ATI practice

A community health nurse visits a client at home. Prednisone 10 mg orally daily has been prescribed for the client and the nurse reinforces teaching for the client about the medication. Which statement, if made by the client, indicates that further teaching is necessary? 1. "I can take aspirin or my antihistamine if I need it." 2."I need to take the medication every day at the same time." 3."I need to avoid coffee, tea, cola, and chocolate in my diet." 4."If I gain more than 5 pounds a week, I will call my doctor."

. "I can take aspirin or my antihistamine if I need it."

The clinic nurse is performing an admission assessment on a client. The nurse notes that the client is taking azelaic acid (Azelex). Because of the medication prescription, the nurse would suspect that the client is being treated for: 1. Acne 2.Eczema 3.Hair loss 4.Herpes simplex

. Acne

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

. Prednisone

Cinoxacin (Cinobac), a urinary antiseptic, is prescribed for the client. The nurse reviews the client's medical record and should contact the health care provider (HCP) regarding which documented finding to verify the prescription? Refer to chart. 1. Renal insufficiency 2.Chest x-ray: normal 3.Blood glucose, 102 mg/dL 4.Folic acid (vitamin B6) 0.5 mg, orally daily

. Renal insufficiency

A nurse is reinforcing teaching for a client regarding how to mix regula insulin and NPH insulin in the same syringe. Which of the following actions, performed by the client, indicates the need for further teaching? 1. Withdraws the NPH insulin first 2.Withdraws the regular insulin first 3.Injects air into NPH insulin vial first 4.Injects an amount of air equal to the desired dose of insulin into the vial

. Withdraws the NPH insulin first

The nurse is applying a topical corticosteroid to a client with eczema. The nurse would monitor for the potential for increased systemic absorption of the medication if the medication were being applied to which of the following body areas? 1. Back 2.Axilla 3. Soles of the feet 4. Palms of the hands

.Axilla

The client with metastatic breast cancer is receiving tamoxifen. The nurs specifically monitors which laboratory value while the client is taking this medication? 1. Glucose level 2.Calcium level 3.Potassium level 4. Prothrombin time

.Calcium level

The client with acquired immunodeficiency syndrome has begun therapy with zidovudine (Retrovir, Azidothymidine, AZT, ZDV). The nurse carefully monitors which of the following laboratory results during treatment with this medication? 1. Blood culture 2.Blood glucose level 3.Blood urea nitrogen 4.Complete blood count

.Complete blood count

The burn client is receiving treatments of topical mafenide acetate (Sulfamylon) to the site of injury. The nurse monitors the client, knowing that which of the following indicates that a systemic effect has occurred? 1.Hyperventilation 2.Elevated blood pressure 3.Local pain at the burn site 4.Local rash at the burn site

.Hyperventilation

The client with ovarian cancer is being treated with vincristine (Oncovin). The nurse monitors the client, knowing that which of the following indicates a side effect specific to this medication? 1. Diarrhea 2.Hair loss 3.Chest pain 4.Numbness and tingling in the fingers and toes

.Numbness and tingling in the fingers and toes

the nurse provides medication instructions to an older hypertensive client who is taking 20 mg of lisinopril (Prinivil, Zestril) orally daily. The nurse evaluates the need for further teaching when the client states which of the following? 1. "I can skip a dose once a week." 2."I need to change my position slowly." 3. "I take the pill after breakfast each day." 4. "If I get a bad headache, I should call my doctor immediately.

1. "I can skip a dose once a week."

Phenytoin (Dilantin), 100 mg orally three times daily, has been prescribed for a client for seizure control. The nurse reinforces instructions regarding the medication to the client. Which statement by the client indicates an understanding of the instructions? 1. "I will use a soft toothbrush to brush my teeth." 2."It's all right to break the capsules to make it easier for me to swallow them." 3. "If I forget to take my medication, I can wait until the next dose and eliminate that dose." 4. "If my throat becomes sore, it's a normal effect of the medication and it's nothing to be concerned about

1. "I will use a soft toothbrush to brush my teeth."

A client received 20 units of NPH insulin subcutaneously at 8 AM. The nurse should check the client for a potential hypoglyce reaction at what time? 1. 5:00 PM 2. 10:00 AM 3. 11:00 AM 4. 11:00 PM

1. 5:00 PM

A nurse has a prescription to give a client albuterol (Proventil HFA) (two puffs) and beclomethasone dipropionate (Qvar) (nasal inhalation, two puffs), by metered- dose inhaler. The nurse administers the medication by giving the: 1. Albuterol first and then the beclomethasone dipropionate 2.Beclomethasone dipropionate first and then the albuterol 3. Alternating a single puff of each, beginning with the albuterol 4. Alternating a single puff of each, beginning with the beclomethasone dipropionate

1. Albuterol first and then the beclomethasone dipropionate

Glimepiride (Amaryl) is prescribed for a client with diabetes mellitus. A nurse reinforces instructions for the client and tells the client to avoid which of the following while taking this medication? 1. Alcohol 2.Organ meats 3. Whole-grain cereals 4. Carbonated beverages

1. Alcohol

A health care provider has written a prescription for ranitidine (Zantac), once daily. The nurse should schedule the medication for which of the following times? 1. At bedtime 2.After lunch 3. With supper 4. Before breakfast

1. At bedtime

aquinavir (Invirase) is prescribed for the client who is human immunodeficiency virus seropositive. The nurse reinforces medicatio instructions and tells the client to: 1. Avoid sun exposure. 2.Eat low-calorie foods. 3. Eat foods that are low in fat. 4. Take the medication on an empty stomach.

