ATI Pharmacology dynamic quiz

A nurse is teaching a client who has severe chronic gout and a new prescription for pegloticase the client has been taking allopurinol for one 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

D. if you experience a flare up you can take an NSAID while receiving this medication the nursing instructor this client who has chronic go out there during the first few months of treatment and increasing out manifestations is expected to reduce the intensity of these manifestations clients are instructed to take NSAIDs such as naproxen

I'm 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? A. oral B. topical C. parenteral D. sublingual

D. sublingual absorption through the sub lingual route occurs by placing the medication under the tongue

A nurse is teaching a client who has a prescription for a transdermal estradiol patch in which of the following locations should the nurse instruct the client to apply the patch? A. Abdomen B. breast C. forearm D. back of the thigh

A. Abdomen The nurse should instruct the client to place the transdermal estradiol patch on to the skin of the trunk/ abdominal area but not the breast. this allows estrogen from the patch to be absorbed through the skin directly into the clients blood

A nurse is preparing a discharge teaching plan for a six-year-old client with asthma who has several prescription medications using metered dose inhaler's which of the following interventions should the nurse include in the plan? A. Add a spacer to each MDI B. instruct the client to inhale more rapidly than usual when using an MDI C. ask the provider to change the clients medications from inhaled to oral formulations D. administer oxygen by face mask along with the MDI

A. 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 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 aminotransferase AL T B. white blood cell count C. potassium D. chloride

A. Alanine aminotransferase AL T 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 new prescription for tamoxifen. the nurse should recognize that tamoxifen has which of the following therapeutic effects? A. Anti-estrogenic B. antimicrobial C. androgenic D. anti-inflammatory

A. Anti-estrogenic tamoxifen is an anti-estrogen medication used to treat cancer of the breast in both premenopausal and postmenopausal women it is also used to prevent breast cancer in women who are at an increased risk

A nurse is preparing to administer medications to a client who is NPO and is receiving enteral feedings through an NG tube which of the following prescriptions to the nurse clarify with the provider? A. Aspirin EC 3 to 5 MG per NG tube daily B. atorvastatin 40 MG per NG tube daily C. propanolol 20 MG per NG tube daily D. sucralfate 2 G oral suspension per NG tube BID

A. Aspirin EC 3 to 5 MG per NG tube daily The nurse should clarify the prescription for aspirin EC 325 MG per NG tube daily as enteric coated tablets should not be crushed

A nurse is caring for a client who had a myocardial infarction two hours ago and is receiving alteplase which of the following findings should the nurse identify as an adverse effect of receiving this medication? A. Bleeding B. increase clot formation C. shortness of breath D. blockage of the central venous catheter

A. Bleeding The nurse should identify that an adverse effect of alteplase is bleeding severe bleeding can occur as a result of the alteplase plasminogen complex which catalyzes the conversion of other plasminogen molecules that digest fibrin clots this action of the medication can contribute to hemorrhage

A nurse is caring for a client who takes ginkgo biloba daily at home which of the following affects should the nurse expect from the use of this herbal supplement? A. Decreased platelet aggregation B. prevention of migraine headaches C. increased risk of deep vein thrombosis D. lower cholesterol and triglyceride levels

A. Decreased platelet aggregation Ginkgo biloba can decrease platelet aggregation by inhibiting the ability of platelets to clump together the nurse and the client should discuss the potential increase in bleeding tendencies when taking ginko biloba and other antiplatelet aggregates such as NSAIDs and clopidogrel

A nurse is providing discharge teaching for a client who has a new prescription for metoprolol which of the following instructions should the nurse include? Select all that apply A. Do not stop taking this medication abruptly. B. Take the medication right before bedtime C. avoid exposure to sunlight D. count your radial pulse daily E. change position slowly

A. Do not stop taking this medication abruptly. D. count your radial pulse daily E. change position slowly Client who stop taking metoprolol abruptly increase the risk of angina hypertension and myocardial infarction they should reduce the dosage gradually over 1 to 2 weeks clients should count the radial pulse daily and report a heart rate slower than 60/MIN metoprolol can cause orthostatic hypotension to prevent injury the client should move slowly from lying down or sitting to standing

A nurse is preparing to administer dantrolene to a client who has muscle spasticity which of the following findings from the clients medical history should the nurse identify as a contraindication to the administration of this medication? A History of cirrhosis B. history of multiple sclerosis C. history of cerebral palsy D. history of malignant hyperthermia

A. History of cirrhosis The nurse should identify that dantrolene is contraindicated for clients who have active liver disease because it is hepatotoxic and can cause liver failure liver function tests are monitored for clients throughout treatment with this medication

A nurse is teaching a client who has osteoporosis about a new prescription for risedronate which of the following client statements indicates an understanding of the teaching? A. I will take this medication with a full cup of water B. I will lie down after I take this medication C. I will take this medication with food D. I will take this medication at bedtime

A. I will take this medication with a full cup of water The nurse should instruct the client that risedronate should be taken with at least 180 to 240 ML of water

A nurse is assessing a client who is taking varenicline for smoking cessation which of the following findings is the nurses priority? A. Mood changes B. nausea C. altered sense of taste D. skin rash

A. Mood changes 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 the 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 the client is a development of neuropsychiatric effects that can progress to depression and suicide therefore the highest priority is a change in the clients mood.

