ATI Study Guide Pharmocology
A nurse is preparing to administer amoxicillin 250 mg liquid suspension PO every 8 hours to an older adult client. The amount available is 50 mg/ml. How many mL should the nurse administer?
5
A nurse is teaching a female client about Vitamin A supplementation. Which of the following client statements indicates an understanding of the teaching?
A deficiency of vitamin A can cause night blindness. A nurse should identify that vitamin A is required for dark light adaption. When a client has a deficiency of vitamin A, night blindness is often then first sign. As deficiency continues, other eye conditions can arise such as a dry and thickened conjunctiva and degeneration of the cornea.
A nurse is reinforcing teaching with a newly licensed nurse about contraindications to vaccines. Which of the following examples should the nurse provide as a true contraindication for all vaccines?
A nurse should identify that a client who has a moderate or severe illness with OR without fever has a true contrindication to receiving a vaccine. The nurse should postpone the immunization.
A nurse is reviewing the lab data for a client who is receiving clozapine schizophrenia. The nurse should identify which of the following findings as a potential adverse effect of the medication
Absolute neutrophil count 1,200 mm^3 This is less than the expected reference range of 2,500 to 8,000 mm^3. An adverse effect of clozapine can include agranulocytosis, which is a life-threatening conditioning in which WBCs (including neutrophils) are severely decreased
A nurse is caring for a client who has peptic ulcer disease and reports a headache. Which of the following medications should the nurse plan to administer?
Acetaminophen This is an analgesic used for mild to moderate pain. It can be administered to a client who has a peptic ulcer disease because it does not affect blood coagulation and does not increase the risk of gastrointestinal bleeding.
A nurse is preparing a discharge teaching plan for a 6 year old client with asthma who has several prescription medications using metered dose inhalers. Which of the following interventions should the nurse include in the plan?
Add a spacer 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 preparing to administer iron dextran IV to client. Which of the following actions should the nurse plan to take.
Administer small test dose before giving the full dose A serious adverse effect of iron dextran is anaphylaxis caused by hypersensitivity to the medication. A small test dose 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 administering subcutaneous heparin to a client who is at rick for deep vein thrombosis. Which of the following actions should the nurse take.
Administer the medication into the client's abdomen
A nurse is administering a medication parenterally to a client. Which of the following techniques should the nurse use to reduce fluctuations in plasma medication levels?
Administering a continuous infusion of the dose By administering a medication by continuous unfustion, plasma levels stay nearly constant, thus reducing fluctuations in plasma levels.
A nurse is caring for a client who has a dry nonproductive cough. Which of the following types of medication should the nurse recommend?
Antitussive Suppresses the cough reflex
A nurse is preparing to administer nitroglycerin topical ointment for a client who has angina. Which of the following actions should the nurse take?
Apply ointment using a dose measuring applicator The nurse should use this because it allows the nurse to measure the correct dose the client should recieve
A nurse is teaching a client who is using topical lidocaine about preventing systemic toxicity. Which of the following pieces of information should the nurse include about the application of topical lidocaine?
Apply topical lidocaine to affect areas that are intact. This will prevent large amount of medication from being absorbed and to decrease risk of systemic toxicity.
A nurse is working in the emergency department is admitting a client who has gastric ulcer and gastrointestinal bleeding. Which of the following factors in the clients medical history should the nurse report to the provider?
Arthritis treated with ibuprofen every 8 hours as needed The nurse should identify that ibuprofen is nonsteroidal anti-inflammatory drug. NSAIDs can cause gastrointestinal bleeding and are contraindicated for clients who have ulcer disease. NSAIDs inhibit prostaglandin secretion, which decreases blood flow in the GI tract and decreases bicarbonate and mucus secretion. This environment promotes the secretion of gastric acid and needs to be reported to the provider.
A nurse is caring for a client who has a positive TB skin test and is beginning a prescription for isoniazid. Which of the following lab values should be monitored while the client is taking this medication
Aspartate aminotransferase (AST) Isoniazid can be toxic to the liver. Therefore, it is important to monitor liver enzymes such as AST during therapy. In addition, the nurse should instruct the client to notify the provider of jaundice, dark colored urine, and other findings indicating hepatitis.
A client is admitted with second degree burns on face, neck, anterior chest and hands. The nurses priority action would be:
Asses for dyspnea or stridor Due to the location of the burns, the client is at risk for developing upper airway edema and subsequent respiratory distress.
A nurse is caring for a client and realizes after administering the 0900 meds that she administered digoxin .25 mg PO to the client instead of the prescribed digoxin 0.125. Which of the following actions should the nurse take first?