1. Avoid sun exposure.

Desmopressin acetate (DDAVP) is prescribed for the treatment of diabetes insipidus.The nurse monitors the client after medication administration for which therapeutic response? 1. Decreased urinary output 2.Decreased blood pressure 3.Decreased peripheral edema 4.Decreased blood glucose level

1. Decreased urinary output

A nurse is collecting data from a client and the client's spouse reports that the client is taking donepezil hydrochloride (Aricept). Which disorder would the nurse suspect that this client may have based on the use of this medication? 1. Dementia 2.Schizophrenia 3.Seizure disorder 4.Obsessive-compulsive disorder

1. Dementia

The home health care nurse is visiting a client who was recently diagnosed with type 2 diabetes mellitus. The client is prescribed repaglinide (Prandin) and metformin (Glucophage) and asks the nurse to explain these medications. The nurse should reinforce which instructions the client? Select all that apply. 1. Diarrhea can occur secondary to the metformin. 2.The repaglinide is not taken if a meal is skipped. 3.The repaglinide is taken 30 minutes before eating. 4.Candy or another simple sugar is carried and used to treat mild hypoglycemia episodes. 5.Metformin increases hepatic glucose production to prevent hypoglycemi associated with repaglinide. 6.Muscle pain is an expected side effect of metformin and may be treate with acetaminophen (Tylenol).

1. Diarrhea can occur secondary to the metformin. 2.The repaglinide is not taken if a meal is skipped. 3.The repaglinide is taken 30 minutes before eating. 4.Candy or another simple sugar is carried and used to treat mild hypoglycemia episodes

A nurse administers a dose of scopolamine (Transderm-Scop) to a postoperative client. The nurse tells the client to expect which of following side effects of this medication? 1. Dry mouth 2.Diaphoresis 3.Excessive urination 4.Pupillary constriction

1. Dry mouth

A hospitalized client is started on phenelzine sulfate (Nardil) for the treatment of depression. The nurse instructs the client to avoid consuming which foods while taking this medication? Select all that apply. 1. Figs 2.Yogurt 3.Crackers 4. Aged cheese 5Tossed salad 6. Oatmeal cookies

1. Figs 2. Yogurt 4. Aged cheese

The client who is human immunodeficiency virus seropositive has been taking stavudine (d4t, Zerit). The nurse monitors which the following most closely while the client is taking this medication 1. Gait 2.Appetite 3. Level of consciousness 4. Hemoglobin and hematocrit blood levels

1. Gait

A histamine (H2)-receptor antagonist will be prescribed for a client. The nurse understands that which medications are H2-receptor antagonists? Select all that apply. 1. Nizatidine (Axid) 2.Ranitidine (Zantac) 3.Famotidine (Pepcid) 4. Cimetidine (Tagamet) 5.Esomeprazole (Nexium) 6.Lansoprazole (Prevacid)

1. Nizatidine (Axid) 2.Ranitidine (Zantac) 3.Famotidine (Pepcid) 4. Cimetidine (Tagamet)

client taking buspirone (BuSpar) for 1 month returns to the clinic for a follow-up visit. Which of the following would indicate medication effectiveness? 1. No rapid heartbeats or anxiety 2.No paranoid thought processes 3. No thought broadcasting or delusions 4. No reports of alcohol withdrawal symptoms

1. No rapid heartbeats or anxiety

A nurse is caring for a client who is receiving an intravenous (IV) infusion of an antineoplastic medication. Duri the infusion, the client complains of pain at the insertion site. During an inspection of the site, the nurse notes redness and swelling and that the rate of infusion of the medication has slowed. The nurse should take which appropriate action? 1. Notify the registered nurse. 2. Administer pain medication to reduce the discomfort. 3.Apply ice and maintain the infusion rate, as prescribed. 4.Elevate the extremity of the IV site, and slow the infusion.

1. Notify the registered nurse.

The nurse is reviewing the history and physical examination of a client who will be receiving asparaginase (Elspar), an antineoplastic agent. The nurse consults with the registered nurse regarding the administration of the medication if which of the following is document in the client's history? 1. Pancreatitis 2.Diabetes mellitus 3.Myocardial infarction 4.Chronic obstructive pulmonary disease

1. Pancreatitis

A client with human immunodeficiency virus is taking nevirapine (Viramune). The nurse should monitor for which adverse effects of the medication? Select all that apply. 1. Rash 2.Hepatotoxicity 3.Hyperglycemia 4. Peripheral neuropathy 5.Reduced bone mineral density

1. Rash 2.Hepatotoxicity

A nurse is reviewing the record of a client who has been prescribed baclofen (Lioresal). Which of the following disorders, if noted in the client's history, would alert the nurse to contact the health care provider? 1. Seizure disorders 2.Hyperthyroidism 3.Diabetes mellitus 4.Coronary artery disease

1. Seizure disorders

Rifabutin (Mycobutin) is prescribed for a client with active Mycobacterium avium complex (MAC) disease and tuberculosis. The nurse monitors for which side effects of the medication? Select all that apply. 1. Signs of hepatitis 2.Flu-like syndrome 3.Low neutrophil count 4. Vitamin B6 deficiency 5.Ocular pain or blurred vision 6.Tingling and numbness of the fingers

1. Signs of hepatitis 2.Flu-like syndrome 3.Low neutrophil count 5.Ocular pain or blurred vision

In monitoring a client's response to disease- modifying antirheumatic drugs (DMARDs), which findings would the nurse interpret as acceptable responses? Select all that apply. 1. Symptom control during periods of emotional stress 2.Normal white blood cell counts, platelet, and neutrophil counts 3. Radiological findings that show non-progression of joint degeneration 4. An increased range of motion in the affected joints 3 months into therapy 5. Inflammation and irritation at the injection site 3 days after injection is given 6.A low-grade temperature upon rising in the morning that remains throughout the day

1. Symptom control during periods of emotional stress 2.Normal white blood cell counts, platelet, and neutrophil counts 3. Radiological findings that show non-progression of joint degeneration 4. An increased range of motion in the affected joints 3 months into therapy

Salicylic acid is prescribed for a client with a diagnosis of psoriasis. The nurse monitors the client, knowing that which of the following would indicate the presence of systemic toxicity from this medication? 1. Tinnitus 2.Diarrhea 3.Constipation 4.Decreased respirations

1. Tinnitus

A nurse is assisting with caring for a client with cancer who is receiving cisplatin. Select the adverse effects that the nurse monitors for that are associated with this medication. Select all that apply. 1. Tinnitus 2.Ototoxicity 3.Hyperkalemia 4. Hypercalcemia 5.Nephrotoxicity 6.Hypomagnesemia