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

A. 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 planning care for a client who is receiving gentamicin IM and has a new prescription to obtain gentamicin peak and trough levels at which of the following times should the nurse plan to obtain a blood sample to evaluate gentamicin peak? A. One hour after administering the IM injection B. just before administering the IM injection C. 12 hours after the last IM injection D. 30 minutes after administering that I am injection

A. One hour after administering the IM injection Timing is important when drawing blood samples for aminoglycoside levels the nurse should obtain blood samples for peak levels one hour after administering an IM injection or 30 minutes after completing an IV infusion

A nurse is assessing a child who has acute lymphocytic leukemia and is receiving vincristine sulfate which of the following findings is the nurse is priority? A. Paresthesia B. alopecia C. stomatitis D. constipation

A. Paresthesia The greatest risk to this client is neurotoxicity vincristine a cell cycle specific chemotherapy agent interrupts cellular reproduction at mitosis and can cause neurotoxicity an early finding with neurotoxicity is paresthesia or numbing of the peripheral extremities as neurotoxicity progresses the client can develop autonomic and central nervous system dysfunction the nurse should report paresthesia immediately as the provider might change the dosage or the therapy

A nurse is providing teaching to a female client who has a new prescription for pravastatin to three 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 evening meal D. laboratory testing to monitor the clients WBC count is required

A. Pravastatin can be taken with grapefruit juice Grapefruit juice increases the bio availability of some medications but it does not have this effect on pravastatin it is safe for the client to take the medication with grapefruit juice if desired

A nurse is caring for a client who is at six weeks of gestation and has received a diagnosis of hypothyroidism the nurse should anticipate a prescription from the provider for which of the following medications? A. Propylthioracil B. Liothyronine C. Methimazole D. iodine - 131

A. Propylthioracil This medication is used to treat 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 trimester of pregnancy

A nurse is caring for a client who has tuberculosis and is taking rifampin the nurse should monitor the client for which of the following address affects of rifampin? A. Red tinged urine B. Tinnitus C. blurred vision D. dry mouth

A. Red tinged urine The nurse should identify that red tinged urine saliva and tears are adverse effects of rifampin The other adverse affects are the adverse effects of lithium

A nurse is caring for a client who received naloxone for a suspected opioid overdose which of the following findings should the nurse identify as an adverse effect of this medication? A. Report of pain B. respiratory rate 8/min C. report of numbness D. report of abdominal cramping and diarrhea

A. Report of pain The nurse should identify that naloxone is used to reverse the effects of an opioid overdose administered for pain sedation euphoria and respiratory depression excess doses of naloxone and can cause the return of pain but can improve the clients respiratory rate

A nurse is providing teaching to a client who has rheumatoid arthritis and a prescription for long-term prednisone therapy the nurse should instruct the client to monitor for which of the following address effects? A. Stress fractures B. orthostatic hypotension C. gingival ulcerations D. weight loss

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

A nurse is teaching a client about a new prescription for extended release oxycodone for pain management which of the following statements should the nurse include in the teaching? A. Swallow this medication whole B. take this medication before meals and at bedtime C. constipation decreases with continued use D. avoid taking other supplemental analgesics with this medication

A. 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 does this medication should be swallowed whole and is administered every 12 hours

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 clients medical history? A. Takes St. John's wort B. breastfeeds a six month old infant C. has a parent with hypertension D. has a positive human papillomavirus test result HPV

A. Takes St. John's wort St. johns wort can reduce the effects of sub dermal etonogestrel because it stimulates hepatic drug metabolizing enzymes therefore the nurse should alert the provider about the clients use of st. johns wort and it should be discontinued

Nurse is providing teaching to a client with the seizure disorder who has a new prescription for carbamazepine which of the following statements should the nurse include in the teaching? A. This medication will decrease the effectiveness of oral contraceptives B. once you are seizure free for a month you'll be able to stop taking the medication C. you can cut the dose in half if gastrointestinal upset occurs D. this medication might initially increase the frequency of your seizures

A. This medication will decrease the effectiveness of oral contraceptives

A nurse is preparing to administer an IV injection to a client for which of the following reasons should the nurse inject the medications slowly? A. To reduce toxicity risk B. to improve absorption pattern C. to prevent medication dilution D. to protect against embolism

A. To reduce toxicity risk Prior to injecting an IV medication the nurse should plan to infuse the medication slowly over one minute to reduce the risk for toxicity to the central nervous system. manifestations of CNS toxicity can become evident as soon as 15 seconds after initiating the injection if they injection is done slowly only a small amount of the total dose will have been administered when manifestations of toxicity appear if the nurse is able to discontinue the administration immediately adverse effects can be much less severe than if the entire does has been given quickly

A nurse is preparing to administer iron dextran IV to a client which of the following actions should the nurse plan to take? A. administer a small test dose before giving the full dose B. infuse the medication over 30 seconds C. monitor the client closely for hypertension after the infusion D. administer cyanocobalamin as an antidote if iron dextran toxicity occurs

A. administer a small test dose before giving the full dose A serious adverse effects of iron dextran is anaphylaxis caused by hypersensitivity to the medication a small test those should be administered over five minutes before giving the full dose. the client should be monitored carefully for an allergic reaction during and for a period of time following the test dose

