metabolism.

A nurse is reviewing the medical record of a client with rheumatoid arthritis who has a prescription for infliximab. Which of the following findings should the nurse identify as a contraindication to the client receiving this medication?

Hepatitis B virus The nurse should identify that infliximab is a tumor necrosis factor (TNF) antibody medication that is used to reduce the disease manifestations and to delay disease progression. Infliximab has immunosuppressant properties that can increase the risk of infection. Clients who have an active or chronic infection such as hepatitis B virus should not take infliximab.

A nurse is reviewing the medical record of a client who has postmenopausal osteoporosis and a prescription for raloxifene. Which of the following findings in the client's medical record should the nurse identify as a contraindication to receiving this medicaiton?

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

A nurse is teaching a client who has chemotherapy-induced anemia and a prescription for epoetin alfa. The nurse should instruct the client to report which of the following findings as an adverse effect of epoetin alfa?

Hypertension The nurse should instruct the client to report hypertension, which is an adverse effect of apoetin alfa. Other adverse effects can include headaches, seizures, heart failure, and thromboemolic events related to increased hemoglobin levels.

A nurse is teaching a group of nurses about the effects of a client receiving spinal anesthesia. Which of the following pieces of information should the nurse include in the teaching?

Hypotension is an adverse effect of spinal anesthesia. The local anesthetic can cause the client's blood pressure to decrease due to venous dilation secondary to a sympathetic nervous system response. If hypotension occurs, the nurse should lower the head of the client's bed, increase fluids if applicable, and administer vasoconstrictive medication as indicated by the provider.

A nurse is providing teaching to a client with hypertension and type 1 diabetes who has a new prescription for metoprolol. Which of the following statements by the client indicates understanding of the teaching?

I might have difficulty recognizing when my blood sugar is low. Metoprolol, a beta-adrenergic blocker, is used to treat hypertension. Because it decreases the heart rate, this common manifestation of hypoglycemia can be masked, and hypoglycemia might become more difficult to recognize. The client should be taught to recognize hypoglycemia by other manifestations like hunger, nausea, and sweating.

A nurse is teaching 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 teaching has been effective?

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

A nurse is preparing to administer oxytocin to a client who is at 41 weeks gestation and is experiencing ineffective labor. Which of the following actions should the nurse plan to take?

Increase the dose of oxytocin to obtain uterine contractions that occur every 2 to 3 minutes

A nurse is teaching a client who has type 2 diabetes about a prescription for insulin lispro. Which of the following statements should the nurse include in the teaching?

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

A nurse is providing teaching to a newly licensed nurse about metoclopramide. The nurse should highlight that which of the following conditions is a contraindication to this medication?

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

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 membrane?

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 medication from the blood.

A charge nurse is monitoring a newly licensed nurse who is caring for a postoperative client who is receiving morphine through a PCA pump. Which of the following actions by the newly licensed nurse requires intervention?

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

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

Nitroglycerin The nurse should identify the need to administer nitroglycerin, which is used to treat angina. Nitroglycerin acts directly on vascular smooth muscle to promote vasodilation.

A nurse is administering a prescription for nifedipine to a client who is pregnant. Which of the following pieces of information related to nifedipine should the nurse monitor and document?

Number of uterine contractions A client who is going into preterm labor can have a prescription for nifedipine, which is a calcium channel blocker that inhibits the entry of calcium into the myometrial cells, which can delay labor.

A nurse is teaching a client who has ADHD and is starting therapy with an 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?

Palpitations The nurse should instruct the client that palpitations can be a sign of cardiovascular adverse reaction and requires 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 consciousness, and nystagmus. Which of the following medications should the nurse anticipate administering to the client?

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-Kersakoff syndrome due to a thiamine deficiency. Therefore the nurse should anticipate giving parenteral thiamine.

The nurse is assessing a client who has been taking linezolid to treat a Staphylococcus aureus infection. Which of the following findings should the nurse report to the provider?