1. Tinnitus 2.Ototoxicity 5.Nephrotoxicity 6.Hypomagnesemia

A client taking lithium carbonate (Lithobid) reports vomiting, abdominal pain, diarrhea, blurred vision, tinnitus and tremors. The lithium level is checked as a part of the routine follow-up and the level is 3.0 mEq/L. The nurse knows that this level is: 1. Toxic 2.Normal 3. Slightly above normal 4. Excessively below normal

1. Toxic

A client with severe acne is seen in the clinic and the health care provider (HCP) prescribes isotretinoin. The nurse reviews the client's medication record and would contact the (HCP) if the client is taking which medication? 1. Vitamin A 2.Digoxin (Lanoxin) 3.Furosemide (Lasix) 4.Phenytoin (Dilantin)

1. Vitamin A

Ibuprofen (Advil) is prescribed for a client. The nurse tells the clie to take the medication: 1. With 8 oz of milk 2.In the morning after arising 3.60 minutes before breakfast 4. At bedtime on an empty stomach

1. With 8 oz of milk

Cyclobenzaprine (Flexeril) is prescribed for a client to treat muscle spasms, and the nurse is reviewing the client's record. Which of the following disorders, if noted in the client's record, would indicate a need to contact the health care provider regarding the administration of this medication? 1. glaucoma 2.Emphysema 3.Hyperthyroidism 4.Diabetes mellitus

1. glaucoma

A nurse is reinforcing discharge instructions to a client receiving baclofen (Lioresal). Which of the following would the nurse include in the instructions? 1. Restrict fluid intake. 2. Avoid the use of alcohol. 3.Stop the medication if diarrhea occurs. 4. Notify the health care

2. Avoid the use of alcohol.

The nurse is reinforcing medication instructions to a client with breast cancer who is receiving cyclophosphamide (Neosar). The nurse tell the client to: 1. Take the medication with food. 2. Increase fluid intake to 2000 to 3000 mL daily. 3.Decrease sodium intake while taking the medication. 4.Increase potassium intake while taking the medication.

2. Increase fluid intake to 2000 to 3000 mL daily.

Ketoconazole is prescribed for a client with a diagnosis of candidiasis. Select the interventions that the nurse includes when administering this medication. Select all that apply. 1. Restrict fluid intake. 2.Instruct the client to avoid alcohol. 3.Monitor hepatic and liver function studies. 4. Administer the medication with an antacid. 5.Instruct the client to avoid exposure to the sun. 6.Administer the medication on an empty stomach.

2. Instruct the client to avoid alcohol. 3. Monitor hepatic and liver function studies. 5. Instruct the client to avoid exposure to thesun.

A nurse is monitoring a client who is taking propranolol (Inderal LA). Which data collection finding would indicate a potential serious complication associated with propranolol? 1. The development of complaints of insomnia 2. The development of audible wheezes 3.A baseline blood pressure of 150/80 mm Hg followed by a blood pressure of 138/72 mm Hg after two doses of the medication 4.A baseline resting heart rate of 88 beats/min followed by a resting heart rate of 72 beats/min after two doses of the medication

2. The development of audible wheezes

A client with coronary artery disease complains of substernal chest pain. After checking the client's heart rate and blood pressure, a nurse administers nitroglycerin, 0.4 mg, sublingually. After 5 minutes, the client states, "My chest still hurts." Select the appropriate actions that the nurse should take. Select all that apply. 1. Call a code blue. 2.Contact the registered nurse. 3.Contact the client's family. 4.Assess the client's pain level. 5.Check the client's blood pressure. 6.Administer a second nitroglycerin,0.4 mg, sublingually.

2. contact the registered nurse 4.Assess the client's pain level. 5.Check the client's blood pressure. 6.Administer a second nitroglycerin,0.4 mg, sublingually.

A client who is receiving digoxin (Lanoxin) daily has a serum potassium level of 3.0 mEq/L and is complaining of anorexia. A health care provider prescribes a digoxin level to rule out digoxin toxicity. A nurse checks the results, knowing that which of the following is the therapeutic serum level (range) for digoxin? 1. 3 to 5 ng/mL 2.0.5 to 2ng/mL 3. 1.2 to 2.8 ng/mL 4. 3.5 to 5.5 ng/mL

2.0.5 to 2ng/mL

A client is taking phenytoin (Dilantin) for seizure control and a sample for a serum drug level is drawn. Which of the following indicates therapeutic serum drug range? 1. 5 to 10 mcg/mL 2.10 to 20 mcg/mL 3.20 to 30 mcg/mL 4.30 to 40 mcg/mL

2.10 to 20 mcg/mL

client is taking Humulin NPH insulin daily every morning The nurse reinforces instructions for the client and tells the client that the most likely time for a hypoglycemic reaction to occur is: 1. 2 to 4 hours after administration 2.4 to 12 hours after administration 3.16 to 18 hours after administration 4.18 to 24 hours after administration

2.4 to 12 hours after administration

Nalidixic acid (NegGram) is prescribed for a client with a urinary tract infection. On review of the client's record, the nurse notes that the client is taking warfarin sodium (Coumadin) daily. Which prescription should the nurse anticipate for this client? 1. Discontinuation of warfarin sodium (Coumadin) 2.A decrease in the warfarin sodium (Coumadin) dosage 3.An increase in the warfarin sodium (Coumadin) dosage 4.A decrease in the usual dose of nalidixic acid (NegGram)

2.A decrease in the warfarin sodium (Coumadin) dosage

A client with myasthenia gravis is receiving pyridostigmine (Mestinon). The nurse monitors for signs a symptoms of cholinergic crisis caused by overdose of the medication. The nurse checks the medication supply to ensure that which medication is available for administration if a cholinergic crisis occurs? 1. Vitamin K 2.Atropine sulfate 3.Protamine sulfate 4.Acetylcysteine (Mucomyst)

2.Atropine sulfate

A nurse is planning to administer amlodipine (Norvasc) to a client. nurse plans to check which of the following before giving the medication? 1. Respiratory rate 2.Blood pressure and heart rate 3.Heart rate and respiratory rate 4. Level of consciousness and blood pressure

2.Blood pressure and heart rate

A client with Crohn's disease is scheduled to receive an infusion of infliximab (Remicade). The nurse assisting in caring for the client should take which action to monitor the effectiveness of treatment? 1. Monitoring the leukocyte count for 2 days after the infusion 2.Checking the frequency and consistency of bowel movements 3. Checking serum liver enzyme levels before and after the infusion 4. Carrying out a Hematest on gastric fluids after the infusion is completed