Assess the client's apical pulse Caring for this client requires application of the nursing process priority-setting framework. The nurse can use the nursing process to plan client care and prioritize nursing actions. Each step of the nursing pocess builds on the previous step, beginning with assessment. Before the nurse can formulate a plan of action, implement a nursing intervention or notify a provider about change in the client's status, she must first collect adequate data from the client. An assessment will provide the nurse with the knowledge needed to make n appropriate decision.
A nurse is caring for a client who has multiple medication allergies. During which of the following steps of the nursing process should the nurse identify the client's allergies? Planning Evaluation Assessment Implementation
Assessment During this process the nurse collects pertinent data which includes the identification of the client's allergies
A nurse is providing teaching to a client who has hypertension and a new prescription for oral clonidine. Which of the following instructions should the nurse include in the teaching?
Avoid driving until the client's reaction to the medication is known. Clonidine can cause drowsiness, weakness, sedation and other CNS effects. Overtime symptoms will decrease
A nurse is caring for a female client in the ED who presented with a fractured ankle after falling down an escalator. A blood alcohol test is ordered and her BAC is .06. Which is true of the following statements is true?
BAC is influenced by gender and body weight in addition to the amount of alcohol by content consumed, gastric absorption rate and duration of time during which the drinks were ingested BAC is determined from measurement of alcohol in blood drawn by venipuncture which is more accurate than a feild test breathalyzer.
A nurse is providing discharge teaching to a client who has venous thrombosis and a prescription for warfarin. Which of the following instructions should the nurse include in the teaching?
Carry a medical alert ID card A client who is taking warfarin is at risk for increased risk for bleeding. In the case of an emergency, any medical personnel must be away of the client's medication history.
A nurse is preparing to administer an epinephrine IV bolus to a client. Which of the following should the nurse verify before initiating the IV medication?
Concentration of the formula The nurse should verify the concentration of the formulation of the medication prior to administration. Epinephrine can be injected through several routes and a solution prepared for use by a certain route can differ in concentration from others. Solutions intended for SubQ are generally really concentrated. Whereas solutions intended for IV use are dilute. If a solution prepared for subcutaneous administration is administered intravenously, the result could be fatal because intravenous administration of concentrated epinephrine can overstimulate the heart and blood vessels which cause severe hypertension, cerebral hemorrhage, stoke and death
A nurse is preparing to administer an IV fluid bolus of 1 L 0.9% sodium chloride over 2 hours to a patient who is dehydrated. The nurse shoudl set the IV pump to deliver how many mL/hr?
Convert 1 L to mL = 1000 Volume (mL)/time (hr) 1000/2=500 500mL/hr
A nurse is reviewing the medical record of a client who is requesting a prescription for sildenafil citrate. Which of the following data in the client's record should the nurse identify as a contraindication to the use of this medication?
Current use of isosorbide to treat heart failure Taking any nitrates such as isosorbide and nitroglycerin is contraindication for sildenafil, a medication that treats erectile dysfunction. Taking it concurrently with nitrates can cause life threatening hypotension
A nurse is caring for a client who has asthma and advanced rheumatoid arthritis and deformity of the hands. The nurse should anticipate that the client will receve which of the following medication delivery devices for the treatment of asthma?
DPI - Dry powdered inhaler which do not require hand-breath coordination and are easier to use for clients who have deformities of the hands.
A nurse is caring for a client who is taking budesonide to treat chrohns disease. Which of the following findings should indicate to the nurse that the treatment is effective?
Decrease in inflammation For a client who has Crohns disease, a decrease in inflammation of gastrointestinal lining of the client's large intestine is a therapeutic effect of taking budesonide. Budesonide is a gluccocorticoid that works by suppressing the immune system. Glucocorticoids inhibit the actions of prostaglandins and leukotrienes.
A nurse is caring for a client who has been taking metformin for 6 months. which of the following findings should the nurse identify as an expected TU effect of the medication
Decreased blood glucose levels A client who has taken metformin for 6 months should experience the expected TU effect of a decrease in blood glucose levels. Metformin is a non insulin medication for clients who have type 2 diabetes
A nurse is caring for a client who has been taking metformin for 6 months. Which of the following findings should the nurse identify as an expected therapeutic effect of the medication.
Decreased blood glucose levels A client who has taken metformin for 6 months should experience the expected TU effect of a decreased BG level. It is a non insulin medication for clients who have type 2 diabetes mellitus.
A nurse is monitoring a client who is receiving lactulose for cirrhosis. Which of the following lab values related to this medication should indicate to the nurse that the treatment is effective?