Paresthesias Although these reactions are rare, some clients who take linezolid develop irreversible peripheral neuropathy and reversible optic neuropathy. The nurse should report this finding to the provider because it might warrant switching to another antibiotic.

A nurse is caring for a client who is taking glucocorticoids. The nurse should monitor the client for which of the following effects of the medication?

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

A nurse is preparing to administer an otic medication to an adult client. Which of the following actions should the nurse take?

Pull the pinna of the client's ear upward and outward.

A nurse is caring for a client who has been taking isoniazid and rifampin for 3 weeks for the treatment of active pulmonary tuberculosis (TB). The client reports that his urine is an orange color. Which of the following statements should the nurse make?

Rifampin can turn body fluids orange Rifampin can cause body fluids, such as tears, sweat, saliva, and urine, to turn a reddish-orange color. The nurse should inform the client that this effect does not cause harm.

A home health nurse is visiting an older client who has Alzheimer's disease. His caregiver tells the nurse she has been administering prescribed lorazepam, 1 mg 3 times per day, to the client for restlessness and anxiety over the past few days. For which of the following adverse effects should the nurse assess the client?

Sedation Lorazepam is a benzodiazepine with anti-anxiety and sedative effects. Older adult clients are especially at risk for CNS depression, even with low doses of benzodiazepines. Clients who are 50 or older can have a more profound and prolonged sedation than younger clients.

A nurse is providing teaching to a client who has a new prescription for sertraline. The client asks the nurse if he should continue to take St. John's wort for depression. Which of the following instructions should the nurse give the client?

Stop taking the herbal supplement while taking this medication. Taking the antidepressant sertraline and the herbal supplement St. John's wort increases the risk of serotonin syndrome.

A nurse is providing teaching to a client who has rheumatoid arthritis and a prescription for long-acting prednisone therapy. The nurse should instruct the client to monitor for which of the following adverse effects?

Stress fractures Prednisone can cause demineralization of the bones and can lead to osteoporosis and stress fractures.

A nurse is providing teaching to a client who has a new prescription for hydrochlorothiazide 50 mg PO daily to treat hypertension. Which of the following instructions should the nurse include in the teaching?

Take hydrochlorothiazide in the morning The client should take it in the morning to allow for diuresis during the day and to prevent nocturia.

A nurse is caring for a client who has a prescription for subdermal etonogestrel. The nurse should alert the provider about which of the following findings in the client's medical history?

Takes St. John's wort St. John's wort can reduce the effects of subdermal etonogestrel because it stimulates hepatic drug-metabolizing enzymes. Therefore, the nurse should alert the provider about the client's use of St. John's wort, and it should be discontinued.

A nurse is teaching a client with chronic asthma who has a new prescription for cromolyn. Which of the following instructions should the nurse include in the teaching?

The medication's therapeutic effects can take up to several weeks to develop.

A nurse is teaching a client with a new diagnosis of peptic ulcer disease (PUD) who has a prescription for bismuth subsalicylate. The client asks the nurse, "How will this medication help my ulcer?" Which of the following statements should the nurse make?

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

A nurse is providing teaching to a client with a seizure disorder who has a new prescription for carbamazepine. Which of the following statements should the nurse include in the teaching?

This medication will decrease the effectiveness of oral contraceptives.

A nurse is teaching a client who has a prescription for a combination oral contraceptive that uses a 28-day cycle. Which of the following instructions should the nurse include in the teaching?

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

A nurse is teaching about the adverse effects of morphine to a client who has acute pain. Which of the following statements should the nurse include in the teaching?

You should increase your fluid intake The nurse should inform the client that an adverse effect of morphine is constipation so increasing oral fluid intake can promote motility of the bowel.

A nurse is reviewing the lab data for a client who is receiving clozapine for schizophrenia. The nurse should identify which of the following findings as a potential adverse effect of the medication?

Absolute neutrophil count 1,200 mm^3 The nurse should identify that an absolute neutrophil count of 1200/mm^3 is less than the expected reference range of 2500 to 8000/mm^3. An adverse effect of clozapine can include agranulocytosis, which is a life-threatening condition in which WBCs (including neutrophils) are severely decreased.