A nurse is cleaning discharge teaching for a client who has major depressive disorder and a new prescription for phenelzine which of the following foods should the nurse include in the plan is safe for the client to consume while taking phenelzine? A. broiled beef steak B. macaroni and cheese C. pepperoni pizza D. smoked salmon

A. broiled beef steak Phenelzine an MAOI is an antidepressant this medication interacts with a variety of foods to produce a hypertensive crisis beef steak and other meats that are fresh do not interact with phenelzine and are safe to consume

A nurse is caring for a client who is experiencing an acute gout attack the nurse should anticipate a prescription from the provider for which of the following medications? A. colchicine B. allopurinol C. probenecid D. pegloticase

A. colchicine the nurse should anticipate a prescription for colchicine because it is the medication of choice for an acute gout attack the client can experience relief from the attack within hours of receiving this medication colchicine can also be prescribed for long-term use to prevent future attacks from occurring

A nurse is preparing to administer amlodipine to a client who has hypertension the nurse should plan to monitor the client for which of the following adverse affects of the medication? Select all that apply A. dizziness B. Pale appearance C. palpitations D. abdominal pain E. peripheral Edema

A. dizziness C. palpitations E. peripheral Edema The nurse should monitor this client who is taking amlodipine for dizziness palpitations and peripheral edema as adverse effects of the medication the nurse should advise the client to avoid activities that require alertness until the effect of the medication is known and to notify the provider if any of these adverse effects occur other adverse effects include flushing and headaches

A nurse is caring for a client who has a prescription for chlorothiazide to treat hypertension the nurse should plan to monitor the client for which of the following adverse effects? A. muscle weakness B. hypoglycemia C. hyperactive reflexes D. thrombophlebitis

A. muscle weakness chlorothiazide is a thiazide diuretic used to treat hypertension and congestive heart failure it promotes the excretion of water sodium and potassium and can cause hypokalemia manifestations of hypokalemia include muscle weakness muscle cramps and dysrhythmias

A nurse is caring for a client who has schizophrenia and a prescription for chlorpromazine for which of the following Adverse effects should the nurse monitor? A. orthostatic hypotension B. diarrhea C. urinary frequency D. bradycardia

A. orthostatic hypotension Orthostatic hypotension is an adverse effect of chlorpromazine other adverse affects include palpitations tachycardia constipation sedation and photosensitivity

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 in? A. Prednisone B. Cosyntropin C. Dexamethazone D. ketoconazole

B. Cosyntropin the nurse should expect the provider to use consyntropin 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 the expected reference range if the cortisol level does not elevate the provider should determined that this client has adrenal insufficiency

A nurse is caring for a client who is taking streptomycin which of the following medications increases the clients risk of developing autotoxicity when taken with streptomycin? A. Cefoxitin B. furosemide C. naproxen D. amphotericin B Furosemide a high ceiling loop diuretic increases the risk of developing otoxicity when taken with streptomycin an aminoglycoside

B. Furosemide Furosemide a high ceiling loop diuretic increases the risk of developing otoxicity when taken with streptomycin an aminoglycoside

A nurse is providing discharge teaching to a client who had a kidney transplant and has a prescription for oral cyclosporine which of the following statements by the client indicates an understanding of the teaching? A. I will be able to stop taking this medication within six months after my surgery B. I am likely to develop higher blood pressure while taking this medication C. I am likely to lose my hair while taking this medication D. I am taking this medication to boost my immune system

B. I am likely to develop higher blood pressure while taking this medication Half the clients will take cyclosporine develop a 10% to 50% increase in blood pressure and might need to start antihypertensive therapy

A nurse is caring for a client who has cystic fibrosis and has a prescription for high dose ibuprofen daily the nurse should identify that which of the following is an expected outcome of the client receiving this medication? A. Thinned pulmonary secretions that are retained in the airways B. Slowed progression of pulmonary damage C. potentiated action of bronchodilator therapy D. decreased risk of fevers associated with CF

B. Slowed progression of pulmonary damage the nurse should identify that clients who have CF are prescribed high-dose ibuprofen which is an NSAID to slow the progression of pulmonary damage by suppressing the inflammatory response that causes pulmonary damage CF as a genetic disorder that primarily affects the lungs pancreas and sweat glands

A nurse is reviewing the medication history of a client who has asthma which of the following medication combinations to the nurse identify as incompatible? A. albuterol and montelukast B. Theophylline and fluticasone C. Aminophylline and fluticasone D. salmeterol and levalbuterol

B. Theophylline and fluticasone The nurse should identify that they zileuton and leukotriene modifier impairs and metabolism of certain medications concurrent use of zileutonwith theophylline can cause toxicity due to elevated theophylline which is a systemic methylxanthine used to relax the smooth muscles of the airway therefore these medications are incompatible when used together

A nurse in a postpartum unit is caring for a client who plans to breast-feed her newborn exclusively the client has a prescription for depot medroxyprogesterone acetate (DMPA) at which of the following time should the nurse schedule the client to receive the first dose of the medication? A. After three months postpartum B. at six weeks postpartum C. within the first five days postpartum D. during the first week of the first post partum menstrual cycle