Decreased serum ammonia Lactulose is a laxative that can be used for chronic liver disorders such as cirrhosis. Lactulose improves the client's condition by decreasing ammonia levels through enhancing intestinal secretion of ammonia so that it can be eliminated from the body.
A nurse is caring for a 6 year old child who is experiencing encorpresis. Which of the following actions should the nurse take?
Determine if there are any recent stressors in the child's environment Encorpresis is can be cause by stress or changes in the child's environment.
A nurse is caring for an older adult client who has a prescription for zolpidem at bedtime to promote sleep. The nurse should plan to monitor the client for which of the following adverse effects?
Dizziness Zolpidem can cause dizziness and daytime drowsiness. It can cause confusion in the older client adult as well.
A nurse is performing an otoscopic examination of a client's right ear. The light reflex is visible in the right lower quadrant of the tympanic membrane.
Document this as an expected finding. The light of the otoscope reflects off the tympanic membran which is cone-shaped or triangular.
A nurse is administering oral hydroxyzine to a client. Which of the following adverse effects should the nurse instruct the client to expect.
Dry mouth Hydroxyzine has anticholinergic properties. Dry mouth is common adverse effect of this medication. The nurse should instruct the client to take sips of water or such hard candies to minimize effects.
A nurse is caring for a male client who has been taking cimetidine for the treatment of a duodenal ulcer. Which of the following manifestations related to the medication should the nurse report to the provider?
Emisis that looks like coffee grounds The nurse should identify that coffee ground emesis is a manifestation of a gastrointestinal bleed as a result of the duodenal ulcer and can indicate that treatment with cimetidine has been ineffective. Therefore, the nurse should report this finding to the provider immediately
A nurse is caring for a client who is 12 hours postoperative following a total hip arthroplasty. Which of the following medications should the nurse anticipate administering to this client to prevent DVT?
Enoxaparin - The nurse should anticipate the administration of enoxaparin for a client who is 12 hour postop. Enoxaparin is low molecular weight heparin that is used to prevent DVT by inhibiting the effects of antithrombin and thrombin.
A nurse is caring for a female client who has been taking clomiphene to treat infertility. Which of the following findings should indicate to the nurse that the medication has been effective.
Follicular enlargement and conversion to corpus luteum after ovulation The nurse should identify that clomiphene is a medication that promotes follicular maturation and is used in the treatment of infertility. Successful treatment reveals progressive follivular enlargement, followed by conversion of the follicle to a corpus luteum after ovulation occurs.
A nurse is caring for a client who has hyperlipidemia and is receiving simvastatin 40 mg PO daily. Which of the following items should the nurse remove from the clients breakfast tray before it is delivered to the room?
Grapefruit juice Grapefruit juice is contraindicated for a client who is taking simvistatin because it raised blood levels of the medication significantly by inactivating a liver enzyme that is responsible for metabolism
A nurse is teaching a newly licensed nurse about caring for a client who is receiving patient controlled analgesia. Which of the following actions by the newly licensed nurse indicates an understanding of the teaching?
Having a second nurse check the PCA setting. The nurse should have a second nurse check the PCA settings to ensure the correct amount of medication is being administered to the client.
A nurse is preparing to administer digoxin to a client. Which of the following findings should the nurse identify as a contraindication to the client receiving the medication?
Heart rate of 51 The nurse should identify that if the client's heart rate is less than 60 the medication should be withheld and the provider should be notified
A nurse is providing discharge teaching to a client who is postoperative and has a new prescription for an oral opioid analgesic. Which of the following pieces of information should the nurse include as rationale for increasing the client's daily intake of fiber?
Helps prevent constipation Opioids have an adverse effect of constipation.
A nurse is reviewing lab results of a client who is taking a medication and notes that the client's blood tests show an elevated level of the enzymes AST and ALT. The nurse recognized that these findings are potential indications of which of the following conditions?
Hepatic Toxicity AST and ALT are indications for hepatic toxicity. These are enzymes that test liver functions. Therefore, this should indicate to the nurse that the medication the client is taking is damaging the liver. The nurse should notify the provider of this finding
A nurse is reviewing the lav results of a client who is taking medication and notes that the client's blood tests show an elevated level of the enzymes aspartate aminotransferase (AST) and alanine aminotransferase (ALT). The nurse should recognize that these findings are a potential indication of which of the following conditions?
Hepatic Toxicity The nurse should identify that these elevated levels are indications that the client might be at risk for hepatic toxicity. AST and ALT are enzymes that test liver function. Therefore, this should indicate to the nurse that the medication the client is taking is damaging to the liver. The client should undergo liver function tests and the nurse should notify the provider.