A nurse is caring for a client who has peptic ulcer disease and reports a headache. Which of the following medications should the nurse plan to administer?

Acetaminophen Acetaminophen is an analgesic for mild to moderate pain. It can be administered to a client who has peptic ulcer disease because it does not affect blood coagulation and does not increase the risk of gastrointestinal bleeding.

A nurse is administering a medication parenterally to a client. Which of the following techniques should the nurse use to reduce fluctuations in plasma medication levels?

Administering a continuous infusion of the dose By administering a medication by continuous infusion, plasma levels stay nearly constant.

A nurse in a provider's office is assessing a client who has been taking amoxicillin for 10 days and reports diarrhea and cramping. The nurse should recognize that these manifestations occur secondary to which of the following adverse effects?

Alterations in gastrointestinal flora The typical gastrointestinal flora are often destroyed by broad-spectrum antibiotics causing poor digestion and possible superinfection with other bacteria.

A nurse is caring for a client who has a new prescription for tamoxifen. The nurse should recognize that tamoxifen has which of the following therapeutic effects?

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

A nurse is assessing a client who is experiencing chest pain. Which of the following medications should the nurse expect to administer to suppress the aggregation of platelets?

Aspirin Aspirin suppresses platelet aggregation, producing an immediate anti-thrombotic effect. The client should chew the first does of aspirin to allow rapid absorption.

A nurse is caring for a client who is taking budesonide to treat Crohn's disease. Which of the following findings should indicate to the nurse that the treatment is effective?

Decrease in inflammation Flor a client who has Crohn's disease, a decrease in inflammation of the gastrointestinal lining of the client's large intestine is a therapeutic effect of taking budesonide. It is a glucocorticoid that works by suppressing the immune system. Glucocorticoids inhibit the actions of prostaglandins and leukotrienes.

A nurse manager is instructing a newly licensed nurse about routes of medication administration. Which of the following routes involves medication absorption through the mucous membranes under the tongue?

Sublingual

A nurse is caring for a client who has a new diagnosis of oral candidiasis after taking tetracycline for 7 days. The nurse should recognize that candidiasis is a manifestation of which of the following adverse effects?

Superinfection A superinfection can develop from fungal overgrowth due to the antibacterial effect of tetracycline. The nurse should monitor the client for manifestations of superinfection such as soreness of the mouth and a swollen tongue.

A nurse is preparing to administer meperidine 100 mg IM to a client who has a BMI of 23. Which of the following needle lengths should the nurse use to administer the medication?

1 1/2 inch In general, needle lengths for IM injections are 1 to 1 1/2 inches unless the client is obese.

A nurse working in the emergency department is admitting a client who has a gastric ulcer and gastrointestinal bleeding. Which of the following factors in the client's medical history should the nurse report to the provider?

Arthritis treated with ibuprofen every 8 hours as needed The nurse should identify that ibuprofen is an NSAID. NSAIDs can cause gastrointestinal bleeding and are contraindicated for clients who have ulcer disease. NSAIDs inhibit prostaglandin secretion, which decreases blood flow in the GI tract and decreases bicarbonate and mucus secretion. This environment promotes the secretion of gastric acid and needs to be reported to the provider.

A nurse is planning to administer diphenhydramine 50 mg via IV bolus to a client who is having an allergic reaction. The client has an IV infusion containing a medication that is incompatible with diphenhydramine in solution. Which of the following actions should the nurse take?

Aspirate to check for IV patency before administering the diphenhydramine It is important to confirm IV patency prior to administering an IV bolus. Some medications can cause severe tissue damage when inadvertently administered into tissue rather than into a vein.

A nurse is caring for a client and realizes after administering the 0900 medications that she administered digoxin 0.25 mg PO to the client instead of the prescribed digoxin 0.125 mg PO. Which of the following actions should the nurse take first?