2.Checking the frequency and consistency of bowel movements

A client has begun therapy with theophylline (Theo-24). The nurse tells the client to limit the intake of which of the following while taking this medication? 1. Oranges and pineapple 2.Coffee, cola, and chocolate 3.Oysters, lobster, and shrimp 4. Cottage cheese, cream cheese, and dairy creamers

2.Coffee, cola, and chocolate

A nurse is monitoring a client receiving desmopressin acetate (DDAVP) for adverse effects to the medication. Which of the following indicates the presence of an adverse effect? 1. Insomnia 2.Drowsiness 3.Weight loss 4.Increased urination

2.Drowsiness

A nurse is performing a follow-up teaching session with a client discharged 1 month ago who is taking fluoxetine (Prozac). What information would be important for the nurse to gather regarding the adverse effects related to the medication? 1. Cardiovascular symptoms 2.Gastrointestinal dysfunctions 3. Problems with mouth dryness 4. Problems with excessive sweating

2.Gastrointestinal dysfunctions

A nurse performs an admission assessment on a client who visits a health care clinic for the first time. The client tells the nurse that propylthiouracil (PTU) is taken daily. The nurse continues to collect data from the client, suspecting that the client has a history of: 1. Myxedema 2.Graves' disease 3.Addison's disease 4.Cushing's syndrom

2.Graves' disease

The client has been taking omeprazole (Prilosec) f 4 weeks. The ambulatory care nurse evaluates that the client is receiving optimal intended effect of the medication if the client reports the absence of which symptom? 1. Diarrhea 2.Heartburn 3.Flatulence 4. Constipation

2.Heartburn

A nurse is reviewing the laboratory studies on a client receiving dantrolene sodium (Dantrium). Which laboratory test would identify an adverse effect associated with the administration of this medication? 1. Creatinine 2.Liver function tests 3.Blood urea nitrogen 4.Hematological function tests

2.Liver function tests

A nurse is reinforcing discharge instructions to a client receiving sulfisoxazole. Which of the following should be included in the list of instructions? 1. Restrict fluid intake. 2.Maintain a high fluid intake. 3. If the urine turns dark brown, call the health care provider (HCP) immediately. 4. Decrease the dosage when symptoms are improving to prevent an allergic response.

2.Maintain a high fluid intake.

A client has been taking isoniazid (INH) for 2 months. The client complains to a nurse about numbness, paresthesias, and tingling in the extremities. The nurse interprets that the client is experiencing: 1. Hypercalcemia 2.Peripheral neuritis 3.Small blood vessel spasm 4.Impaired peripheral circulation

2.Peripheral neuritis

A nurse has given a client taking ethambutol (Myambutol) information about the medication. The nurse determines that the client understands the instructions if the client states that he or she will immediately report: 1. Impaired sense of hearing 2.Problems with visual acuity 3.Gastrointestinal (GI) side effects 4.Orange-red discoloration of body secretions

2.Problems with visual acuity

A home care nurse visits a client recently diagnosed with diabetes mellitus who is taking Humulin NPH insulin daily. The client asks the nurse how to store the unopened vials of insulin. The nurse tells the client to: 1. Freeze the insulin. 2.Refrigerate the insulin .3. Store the insulin in a dark, dry place. 4. Keep the insulin at room temperature.

2.Refrigerate the insulin

The client who chronically uses nonsteroidal anti- inflammatory drugs has been taking misoprostol (Cytotec). The nurse determines that the medication is having the intended therapeutic effect if which of the following is noted? 1. Resolved diarrhea 2.Relief of epigastric pain 3. Decreased platelet count 4. Decreased white blood cell count

2.Relief of epigastric pain

A client is to begin a 6- month course of therapy with isoniazid (INH). A nurse plans to teach the client to: 1. Drink alcohol in small amounts only .2.Report yellow eyes or skin immediately. 3.Increase intake of Swiss or aged cheeses. 4. Avoid vitamin supplements during therapy.

2.Report yellow eyes or skin immediately.

A client who has been newly diagnosed with diabetes mellitus has been stabilized with daily insulin injections. Which information should the nurse teach when carrying out plans for discharge? 1. Keep insulin vials refrigerated at all times. 2.Rotate the insulin injection sites systematically. 3.Increase the amount of insulin before unusual exercise. 4.Monitor the urine acetone level to determine the insulin dosage

2.Rotate the insulin injection sites systematically.

A postoperative client requests medication for flatulence (ga pains). Which medication from the following PRN list should the nur administer to this client? 1. Ondansetron (Zofran) 2.Simethicone (Mylicon) 3.Acetaminophen (Tylenol) 4. Magnesium hydroxide (milk of magnesia, MOM)

2.Simethicone (Mylicon)

A client has a prescription to take guaifenesin (Humibid) every hours, as needed. The nurse determines that the client understand the most effective use of this medication if the client states that he or she will: 1. Watch for irritability as a side effect. 2.Take the tablet with a full glass of water. 3.Take an extra dose if the cough is accompanied by fever. 4.Crush the sustained-release tablet if immediate relief is needed.

2.Take the tablet with a full glass of water.

The health care provider (HCP) prescribes exenatide (Byetta) for a client with type 1 diabetes mellitus who takes insulin. The nurse knows that which of the following is the appropriate intervention? 1. The medication is administered within 60 minutes before the morning and evening meal. 2.The medication is withheld and the HCP is called to question the prescription for the client. 3. The client is monitored for gastrointestinal side effects after administration of the medication. 4. The insulin is withdrawn from the Penlet into an insulin syringe to prepare for administration.

2.The medication is withheld and the HCP is called to question the prescription for the client.

The client has been on treatment for rheumatoid arthritis for 3 weeks During the administration of etanercept (Enbrel), it is most important for the nurse to check: 1. The injection site for itching and edema 2.The white blood cell counts and platelet counts 3.Whether the client is experiencing fatigue and joint pain 4.A metallic taste in the mouth, with a loss of appetite

2.The white blood cell counts and platelet counts

cycloserine (Seromycin) is added to the medication regimen for a client with tuberculosis. Which of the following would the nurse include in the client- teaching plan regarding this medication? 1. To take the medication before meals 2.To return to the clinic weekly for serum drug-level testing 3.It is not necessary to call the health care provider (HCP) if a skin rash occur 4. It is not necessary to restrict alcohol intake with this medication.