A nurse in a providers office is reviewing a client's medication history. The client asks the nurse if she should begin taking high dose vitamins as she ages. Which of the following pieces of information should the nurse provide about high doses of vitamin supplements?
High doses of water soluble vitamins can have adverse effects. Any vitamin supplement consumed should not exceed the recommended dietary allowance. Elevated levels of vitamin A can increase the risk of developing osteoporosis and cause birth defects when taken during pregnancy. Excessive intake of beta-carotene can increase the risk of lung cancer in clients who smoke. In addition, increased doses of vitamin E can increase the risk of death in clients who have chronic illness.
A nurse is caring for a client who has osteoporosis and has been taking a vitamin D supplement. The nurse notes that the client reports also taking a multivitamin daily. Which of the following findings should indicated to the nurse that the client might be experiencing vitamin D toxicity?
Hypercalcemia The nurse should identify that vitamin D increases plasma calcium levels by increasing reabsorption from bone, decreasing excretion by the kidneys and increasing absorption from the intestines. Clients who take a vitamin D supplement along with a multivitamin daily might be taking too much calcium.
A nurse is planning to administer diltiazem via IV bolus to a client who has atrial fibrillation. When assessing the client, the nuse should recognize that which of the following findings is a contraindication to administration of diltiazem?
Hypotension Dilitazem can be a treatment option for essential hypertension. This med will lower blood.
A client reports a 6 week history of depression with somnolence, fatigue and weight gain. Which of the following medical illnesses is a cause of depression? Inflammatory Bowel Disease Pernicious anemia Hypothyroidism Type 2 Diabetes
Hypothyroidism - it can result in symptoms of depression. Weight gain, cold intolerance, fatigue, bradycardia, depression, memory loss, constipation and dry skin are all symptoms of hypothyroidism.
A nurse is caring for a client with multiple sclerosis and neurogenic bladder who is receiving bathanechol. The nurse should identify that which of the following client statements indicates a therapeutic action of the medication.
I am able to urinate more freely. Bethanechol is administered for treatment of urinary retention. A TU effect is indicated by the client stating urination occurs more freely.
A nurse in a provider's office is assessing a client who has been taking feverfew. Which of the following statements by the client indicates a therapeutic effect of the supplement.
I am having fewer migraine headaches since I started taking feverfew Feverfew is an herb that is used for the prophylaxis of migraines. It can reduce the frequency of migraines and decrease the severity of accompanying manifestations such as nausea and photophobia
A nurse is providing teaching to a client with hypertension and a type 1 diabetes mellitus who has a new prescription for metoprolol. Which of the following statements by the client indicates an understanding of the teaching?
I might have difficulty recognizing when my blood sugar is low Metoprolol, a beta-adrenergic blocker, is used to treat hypertension. Because it decrease the heart rate, this common manifestation of hypoglycemia can be masked, and hypoglycemia might become more difficult to recognize. The client should be taught to recognize hypoglycemia by other manifestations like hunger, nausea and sweating.
A nurse is teaching a client who has a new diagnosis of angina and has a prescription for isosorbide mononitrate 10 mg PO twice daily. Which of the following statements indicates an understanding of the teaching?
I should change positions slowly when getting out of bed. Isosorbide mononitrate is antianginal medication that produces vasodilation. Therefore, this medication can cause orthostatic hypotension. Clients should bhange positions slowly upon rising to minimize the effects of orthostatic hypotension
A nurse is providing discharge teaching to a client who has heart failure and a prescription for digoxin .125 mg PO daily and furosemide 20 mg PO daily. Which of the following statements by the client indicates an understanding of the teaching?
I will eat fruits and vegetables that have high potassium content every day Hypokalemia is an adverse effect of diuretic therapy. Because the client is taking digoxin it is important to maintain potassium levels between 3.5-5.0 to avoid digoxin toxicity.
A nurse is caring for a client who has heart failure and is prescribed dobutamine hydrochloride by continuous IV infusion. The nurse should identify that which of the following therapeutic effects happens with this medication?
Improve cardiac output The nurse should identify that dobutamine is a vasopressor that improves cardiac output and hemodynamic status in clients.
A nurse is caring for a client who has heart failure and is prescribed dobutamine hydrochloride by continuous IV infusion. The nurse should identify that which of the following is the theraputic effect of this medication?
Improves cardiac output. Dobutamine is a vasopressor that improves cardiac output and hympdynamic status in clients
A nurse is teaching a client who had kidney transplant surgery about immunosuppressive medications. Which of the following adverse effects of these medications should the nurse include in the teaching
Increased susceptibility to infection. Immunosuppressive medications such as cyclosporine increases the risk of infection. As the medication classification indicates these medications impair immunity and adversely affect the client's ability to resist and fight infection.