Assess the client's apical pulse Caring for this client requires application of the nursing process priority-setting framework. The nurse can use the nursing process to plan client care and prioritize nursing actions. Each step of the process builds on the previous step, beginning with assessment. Before the nurse can formulate a plan of action, implement a nursing intervention, or notify a provider about a change in the client's status, she must first collect adequate data from the client. An assessment will provide the nurse with the knowledge needed to make an appropriate decision.

A nurse is caring for a client who has a suspected adrenal insufficiency. Which of the following medications should the nurse anticipate the provider using to determine the presence of adrenal insufficiency?

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

A nurse is assessing a client who has AIDS and is taking zidovudine. Which of the following findings is the priority for the nurse to report to the provider?

Decreased hemoglobin The nurse should apply the safety and risk-reduction priority-setting framework, which assigns priority to the factor or situation posing the greatest safety risk to the client. When there are several risks to client safety, the one posing the greatest threat is the highest priority. The nurse should use Maslow's hierarchy of needs, the ABC priority setting framework, and/or nursing knowledge to identify which risk poses the greatest threat to the client. Therefore, the priority finding for the nurse to report is a decreased hemoglobin level. Zidovudine can cause severe anemia and neutropenia from bone marrow suppression, resulting in hematologic toxicity.

A nurse is teaching a client who is about to start taking propylthiouracil to treat hyperthyroidism. Which of the following statements should the nurse identify as an indication that the teaching has been effective?

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

A nurse is providing teaching to a client who has heart failure and is taking spironolactone. Which of the following statements by the client indicates an understanding of the teaching?

I will watch for increased breast tissue growth while taking this medication. Spironolactone, which is derived from steroids, can cause adverse endocrine effects such as gynecomastia, impotence in men, and irregular menses and hirsutism in women. The nurse should instruct the client that these changes can occur.

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

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

A nurse is assessing an infant during a routine checkup. The parents ask the nurse about the infant's immunization schedule. Which of the following responses should the nurse make?

It is recommended that your infant receives 6 immunizations at 2 months of age An infant who is 2 months of age should receive 6 immunizations, followed by 5 immunizations at 4 months of age. The monovalent hepatitis B vaccine is administered within 12 hours of birth.

A nurse is monitoring a client with pneumonia who has received penicillin G IM. Which of the following findings should the nurse plan to evaluate first?

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

A nurse is caring for a client who was recently diagnosed with Addison's disease and has been placed on long-term mineralocorticoid therapy with fludrocortisone. Which of the following pieces of information should the nurse provide when explaining the purpose of this therapy?

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

A nurse is preparing to administer IV nitroprusside for a client who had a myocardial infarction. Which of the following actions should the nurse take?

Regulate the infusion pump rate using the client's weight in the calculation. The nurse should regulate the infusion pump rate based on the client's weight. Sodium nitroprusside is a potent vasodilator that works faster than any other medication available and is administered as a continuous IV infusion to client's who require a rapid reduction of blood pressure. The nurse should monitor the client's blood pressure either continuously with an arterial line or at least every 15 minutes with an electronic monitoring device because this medication can cause rapid reduction of blood pressure that can be life-threatening if not managed properly.

A nurse is administering subcutaneous epinephrine for a client who is experiencing anaphylaxis. The nurse should monitor the client for which of the following adverse effects?

Tachycardia Adverse effects of epinephrine, an adrenergic agonist, can include tachycardia and dysrhythmias due to cardiac stimulation.

A nurse is teaching a client with type 2 diabetes about self-administration of a new prescription for acarbose. Which of the following pieces of information should the nurse include in the teaching?

Tell the client to take the medication with food Acarbose should be taken with food. The nurse should advise the client that this medication should be taken with the first bite of a meal 3 times each day. Acarbose inhibits an enzyme in the intestines that slows the digestion of carbohydrates and results in a lower postprandial increase of blood glucose levels.