2.To return to the clinic weekly for serum drug-level testing

A nurse reinforces medication instructions to a client who is taking levothyroxine (Synthroid). The nurse instruc the client to notify the health care provider (HCP) if which the following occurs? 1. Fatigue 2.Tremors 3. Cold intolerance 4. Excessively dry skin

2.Tremors

A client is receiving meperidine hydrochloride (Demerol) for pain. Which of the following are side effects of this medication. Select all that apply. 1. Diarrhea 2.Tremors 3.Drowsiness 4. Hypotension

2.Tremors 3.Drowsiness 4. Hypotension

Isotretinoin is prescribed for a client with severe acne. Before the administration of this medication, the nurse anticipates that which laboratory test will be prescribed? 1. Platelet count 2.Triglyceride level 3.Complete blood count 4.White blood cell count

2.Triglyceride level

The client with acute myelocytic leukemia is being treated with busulfan (Myleran). Which laboratory value would the nurse specifically monitor during treatment with this medication? 1. Clotting time 2.Uric acid level 3.Potassium level 4.Blood glucose level

2.Uric acid level

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

2.Urinary strictures

An older client recently has been taking cimetidine (Tagamet). The nurse monitors the client for which most frequent central nervous system side effect of this medication? 1 . T r e m o r s 2 . Dizziness 3 . C o n f u s i o n 4. Hallucinations

3 . C o n f u s i o n

Prednisone is prescribed for a client with diabetes mellitus who is taking Humulin neutral protamine Hagedorn (NPH) insulin daily. Which of the following prescription changes does the nurse anticipate during therapy with the prednisone? 1. An additional dose of prednisone daily 2.A decreased amount of daily Humulin NPH insulin 3. An increased amount of daily Humulin NPH insulin 4. The addition of an oral hypoglycemic medication daily

3. An increased amount of daily Humulin NPH insulin

A client has been started on long-term therapy with rifampin (Rifadin). A nurse teaches the client that the medication: 1. Should always be taken with food or antacids 2.Should be double-dosed if one dose is forgotten 3. Causes orange discoloration of sweat, tears, urine, and feces 4. May be discontinued independently if symptoms are gone in 3 months

3. Causes orange discoloration of sweat, tears, urine, and feces

A daily dose of prednisone is prescribed for a client. A nurse reinforces instructions to the client regarding administration of the medication and instructs the client that the best time to take this medication is: 1. At noon 2.At bedtime 3. Early morning 4. Anytime, at the same time, each day

3. Early morning

The nurse is analyzing the laboratory results of a client with leukemia who has received a regimen of chemotherapy. Which laboratory value would the nurse specifically note as a result of the massive cell destruction that occurred from the chemotherapy? 1. Anemia 2.Decreased platelets 3. Increased uric acid level 4. Decreased leukocyte count

3. Increased uric acid level

A nurse reinforces instructions to a client who is taking levothyroxine (Synthroid). The nurse tells the client to take the medication: 1. With food 2.At lunchtime 3. On an empty stomach 4. At bedtime with a snack

3. On an empty stomach

The client has begun medication therapy with pancrelipase (Pancrea MT). The nurse evaluates that the medication is having the optimal intended benefit if which effect is observed? 1. Weight loss 2.Relief of heartburn 3. Reduction of steatorrhea 4. Absence of abdominal pain

3. Reduction of steatorrhea

Isosorbide mononitrate (Imdur) is prescribed for a client with angina pectoris. The client tells the nurse that the medication is causing a chronic headache. The nurse appropriately suggests that the client: 1. Cut the dose in half. 2.Discontinue the medication. 3. Take the medication with food. 4. Contact the health care provider (HCP).

3. Take the medication with food.

Megestrol acetate (Megace), an antineoplastic medication, is prescribed for the client with metastatic endometrial carcinoma. The nurse reviews the client's history and contacts the registered nurse if which diagnosis is documented in the client's history? 1. Gout 2.Asthma 3. Thrombophlebitis 4. Myocardial infarction

3. Thrombophlebitis

A nurse is caring for a client after thyroidectomy and notes that calcium gluconate is prescribed for the client. The nurse determines that this medication has been prescribed to: 1. Treat thyroid storm. 2.Prevent cardiac irritability. 3. Treat hypocalcemic tetany. 4. Stimulate the release of parathyroid hormone.

3. Treat hypocalcemic tetany.

Sildenafil (Viagra) is prescribed to treat a client with erectile dysfunction. A nurse reviews the client's medical record and would question the prescription if which of the following is noted in the client's history? 1. Neuralgia 2.Insomnia 3. Use of nitroglycerin 4. Use of multivitamins

3. Use of nitroglycerin

A client with trigeminal neuralgia is being treated with carbamazepine (Tegretol). Which laboratory result would indicate that the client is experiencing an adverse reaction to the medication? 1. Sodium level, 140 mEq/L 2.Uric acid level, 5.0 mg/dL 3. White blood cell count, 3000 cells/mm3 4. Blood urea nitrogen (BUN) level, 15 mg/dL

3. White blood cell count, 3000 cells/mm3

A nurse is providing instructions to an adolescent who has a history of seizures and is taking an anticonvulsant medication. Which of the following statements indicates that the client understands the instructions? 1. "I will never be able to drive a car." 2."My anticonvulsant medication will clear up my skin." 3."I can't drink alcohol while I am taking my medication." 4. "If I forget my morning medication, I can take two pills at bedtime."

3."I can't drink alcohol while I am taking my medication."

Fluoxetine (Prozac) is prescribed for the client. The nurse reinforces instructions to the client regarding the administration of the medication. Which statement by the client indicates an understanding about administration of the medication? 1. "I should take the medication with my evening meal." 2."I should take the medication at noon with an antacid." 3."I should take themedication in the morning when I first arise." 4. "I should take the medication right before bedtime with a snack."

3."I should take themedication in the morning when I first arise."