B. at six weeks postpartum The nurse should tell the client that the first dose should be administered at six weeks postpartum if the client is exclusively breast-feeding and after ensuring the client is not pregnant

A nurse is caring for a client with Alzheimer's disease who has a new prescription for mematine which of the following laboratory results show the nurse identify as increasing the clients risk for decreased clearance of the medication? A. Alannine aminotransferase (AL T) 30 units/L B. creatinine clearance 35 ML/MIN C. HbA1c 5% D. BMI 31

B. creatinine clearance 35 ML/MIN Creating clearance is an estimate of the glomerular filtration rate and the kidneys ability to filter waste a creatinine clearance of 35 mL/min indicates moderate renal impairment the kidneys excrete memantine and decreased clearance occurs with moderate renal impairment

A nurse is assisting with a clients laceration repair in which the provider will use both lidocaine and epinephrine the nurse should inform the client that the epinephrine will perform which of the following actions? A. Act as a catalyst for the anesthetic properties of lidocaine B. delay systemic absorption of the anesthetic properties of lidocaine C. open the blood vessels for rapid anesthesia from the lidocaine D. prevent medication toxicity during the procedure

B. delay systemic absorption of the anesthetic properties of lidocaine the nurse should inform the client that medication such as lidocaine are often administered in combination with vasoconstrictor such as epinephrine epinephrine decrease his local blood flow and doing systemic absorption of the anesthetic property of lidocaine

A nurse is preparing to administer meperidine to a client who is postoperative and reports a pain level of 8 on a scale of 0 to 10 which of the following route of administration will deliver the medication with the shortest time up on set? A. Oral B. intravenous C. intramuscular D. subcutaneous

B. intravenous Dinner should identify that meperidine given intravenously 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 nurse is reviewing the medical record for a client who has a migraine and a prescription for sumatriptan which of the following factors in the clients medical history should the nurse identify as a contraindication to receiving sumatriptan? A. renal impairment B. ischemic heart disease C. severe osteoporosis D. cirrhosis

B. ischemic heart disease the nurse should identify that ischemic heart disease is a contraindication to receiving sumatriptan. sumatriptan is a serotonin receptor agonist that can cause vasoconstriction and coronary vasospasms this medication is also contraindicated in clients who had a myocardial infarction or clients who have coronary artery disease uncontrolled hypertension or other types of heart disease

A nurse is administering medication to a client the nurse should identify that which of the following medication disruption factors facilitates the effective passage of the medication across the clients cell membranes? A. Protein binding ability B. lipid solubility C. hepatic metabolism D. slow dissolution

B. 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 seperate The medication from the blood

A nurse working in a mental health facility is admitting a client with opioid use disorder who is experiencing with drawl the nurse and anticipate a prescription for which of the following medications from the provider? A. Methylnaltrexone B. methadone C. naloxone D. Hydromirphone

B. methadone The nurse should anticipate a prescription from the provider for methadone for a client who is experiencing opioid withdrawal methadone is an opioid medication that is used for pain management and treatment of withdraw manifestations and clients who have opioid use disorder

A nurse is caring for a client who is taking glucocorticoids the nurse should monitor the client for which of the following adverse effects of the medication? A. Weight loss B. peptic ulcer C. hyperkalemia D. diplopia

B. peptic ulcer the nurse should monitor this client who is taking glucocorticoids for peptic ulcer disease due to irritation of the gastric mucosal the nurse should periodically check the clients stool for occult blood and instruct the client to contract contact the provider of any black or tarry stools occur.

A nurse is monitoring the laboratory values of a male client who has leukemia and is receiving weekly chemotherapy with methotrexate via IV infusion which of the following laboratory values should the nurse report to the provider? A. BUN 18 MG/DL B. platelets 78,000/MM C. hemoglobin 14.2 G/DL D. Asperatate aminotransferase 35 units/L

B. platelets 78,000/MM The nurse should monitor the platelet count for a client who is taking methotrexate because the medication can cause thrombocytopenia this clients platelet count is very low and puts the client at risk of severe bleeding the nurse should report this finding promptly to the provider

A nurse is providing teaching for a client who has received a liver transplant and has a prescription to transition from cyclosporine to tacrolimus which of the following instructions to the nurse include in the teaching? A. Take both medications together for 72 hours and then stop taking the cyclosporine B. stop taking the Cyclosporine for 24 hours and then begin taking the tacrolimus C. alternate taking the medications for 48 hours and then take only the tacrolimus D. if adverse reactions to the tacrolimus occur stop taking it and restart cyclosporine

B. stop taking the Cyclosporine for 24 hours and then begin taking the tacrolimus The nurse should instruct the client at his medication should not be taken concurrently due to the increased risk of developing nephrotoxicity the client Should stop cyclosporine for 24 hours prior to beginning the tacrolimus prescription

A nurse is providing teaching to a client who has a new prescription for sertraline the client asked the nurse if he should continue to take st. johns wort for depression which of the following instructions should the nurse gave the client? A. Take the medication and herbal supplement together B. stop taking the herbal supplement while taking the medication C. take the herbal supplement and the medication at least two hours apart D. take an antacid with both of the herbal supplement on the medication