A nurse is assessing an infant who is scheduled to receive the rotavirus vaccine. Which of the following criteria should the nurse identify as a potential contraindication for administering this vaccine?

The infant has a history of intussusception The nurse should identify that the rotavirus vaccine is contraindicated for infants who have a history of intussusception. The rotavirus vaccine is also contraindicated for infants who have an uncorrected gastrointestinal congenital malformation that could result in intussusception.

A nurse is providing teaching to a client who is scheduled to start taking hydrochlorothiazide for hypertension. The nurse instructs the client to eat foods rich in potassium. Which of the following statements by the client indicates an understanding of the teaching?

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

A nurse is providing teaching to a client who has hypothyroidism and is taking levothyroxine. The nurse should instruct the client that which of the following findings indicate thyrotoxicosis?

Chest pain Thyrotoxicosis can result if a client takes too much levothyroxine. Manifestations include chest pain, tachycardia, insomnia, tremors, hyperthermia, heat intolerance, and diaphoresis. The client should notify the provider if any of these are present.

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?

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

A nurse is teaching a client about the proper placement of a nitroglycerin patch. Which of the following statements by the client indicates an understanding of the teaching?

I can place the patch on any area of my body without hair. The patch should be placed in a hair-free area because hair creates a physical barrier to absorption.

A nurse is providing teaching to a client about a new prescription for captopril to treat hypertension. Which of the following client statements indicates an understanding of the teaching?

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 position slowly.

A nurse is providing teaching to the parents of a child who has a new prescription for lamotrigine for a seizure disorder. The nurse should instruct the parents that which of the following adverse effects is the priority to report to the provider?

Rash The nurse should apply the safety and risk-reduction priority-setting framework, which assigns priority to the factor or situation posing the greatest safety risk to the client. When there are several risks to client safety, the one posing the greatest threat is the highest priority. The nurse should use Maslow's hierarchy of needs, the ABC priority-setting framework, and/or nursing knowledge to identify which risk poses the greatest threat to the client. The greatest risk to this client is an injury from Stevens-Johnson syndrome or toxic epidermal necrolysis, which are life-threatening reactions that manifest initially as a rash in the first 2 to 8 weeks of treatment with lamotrigine. The nurse should instruct the parents to report a rash immediately.

A nurse is administering a client's first dose of sucralfate. Which of the following explanations should the nurse provided about the action of sucralfate?

Sucralfate forms a gel-like substance that protects ulcers This protective mechanism lasts for 6 hours and allows the ulcer to heal.

A nurse is teaching a client about a new prescription for extended-release oxycodone for pain management. Which of teh following statements should the nurse include in the teaching?

Swallow this medication whole The nurse should tell the client that extended-release oxycodone is a long-acting opioid medication and should not be cut in half or crushed to prevent immediate absorption of the entire dose. This medication should be swallowed whole and is administered every 12 hours.

A nurse in an outpatient facility is assessing a client who is prescribed furosemide 40 mg daily. The client reports taking extra doses to promote weight loss. Which of the following findings should indicate to the nurse that the client is dehydrated?

Urine specific gravity 1.035 Oliguria, an increased urine concentration, and an increased urine specific gravity greater than 1.030 are expected findings in clients who are dehydrated.

A nurse is administering an enteric-coated tablet to a client and explaining the pharmaceutical preparation. Which of the following statements should the nurse make?

You are less likely to have an upset stomach with this pill because of the coating on the tablet. Enteric-coated preparations have an outside coating of a substance that dissolves in the intestines instead of in the stomach. This protects the medication from the acids and enzymes in the stomach and protects the stomach from ingredients in the medication that cause gastric upset.

A nurse is providing teaching to a client who has a new prescription for a fentanyl transdermal patch. Which of the following statements by the client indicates an understanding of the teaching?

I will have to stop drinking grapefruit juice while using the patch. The nurse should instruct the client to avoid drinking grapefruit juice because it can increase the absorption of the medication, raising the amount of fentanyl in the client's blood. This effect can place the client at risk for CNS and respiratory depression.