The health care provider has prescribed silver sulfadiazine (Silvadene) for the client with a partial- thickness burn, which has cultured positive for gram- negative bacteria. The nurse is reinforcing information to the client about the medication. Which statement made by the client indicates a lack of understanding about the treatments? 1. "The medication is an antibacterial." 2."The medication will help heal the burn." 3."The medication will permanently stain my skin." 4."The medication should be applied directly to the wound."

3."The medication will permanently stain my skin."

A client with a peptic ulcer is diagnosed with a Helicobacter pylori infection. The nurse is reinforcing teaching for the client about the medications prescribe including clarithromycin (Biaxin), esomeprazole (Nexium), and amoxicillin (Amoxil). Which statement by the client indicates the best understanding of the medication regimen? 1. "My ulcer will heal because these medications will kill the bacteria." 2."These medications are only taken when I have pain from my ulcer." 3."The medications will kill the bacteria and stop the acid production." 4. "These medications will coat the ulcer and decrease the acid production in my stomach."

3."The medications will kill the bacteria and stop the acid production."

The nurse has reinforced instructions to a client who has been prescribed cholestyramine (Questran). Which statement by the client indicates a need for further instructions? 1. "I will continue taking vitamin supplements." 2."This medication will help lower my cholesterol." 3."This medication should only be taken with water." 4."A high-fiber diet is important while taking this medication."

3."This medication should only be taken with water."

A client is taking lansoprazole (Prevacid) for the chronic management of Zollinger- Ellison syndrome. The nurse advises the client to take which of the following products if needed for a headache? 1. Naprosyn (Aleve) 2.Ibuprofen (Advil) 3.Acetaminophen (Tylenol) 4.Acetylsalicylic acid (aspirin)

3.Acetaminophen (Tylenol)

A client receiving a tricyclic antidepressant arrives at the mental health clinic. Which observation indicates that the client is correctly following the medication plan? 1. Reports not going to work for this past week 2.Complains of not being able to "do anything" anymore 3.Arrives at the clinic neat and appropriate in appearance 4. Reports sleeping 12 hours per night and 3 to 4 hours during the day

3.Arrives at the clinic neat and appropriate in appearance

The nurse is caring for a postrenal transplant client taking cyclosporine (Sandimmune, Gengraf, Neoral). The nurse notes an increase in one of the client's vital signs, and the client is complaining of a headache. What is the vital sign that is most lik increased? 1. Pulse 2.Respirations 3.Blood pressure 4. Pulse oximetry

3.Blood pressure

A nurse who is administering bethanechol chloride (Urecholine) is monitoring for acute toxicity associated with the medication. The nurse checks the client for which sign of toxicity? 1. Dry skin 2.Dry mouth 3.Bradycardia 4.Signs of dehydration

3.Bradycardia

A nurse is caring for a client with hyperparathyroidism and notes that the client's serum calcium level is 13 mg/dL. Which medication should the nurse prepare to administer as prescribed to the client? 1. Calcium chloride 2.Calcium gluconate 3.Calcitonin (Miacalcin) 4.Large doses of vitamin D

3.Calcitonin (Miacalcin)

The clinic nurse is reviewing a teaching plan for the client receiving an antineoplastic medication. When implementing the plan, the nurse tells the client: 1. To take aspirin (acetylsalicylic acid) as needed for headache 2.Drink beverages containing alcohol in moderate amounts each evening 3.Consult with health care providers (HCPs) before receiving immunizations 4. That it is not necessary to consult HCPs before receiving a flu vaccine at the local health fair

3.Consult with health care providers (HCPs) before receiving immunizations

A nurse is monitoring a client receiving baclofen (Lioresal) for side effects related to the medication. Which of the following would indicate that the client is experiencing a side effect? 1. Polyuria 2.Diarrhea 3.Drowsiness 4.Muscular excitability

3.Drowsiness

After kidney transplantation, cyclosporine (Sand immune) is prescribed for a client. Which laboratory result would indicate an adverse effect from the use of this medication? 1. Decreased creatinine level 2.Decreased hemoglobin level 3.Elevated blood urea nitrogen level 4.Decreased white blood cell count

3.Elevated blood urea nitrogen level

Amikacin (Amikin) is prescribed for a client with a bacterial infection. The client is instructed to contact the health care provider (HCP) immediately if which of the following occurs? 1. Nausea 2.Lethargy 3.Hearing loss 4.Muscle aches

3.Hearing loss

A nurse is planning to administer hydrochlorothiazide (HydroDIURIL) to a client. The nurse understands that which of the following are concerns related to the administration of this medication? 1. Hypouricemia, hyperkalemia 2.Increased risk of osteoporosis 3.Hypokalemia, hyperglycemia,sulfa allergy 4.Hyperkalemia, hypoglycemia, penicillin allergy

3.Hypokalemia, hyperglycemia,sulfa allergy

A client who has begun taking fosinopril (Monopril) is very distressed, telling the nurse that he cannot taste food normally since beginning the medication 2 weeks ago. The nurse provides the best support to the client by: 1. Telling the client not to take the medication with food 2.Suggesting that the client taper the dose until taste returns to normal 3.Informing the client that impaired taste is expected and genera disappears in 2 to 3 months 4.Requesting that the health care provider (HCP) change the prescription to another brand of angiotensin-converting enzyme (ACE) inhibitor

3.Informing the client that impaired taste is expected and generally disappears in 2 to 3 months

Mafenide acetate (Sulfamylon) is prescribed for the client with a burn injury. When applying the medication, the client complains of local discomfort and burning. Which of the following is the most appropriate nursing action? 1. Notifying the registered nurse 2.Discontinuing the medication 3.Informing the client that this is normal 4.Applying a thinner film than prescribed to the burn site

3.Informing the client that this is normal

A client with tuberculosis is being started on antituberculosis therapy with isoniazid (INH). Before giving the client the first dose, a nurse ensures that which of the following baseline studies has been completed? 1. Electrolyte levels 2.Coagulation times 3.Liver enzyme levels 4.Serum creatinine level

3.Liver enzyme levels

A client is diagnosed with an acute myocardial infarction and is receiving tissue plasminogen activator, alteplase (Activase, tPA). Which action is a priority nursing intervention? 1.Monitor for renal failure. 2.Monitor psychosocial status. 3.Monitor for signs of bleeding. 4. Have heparin sodium available.