B. stop taking the herbal supplement while taking the medication Taking the anti-depressant sertraline and the herbal supplement Saint johns wort increases the clients risk of serotonin syndrome

A nurse is teaching a client who is postmenopausal and has a prescription for alendronate which of the following statements should the nurse include in the teaching? A. You can lay down 15 minutes after taking this medication B. take this medication on an empty stomach C. crush this medication to improve absorption D. avoid taking anti-acids or supplements that contain calcium while takings this medication

B. take this medication on an empty stomach The nurse should instruct the client to avoid taking alendronate with food or liquids other than water because it can decrease absorption this client should only take this medication with water 30 minutes before breakfast

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

B. the clients respiratory rate is 10/min the nurse should identify that morphine can cause respiratory depression therefore if the clients respiratory rate is less than 12/min the nurse should withhold the next dose of morphine and notify the provider

A nurse is assessing an infant who is scheduled to receive the rotavirus vaccine which of the following criteria should learner so identify as a potential contraindication for administering this vaccine? A. The infant is teething B. the infant has a history of intussusception C. the infant has been constipated for three days D. the infant is nine weeks old

B. 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 malformations that could result in intussusception

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? A. Use the inhaler just before exercise B. the medications therapeutic effects can take up to several weeks to develop C. you will shake the medication container for three seconds D. you will need to exhale slowly after you inhale

B. the medications 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 reviewing a new prescription for fexofenadine for a seven-year-old client who has seasonal allergies which of the following findings should the nurse clarify with the provider A. the prescription says to avoid taking the medicine with orange juice B. the prescription says to take standard tablets C. the prescription says to take 30 mg twice daily D. the prescription says to administer the medicine orally

B. the prescription says to take standard tablets the nurse should identify that the seven-year-old client has been prescribed a standard tablet which is appropriate for clients 12 years of age and older therefore the nurse should clarify this aspect of the prescription with the provider because a client who is seven years old should be administered orally disintegrating tablets or a suspension

Oh and nurse is providing teaching to a client with chronic bronchitis about administering acetylcysteine using a handheld nebulizer which of the following client statements indicates an understanding of the teaching A. "I should discard an open vial of the medication after 24 hours" B. "I should limit my fluid intake while taking this medication" C. "I should try to cough productively just before I begin the treatment" D. "if the medication becomes discolored I should throw it out and get a new supply"

C. "I should try to cough productively just before I begin the treatment" a productive cough prior to the beginning of treatment will clear sputum from lung surfaces allowing better absorption of the medication

A nurse is teaching a client who has a new prescription for sucralfate for a duodenal ulcer which of the following client statements indicates an understanding of the teaching? A. "I should take this medication with my meals and at bedtime" B. "I should only have to take this medication for about two weeks" C. "I should wait at least 30 minutes before taking this medication" D. "after I take an antacid I should swallow these tablets whole"

C. "I should wait at least 30 minutes before taking this medication" the nurse should recognize that antacids can raise the gastric pH above four which can interfere with the effects of sucralfate to minimize these interactions sucralfate should be taken at least 30 minutes apart from antacids

A nurse is teaching a client who has osteoporosis and a new prescription for alendronate which of the following client statements indicates that the teaching was effective? A. "I should take the medication with a glass of orange juice" B. "I will allow the medication to dissolve in my mouth" C. "I will sit upright for 30 minutes after taking the medication" D. "I should take the medication right after eating breakfast"

C. "I will sit upright for 30 minutes after taking the medication" the nurse should instruct the client to set up right for or stand for at least 30 minutes after taking the medication to prevent esophagitis

A nurse is caring for a client who receives gastrostomy tube feedings and insulin the client is scheduled to receive a tube feeding at 0700 which of the following time should the nurse plan to administer insulin lispro subcutaneously? A. 0600 B. 0630 C. 0645 D. 0730

C. 0645 Lispro is a rapid acting insulin with an answer of 15 minutes the nurse should administer the insulin those 15 minutes prior to the feeding

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

C. Hypotension Enalapril angiotensin converting enzyme inhibitor can cause hypotension and postural hypotension especially during the first three hours following the initial dosage

And a nurse is providing discharge teaching about lithium toxicity to a client who has a new prescription for lithium 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

C. I can develop lithium toxicity if I experience vomiting or diarrhea vomiting or diarrhea can cause electrolyte in balance is if serum sodium decreases lithium is retained by the kidneys and the risk of lithium toxicity increases

A nurse is providing teaching to a client who has postmenopausal osteoporosis and a new prescription for intranasal calcitonin salmon which of the following statements by the client indicates an understanding of the teaching? A. I will administer a spray into each nostril daily B. I should expect nasal bleeding for the first week C. I will need to depress the side arms to activate the pump D. I should expect to take this medication for a short term course of treatment

C. I will need to depress the side arms to activate the pump the nurse should instruct the client to activate the pump for the initial used by holding the bottle upright and depressing both white side arms toward the bottle six times

A nurse is teaching a client who has a new prescription for warfarin which of the following statements should the nurse identify as an indication that the client understands the instructions? A. Ill use a safety razor to shave each day B. I'll be sure to eat lots of spinach C. I'll avoid contact sports like football D. I'll take ibuprofen if I get a headache

C. I'll avoid contact sports like football The most common adverse effects of taking anticoagulants is bleeding therefore the client should avoid any activities that have a high risk of causing injury such as contact sports

A nurse is caring for a client who is experiencing cycloplegia following the administration of atropine eyedrops during an eye examination which of the following findings should the nurse expect as a result of cycloplegia A. inability to tolerate bright lights B. pinpoint pupils C. blurred vision D. inability to perform an upward gaze

C. blurred vision Assessment findings of cycloplegia 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 teaching a client who has severe generalized rheumatoid arthritis and is scheduled to start taking prednisone for long-term therapy the nurse should instruct the client to report which of the following as an adverse effect of prednisone? A. Thrombosis B. immunosuppression C. gastric ulceration D. liver toxicity

C. gastric ulceration The nurse should instruct the client to monitor for gastric ulceration as an adverse effect of the long-term use of prednisone other adverse effects of this medication include osteoporosis at adrenal suppression

A nurse is teaching a client about the use of a Dinoprostone vaginal insert pouch to stimulate labor which of the following statements should the nurse include in the teaching? A. It is inserted using a catheter B. one pouch is given every four hours until labor occurs C. lie on your back for at least two hours without getting up D. if labor doesn't occur within six hours a second dose can be administered

C. lie on your back for at least two hours without getting up The client should remain supine for at least two hours after the Dinoprostone vaginal pouch is inserted to allow slow release of the medication from the pouch to stimulate labor

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? A. Nausea B. headaches C. paresthesias D. insomnia

C. 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 the client to another antibiotic

A nurse is reviewing laboratory reports for a client who has Clostridium difficile infection and is receiving vancomycin which of the following results should the nurse report to the provider before administering the next dose? A. Hematocrit 46% B. serum glucose 110 mg/dL C. serum creatinine 2.5 mg/dL D. serum potassium 4.8 meq/L

C. serum creatinine 2.5 mg/dL Vancomycin is nephrotoxic and can result in renal failure which is indicated by elevated levels of creatine above the expected reference range of 0.5 to 1.3 mg/dL the nurse should report this laboratory value to the provider prior to administering any further doses of the medication

A nurse is preparing to administer the first injection of the diphtheria tetanus and pertussis DTaP vaccine to an infant which of the following pieces of information should the nurse tell the guardian prior to administering the immunization? A. Your chil might develop diarrhea or vomiting within 24 hours of receiving this vaccine B. I can either give your child all of the injections in the series at once or individually C. the vaccine will be injected into the infant thigh D. this injection contains a live a virus

C. the vaccine will be injected into the infant thigh the DTaP vaccine is administered intramuscularly in the deltoid or medial lateral thigh because these are larger muscles that can better diffuse inflammation therefore the nurse should prepare to administer the IM injection in the medial lateral thigh

A nurse is caring for a client who is experiencing a seizure while in bed which of the following actions should the nurse take? A. Raise the head of the clients bed B. restrain the clients arms and legs C. turn the clients head to the side D. insert a tongue blade in the clients mouth

C. turn the clients head to the side the nurse should turn the clients head to the side during the seizure this prevents the clients airway from becoming obstructed and keeps the airway patent

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

C. vitamin K The nurse should anticipate the provider to prescribe vitamin K for a client who has a INR of 6.2 vitamin K antagonizes war friends actions which can reverse warfarin induced inhibition of clotting factor synthesis.

A nurse is teaching a client who has a prescription for doxycycline for the treatment of a Helicobacter pylori infection which of the following instructions should the nurse include in the teaching? A. Take this medication with meals to decrease gastrointestinal upset B. continue this medication of you become pregnant C. wear protective clothing while in the sun D. expect to have severe diarrhea while taking this medication

C. wear protective clothing while in the sun The nurse should include in the teaching that all tetracycline medications increase the sensitivity of the skin to ultraviolet light and sunlight therefore clients are encouraged to avoid prolonged exposure to the sun and to wear protective clothing a while outside and exposed to the sun

A nurse is preparing to administer medication to a person preschooler the nurse should use which of the following measurements to calculate the medication dosage for this client? A. BMI B. height C. weight D. Rule of nines

C. weight The nurse should use the child's weight to calculate the medication dose children's doses are generally written in units of measure per body weight such as milligrams / kilogram

A nurse is administrating ciprofloxacin and phenazopyridine to a client who has a severe urinary track infection the client asks why both medications are needed which of the following responses should the nurse make? A. "phenazopyridine decreases the adverse effects of ciprofloxacin Hydrochloride" B. "combining phenazopyridine with ciprofloxacin Hydrochloride shortens the course of therapy" C. "the use of phenazopyridine allows a doctor to prescribe a lower dosage of ciprofloxacin Hydrochloride" D. "ciprofloxacin hydrochloride treats the infection and phenazopyridine treats pain"

D. "ciprofloxacin hydrochloride treats the infection and phenazopyridine treats pain" ciprofloxacin hydrochloride is a broad-spectrum quinolone antibiotic and phenazopyridine is a bladder anelgesic /anesthetic that relieves burning and pain in the bladder mucosa caused by bladder spasm and inflammation

A nurse is caring for a client who is pregnant and inquiring about alternative non-pharmacological therapies for nausea vomiting of pregnancy which of the following options shut the nurse recommend? A. Be sure to be eat at least three 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