3.Monitor for signs of bleeding.

A nurse is reinforcing instructions for a client regarding intranasal desmopressin acetate (DDAVP). The nurse tells the client that which of the following is a side effect of the medication? 1. Headache 2.Vulval pain 3.Runny nose 4.Flushed skin

3.Runny nose

The nurse is reviewing the results of serum laboratory studies drawn on a client with acquired immunodeficiency syndrome who is receiving didanosine (Videx). The nurse interprets that the client may have the medication discontinued by the health care provider if which of the following significantly elevated results is noted? 1. Serum protein 2.Blood glucose 3.Serum amylase 4.Serum creatinine

3.Serum amylase

The nurse is assigned to care for a client with cytomegalovirus retinitis and acquired immunodeficiency syndrome who is receiving foscarnet. The nurse should check the latest results of which of the following laboratory studies while the client is taking this medication? 1. CD4 cell count 2.Serum albumin 3.Serum creatinine 4.Lymphocyte count

3.Serum creatinine

A postoperative client has received a dose of naloxone hydrochloride for respiratory depression shortly after transfer to the nursing unit from the postanesthesia care unit. After administration of the medication, the nurse checks the client for: 1. Pupillary changes 2.Scattered lung wheezes 3.Sudden increase in pain 4.Sudden episodes of diarrhea

3.Sudden increase in pain

A nurse is caring for a client who is taking phenytoin (Dilantin) for control of seizures. During data collection, the nurse notes that the client is taking birth control pills. Which of the following information should the nurse provide to the client? 1. Pregnancy should be avoided while taking phenytoin (Dilantin). 2.The client may stop taking the phenytoin (Dilantin) if it is causing severe gastrointestinal effects. 3.The potential for decreased effectiveness of the birth control pills exists while taking phenytoin (Dilantin). 4. The increased risk of thrombophlebitis exists while taking phenytoin (Dilantin) and birth control pills together.

3.The potential for decreased effectiveness of the birth control pills exists while taking phenytoin (Dilantin).

A nurse is caring for a hospitalized client who has been taking clozapine (Clozaril) for the treatment of a schizophrenic disorder. Which laboratory study prescribed for the client will the nurse specifically review to monitor for an adverse effect associated with the use of this medication? 1. Platelet count 2.Cholesterol level 3.White blood cell count 4.Blood urea nitrogen level

3.White blood cell count

Heparin sodium is prescribed for the client. The nurse expects that the health care provider will prescribe which of the following to monitor for a therapeutic effect of the medication? 1. Hematocrit level 2.Hemoglobin level 3.Prothrombin time (PT) 4. Activated partial thromboplastin time (aPTT)

4. Activated partial thromboplastin time (aPTT)

Tamoxifen is prescribed for the client with metastatic breast carcinoma. The nurse understands that the primary action of this medication is to: 1. Increase DNAand RNA synthesis. 2.Promote thebiosynthesis of nucleic acids. 3. Increase estrogen concentration andestrogen response. 4. Compete with estradiol for binding to estrogen in tissues containing high concentrations of receptors

4. Compete with estradiol for binding to estrogen in tissues containing high concentrations of receptors

A client with chronic renal failure is receiving ferrous sulfate (Feosol). The nurse monitors the client for which common side effect associated with this medication? 1. Diarrhea 2.Weakness 3.Headache 4. Constipation

4. Constipation

A nurse has given the client taking ethambutol (Myambutol) information about the medication. The nurse determines that the client understands the instructions if the client immediately reports: 1. Impaired sense of hearing 2.Distressing gastrointestinal side effects 3.Orange-red discoloration of body secretions 4. Difficulty discriminating the color red from green

4. Difficulty discriminating the color red from green

A client with myasthenia gravis is suspected of having cholinergic crisis. Which of the following indicate that this crisis exists? 1. Ataxia 2.Mouth sores 3.Hypotension 4. Hypertension

4. Hypertension

The client with a gastric ulcer has a prescription for sucralfate (Carafate), 1 g by mouth four times daily. The nurse schedules the medication for which times? 1. With meals and at bedtime 2.Every 6 hours around the clock 3. One hour after meals and at bedtime 4. One hour before meals and at bedtime

4. One hour before meals and at bedtime

The client with small cell lung cancer is being treated with etoposide (VePesid). The nurse who is assisting in caring for the client during its administration understands that which side effect is specifically associated with this medication? 1. Alopecia 2.Chest pain 3. Pulmonary fibrosis 4. Orthostatic hypotension

4. Orthostatic hypotension

The client with squamous cell carcinoma of the larynx is receiving bleomycin intravenously. The nurse caring for the client anticipates that which diagnostic study will be prescribed? 1. Echocardiography 2.Electrocardiography 3. Cervical radiography 4. Pulmonary function studies

4. Pulmonary function studies

Oxybutynin chloride (Ditropan XL) is prescribed for a client with neurogenic bladder. Which sign would indicate a possible toxic effect related to this medication? 1. Pallor 2.Drowsiness 3.Bradycardia 4. Restlessness

4. Restlessness

Phenazopyridine hydrochloride (Pyridium) is prescribed for a client for symptomatic relief of pain resulting from a lower urinary tract infection. The nurse reinforces to the client: 1.To take the medication at bedtime 2. To take the medication before meals 3.To discontinue the medication if a headache occurs 4. That a reddish orange discoloration of the urine may occur

4. That a reddish orange discoloration of the urine may occur

Disulfiram (Antabuse) is prescribed for a client who is seen in the psychiatric health care clinic. The nurse is collecting data on the client and is providing instructions regarding the use of this medication. Which is most important for the nurse to determine before administration of this medication? 1. A history of hyperthyroidism 2.A history of diabetes insipidus 3. When the last full meal was consumed 4. When the last alcoholic drink was consumed

4. When the last alcoholic drink was consumed

A nurse is caring for an older client with a diagnosis of myasthenia gravis and has reinforced self-care instructions. Which statement by the client indicates that further teaching is necessary? 1. "I rest each afternoon after my walk." 2."I cough and deep breathe many times during the day." 3."If I get abdominal cramps and diarrhea, I should call my doctor." 4."I can change the time of my medication on the mornings that I feel strong."