D. Ginger is effective in the treatment of nausea and vomiting The nurse should recommend seasoning food with ginger to alleviate the clients 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 caring for a client who has peptic ulcer disease and reports a headache which of the following medications should the nurse plan to administer? A. Ibuprofen B. naproxen C. aspirin D. acetaminophen

D. acetaminophen Acetaminophen is an analgesic used 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 in a providers 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? A. Development of gastric ulcers B. development of milk intolerance C. allergic reactions to the medication D. alterations in gastrointestinal Flora

D. alterations in gastrointestinal Flora The typical gastrointestinal Flora are often destroyed by broad-spectrum antibiotics like amoxicillin causing poor digestion and possible super infection with other bacteria

A nurse is caring for a client who is due to receive general anesthesia the client ask the nurse what is the difference between an analgesic and anesthesia? Which statement should the nurse make? A. Analgesics can cause a lack of sensation B. anesthesia is specifically for eliminating pain perception C. analgesic treat pain without causing sedation D. anesthesia can cause loss of consciousness

D. anesthesia can cause loss of consciousness General anesthesia reduces or causes a complete loss of consciousness

A nurse is caring for a client who is receiving sumatriptan for cluster headaches which of the following findings should the nurse expect as an adverse effect? A. Hypotension B. Tinnitus C. urinary retention D. chest pressure

D. chest pressure A client who takes sumatriptan can develop sensations of chest pressure and heavy arms the nurse should monitor the client if the chest pressure continues the nurse should notify the provider about 50% of clients who take sumatriptan experience chest pressure and heaviness of the arms that are transient and resolve

A nurse is reviewing the laboratory results of a client who is taking tobramycin and notes that the medications peak level is 7 mcg/ml which of the following actions should the nurse take? A. Administer half of the prescribed dosage at the clients next schedule dose B. tell the client that the medication seems to be effective C. advise the client to drink more water throughout the day D. continue to administer the medication as prescribed

D. continue to administer the medication as prescribed The nurse should identify the peak level of 7 mcg/ml for a tobramycin is within the expected reference range of 5 to 10 mcg/ml therefore the nurse should continue to administer the schedule of medication as prescribed

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 of the treatment is effective? A. Decrease blood glucose B. increase potassium C. increased prostaglandin synthesis D. decreased inflammation

D. decreased inflammation for a client who has Crohn's disease a decrease in inflammation of the Gastrointestinal lining of the clients large intestine is a therapeutic affective taking budesonide. budesonide as a glucocorticoid that works by suppressing the immune system glucocorticoids inhibit the actions of prostaglandins and Leukotrienes

A nurse is monitoring a client who is receiving lactulose for cirrhosis which of the following laboratory values related to this medication should indicate to the nurse that the treatment is effective? A. increased aspartate aminotransferase (AST ) B. decreased alanine aminotransferase (ALT) C. increased prothrombin time (PT) D. decreased serum ammonia

D. decreased serum ammonia the nurse should identify that lactulose is a laxative that can be used for chronic liver disorder such a cirrhosis lactulose improves the clients condition by decreasing ammonia levels through enhancing intestinal secretion of ammonia so that you can be eliminated from the body

A nurse is providing teaching to a newly licensed nurse about caring for a client who has a prescription for gemfibrozil the nurse should instruct the newly licensed nurse to monitor which of the following laboratory tests? A. Platelet count B. electrolyte levels C. thyroid function D. liver function

D. liver function Gemfibrozil reduces triglycerides by decreasing the livers uptake of fatty acids it can cause liver toxicity therefore the nurse should monitor the clients liver function

A nurse is assessing a client who has multi drug resistant tuberculosis and takes ethambutol the nurse should identify which of the following findings as an adverse effect of this medication? A. Motteling of the extremities B. orange red urine and bodily secretions C. yellowing of the sclera D. loss of the red green color discrimination

D. loss of the red green color discrimination Ethambutol is an antitubercular medication that impairs ribonucleic acid synthesis a common adverse reaction is the loss of red green color discrimination due to optic neuritis the nurse should notify the provider of this finding and expect to discontinue the medication

A nurse in an acute care facility is preparing a reconciled list of medications for a client who is being discharged home which of the following actions should the nurse take? A. Give the client a hand written medication list to take to the next care provider following discharge B. include a list of medications the client received during care at the facility C. inform the client that he can get a complete list of his medications from the provider who will care for him after discharge D. provide the client and the next care provider with a list of medications the client will take after discharge

D. provide the client and the next care provider with a list of medications the client will take after discharge the nurse should provide a reconciled medication list that includes any medications the provider prescribed at the time of discharge for the client to take after discharge the list should also include any other medications the client will be taking including over-the-counter medications and supplements if the client was taking other prescription medications before admission to the acute care facility and did not receive them during treatment in the facility a provider should confirm whether the client should resume taking them after discharge

The nurse is providing teaching to a client who has cirrhosis and a new prescription for lactulose the nurse should instruct the client that lactulose has which of the following therapeutic effects? A. Increases blood pressure B. prevents esophageal bleeding C. decreases heart rate D. reduces ammonia levels

D. reduces ammonia levels 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 teaching a client who has type two 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 files in the refrigerator

D. store the files 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 to the printed expiration date

A nurse administering subcutaneous epinephrine for a client who is experiencing anaphylaxis the nurse should monitor the client for which of the following adverse effects? A. Hypotension B. Hyperthermia C. hypoglycemia D. tachycardia

D. tachycardia adverse effects of epinephrine and adrenergic agonist can include tachycardia and dysrhythmias due to cardiac stimulation

A nurse is providing teaching to a client who has a new prescription for a hydrochlorothiazide 50 MGPO daily to treat hypertension which of the following instructions should the nurse include in the teaching? A. Take hydrochlorothiazide as needed for edema B. Check your weight once each week C. take hydrochlorothiazide on an empty stomach D. take hydrochlorothiazide in the morning

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

A nurse is teaching a client who is taking level thyroxine for hypothyroidism about a new prescription for a calcium supplement which of the following pieces of information should the nurse include in the teaching? A. The calcium supplement will enhance the effect of the levothyroxine B. the calcium supplement will accelerate the metabolism of the levothyroxine C. take the medications together at 1700 for the greatest effect D. take the calcium supplement 4 hours after taking the levothyroxine thyroxine

D. take the calcium supplement 4 hours after taking the levothyroxine thyroxine Levothyroxine should be taken in the morning on an empty stomach and the calcium supplement should be taken at least four hours later food or supplements containing iron magnesium or zinc also bind to levothyroxine and prevent complete absorption of the medication

A nurse is assessing a client who is receiving clozapine to treat schizophrenia the nurse should identify an increase in which of the following parameters as an early indication of an adverse affect of this medication? A. Urine specific gravity B. Urine output C. blood pressure D. temperature

D. temperature Mom antipsychotic medications such as clozapine can cause agranulocytosis which is the depletion of white blood cells this increases their clients risk of infection a fever is an early indication to check the clients white blood cell count to detect agranulocytosis

A nurse is teaching a client who has a new prescription for phenytoin the nurse should inform the client that which of the following adverse effects can occur with the abrupt withdrawal of phenytoin? A. Status epilepticus B. bleeding gums C. disorientation D. severe nausea

A. Status epilepticus The nurse should instruct the client that abruptly discontinuing phenytoin can cause status epilepticus

A nurse in a providers office is assessing a client who reports taking a dietary supplement to reduce hot flashes related to menopause which of the following supplements should the nurse expect the client to report taking? A. Flaxseed B. ginkgo biloba C. black cohosh D. St. John's wort

C. black cohosh black cohosh is an herb that is used for the treatment of menopausal symptoms such as hot flashes vagina dryness irritability and sleep disturbance

A nurse in a long-term care facility is administering medications to a group of older adult clients which of the following factors of pharmacokinetics should the nurse consider when caring for this age group? A. The excretion of medication is reduced B. the percentage of medication absorbed is increased C. The liver metabolizes medication more quickly D. the rate at which the liver metabolizes medication declines with age

A. The excretion of medication is reduced

A nurse is preparing to administer benztropine 8 mg PO daily and 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 round to the nearest whole number

2 tablets

A nurse is preparing to administer furosemide 4 MG/KG/day PO divided into 2 equal doses daily to a toddler who weighs 22 pounds how many MG should the nurse administered per dose? round to the nearest whole number

20

A nurse is preparing to administer 150 units per hour of regular insulin to a client. regular insulin is available at 1500 units in 0.9% sodium chloride 500 ML the nurse should set the IV pump to deliver how many ml/hr? (Fill in the blank with the numeric value only round to the nearest whole number and use a leading zero if applicable do not use a trailing zero)

50 Follow these steps for the ratio and proportion method of calculation step one: what is the unit of measurement the nurse should calculate? ml/hr step two: what is the does the nurse should administer? 150 units step three: what is the dose available? 1500 units step four: should the nurse convert the units of measurement? No step five: what is the quantity of the dose available? 500 ml step six: set up an equation and solve for X have/quantity = desired/X 1500 units/500 ml = 150 units/ X ml X=50 ml Step seven: round if necessary step eight: reassess to determine whether the amount you get makes sense if there are 1500 units/500 ml and the amount prescribed is 150 units/hr the nurse should set the IV pump to deliver 50 ml/hr

A nurse is caring for a client who has a prescription for an oral contraceptive to prevent pregnancy the nurse should identify that which of the following actions is the purpose of this medication? A. Inhibition of ovulation B. thinning of the endometrial lining C. inhibition of luteinizing hormone D. thinning of cervical mucus

A. Inhibition of ovulation the nurse should identify that this medication inhibits ovulation to prevent pregnancy

A nurse is providing teaching to a client who has a new prescription for fentanyl transdermal patch which of the following statements by the client indicates an understanding of the teaching? A. The patch would not cause constipation like other pain medications do B. I will have to stop drinking grapefruit juice while using the patch C. I will place a heating pad over the patch to boost it's effectiveness D. the patch will give me a relief for my pain faster than pills can

B. I will have to stop drinking grapefruit juice while using the patch The nurse should instruct the client to avoid drinking grapefruit juice while using the fentanyl transdermal patch grapefruit juice can increase the absorption of the medication raising the amount of fentanyl in the clients blood does affect can place the client at risk for CNS and respiratory depression