4."I can change the time of my medication on the mornings that I feel strong."

A nurse reinforces discharge instructions to a postoperative client who is taking warfarin sodium (Coumadin). Which statement, if made the client, reflects the need for further teaching? 1. "I will take my pills every day at the same time." 2."I will be certain to avoid alcohol consumption." 3. "I have already called my family to pick up a Medic-Alert bracelet." 4."I will take Ecotrin (enteric-coated aspirin) for my headaches because it is coated."

4."I will take Ecotrin (enteric-coated aspirin) for my headaches because it is coated."

A home health care nurse is visiting a client with elevated triglyceride levels and a serum cholesterol level of 398 mg/dL. The client is taking cholestyramine (Questran). Which of the following statements, if made by the client, indicates the need for further education? 1. "Constipation and bloating might be a problem." 2."I'll continue to watch my diet and reduce my fats." 3."Walking a mile each day will help the whole process." 4."I'll continue my nicotinic acid from the health food store."

4."I'll continue my nicotinic acid from the health food store."

client is on nicotinic acid (niacin) for hyperlipidemia and the nurse provides instructions to the client about the medication. Which statement by the client would indicate an understanding of the instructions? 1. "It is not necessary to avoid the use of alcohol." 2."The medication should be taken with meals to decrease flushing." 3."Clay-colored stools are a common side effect and should not be of concern." 4."Ibuprofen (Motrin) taken 30 minutes before the nicotinic acid should decrease the flushing."

4."Ibuprofen (Motrin) taken 30 minutes before the nicotinic acid should decrease the flushing."

A client with acute muscle spasms has been taking baclofen (Lioresal) The client calls the clinic nurse because of continuous feelings of weakness and fatigue and asks the nurse about discontinuing the medication. The nu should make which appropriate response to the client? 1. "You should never stop the medication." 2."It is best that you taper the dose if you intend to stop the medication." 3."It is okay to stop the medication if you think that you can tolerate th muscle spasms." 4."Weakness and fatigue commonly occur and will diminish with continued medication use."

4."Weakness and fatigue commonly occur and will diminish with continued medication use."

A client with myasthenia gravis becomes increasingly weak. The health care provider prepares to identify whether the client is reacting to an overdose of the medication (cholinergic crisis) or increasing severity of the disease (myasthenic crisis). An injection of edrophonium (Enlon) is administered. Which of the following indicates that the client is in cholinergic crisis? 1. No change in the condition 2.Complaints of muscle spasms 3.An improvement of the weakness 4.A temporary worsening of the condition

4.A temporary worsening of the condition

Carbidopa-levodopa (Sinemet) is prescribed for a client with Parkinson's disease, and the nurse monitors the client for adverse reactions to the medication. Which of the following indicates that the client is experiencing an adverse reaction? 1. Pruritus 2.Tachycardia 3.Hypertension 4.Impaired voluntary movements

4.Impaired voluntary movements

A client with diabetes mellitus who has been controlled wit daily insulin has been placed on atenolol (Tenormin) for the control of angina pectoris. Because of the effects of atenolol, the nurse determines that which of the following is the most reliable indica of hypoglycemia? 1. Sweating 2.Tachycardia 3.Nervousness 4.Low blood glucose level

4.Low blood glucose level

A client has just taken a dose of trimethobenzamide (Tigan). The nurse plans to monitor this client for relief of: 1. Heartburn 2.Constipation 3.Abdominal pain 4.Nausea and vomiting

4.Nausea and vomiting

The client has a PRN prescription for ondansetron (Zofran). For which condition should this medication be administered to the postoperative client? 1. Paralytic ileus 2.Incisional pain 3.Urinary retention 4.Nausea and vomiting

4.Nausea and vomiting

Oral iron supplements are prescribed for a 6-year-old child with iron deficiency anemia. The nurse instructs the mother to administer the iron with which best food item? 1. Milk 2.Water 3.Apple juice 4.Orange juice

4.Orange juice

A client is taking docusate sodium (Colace). The nurse monitors which of the following to determine whether the client is having a therapeutic effect from this medication? 1. Abdominal pain 2.Reduction in steatorrhea 3.Hematest-negative stools 4.Regular bowel movements

4.Regular bowel movements

Trimethoprim-sulfamethoxazole (TMP-SMZ) is prescribed for a client nurse should instruct the client to report which symptom if it developed during the course of this medication therapy? 1. Nausea 2.Diarrhea 3.Headache 4.Sore throat

4.Sore throat

A client is receiving acetylcysteine (Mucomyst), 20% solution diluted in 0.9% normal saline by nebulizer. The nurse should have which item available for possible use after giving this medication? 1. Ambu bag 2.Intubation tray 3.Nasogastric tube 4.Suction equipment

4.Suction equipment

The client with acquired immunodeficiency syndrome and Pneumocystis jiroveci infection has been receiving pentamidine isethionate (Pentam 300). The client develops a temperature of 101° F. The nurse does further monitoring of the client, knowing that this sign would most likely indicate: 1. The dose of the medication is too low. 2.The client is experiencing toxic effects of the medication. 3.The client has developed inadequacy of thermoregulation. 4.The result of another infection caused by leukopenic effects of the medication.

4.The result of another infection caused by leukopenic effects of the medication.

A client who is taking hydrochlorothiazide (HydroDIURIL, HCTZ) has been started on triamterene (Dyrenium) as well. The client asks the nurse why both medications are required. The nurse formulates a response, based on the understanding that: 1. Both are weak potassium-losing diuretics. 2. The combination of these medications prevents renal toxicity. 3. Hydrochlorothiazide is an expensive medication, so using a combination of diuretics is cost-effective 4.Triamterene is a potassium-sparing diuretic, whereas hydrochlorothiazide is a potassium-losing diuretic.

4.Triamterene is a potassium-sparing diuretic, whereas hydrochlorothiazide is a potassium-losing diuretic.

The client has a new prescription for metoclopramide (Reglan). On review of the chart, the nurse identifies that this medication can be safely administered with which condition? 1. Intestinal obstruction 2.Peptic ulcer with melena 3.Diverticulitis with perforation 4.Vomiting following cancer chemotherapy

4.Vomiting following cancer chemotherapy