A nurse is preparing to administer meperidine to a client who is postoperative and reports a pain level of 8/10. Which of the following routes of administration will deliver the medication with the shortest time of onset
Intravaneous IV has no barriers to absorption because it is depsosited directly into the circulatory system. An instantaneous time of onset and absorption gives the client immediate release.
A nurse is reviewing lab values for a client who reports fatigue and cold intolerance. The client has an increased thyroid stimulating hormone TSH level and a decreased total T3 and T4 level. The nurse should anticipate a presciption for which of the following medications?
Levithroxine The med replaces thyroid hormone for a client who has hypothyroidism. Laboratory values of hypothyroidism include an increased TSH level and a decreased total T3 and T4 level. Clinical manifestations of hypothyroidism include fatigue and cold intolerance, decreased body temperature and pulse.
A nurse is administering a medication to a client. The nurse should identify that which of the following medication distribution factors facilitates the effective passage of the medication across the client's cell membranes?
Lipid solubility Medication being lipid soluble and the presence of a transport system both facilitate the ability of the medication to cross cell membranes that separate the medication from the blood
A nurse is caring for an 18 year old adolescent who is up to date on immunization and is planning on attending college. The nurse should recommend which of the following immunizations prior to moving into a campus dorm?
Meningococcal polysaccharide This immunization is used to prevent infection by certain groups of meningococcal bacteria. Meningococcal infection can cause life threatening illnesses such as meningitis which affects the brain, meningoccoccemia which affects the blood. Noth these conditions can be fatal. College freshmen particularly those who live in dorms are at an increased risk for meningococcal diseasse relative to other persons their age.
A nurse is caring for a client who has a presciption for chlorothiazide to treat hypertension. The nurse should plan to monito client for which of the follow adverse effects.
Muscle weaknes Chlorothiazide is a thiazide diuretic used to treat HTN and CHF. It promotes excretion of water, sodium and potassium which can cause hypokalemia. Manifestations of hypokalemia include muscle weakness, muscle cramps and disrhythmias.
A nurse is caring for a client who has been in the PACU for more than 1 hour, has respiratory rate of 9/min and is difficult to arouse. The nurse should expect a prescription for which of the following?
Naloxone This medication displaces opiate medications from receptor sites, reversing the respiratory depression, sedation, and analgesia.
A nurse is caring for a client who reports crushing chest pain. The nurse reviews the client's ECG results and notes ST changes. Which of the following medications should the nurse administer?
Nitroglycerin The nurse should identify the need to administer nitroglycerin which is used to treat angina. Nitroglycerin acts directly on vascular smooth muscle to promote vasodilation
A nurse is admitting a client who has unstable angina. Which of the following medications should the nurse anticipate administering to the client.
Nitroglycerine This medication acts by relaxing or preventing spasms in the coronary arteries along with dilating the arteries which increases oxygenation
A nurse is teaching the parent of a child who has sever reactive airway disease about glucocorticoid therapy. The parent asks why her child has to inhale the medication instead of taking it orally. Which of the following pieces of information should the nurse provide to the patent?
Oral glucocorticoids are more likely to slow linear growth in children The chronic use of oral glucocorticoids in high doses by children can result in decreased linear growth. Inhaled deliver the antiinflammatory agent directly to the local target area.
A nurse is caring for a client who is taking a prescription for glucocorticoid adrenal replacement medication for the long-term treatment of addison's disease. Which of the following findings indicates that the client is experiencing an adverse effect of the medication?
Osteoporosis Long-term use of steroid medications such as glucocorticoid medication can inhibit bone growth and result in the adverse effect of osteoporosis with long term treatment.
A nurse is caring for a client who is taking gluccocorticoids. The nurse should monitor the client for which of the follow adverse effects of the medication?
Peptic Ulcer The nurse should monitor this client who is taking glucocorticoids for peptic ulcer disease due to irritation of the gastric mucosa. The nurse should periodically check the client's stool for occult blood and instruct the client to contact provider if black stools occur.
A nurse is caring for a client who is undergoing peritoneal dialysis. Which of the following is a complication associated with this procedure?
Peritonitis Peritonitis is a common complication of peritoneal dialysis. Peritonitis refers to infection and inflammation of the peritoneal cavity typically as a result of the entrance of bacteria through the tubing placed in the peritoneum. The nurse should maintain aseptic technique whenever working with the dialysis catheter in order to reduce the risk of infection.
A nurse is assigned to care for several clients who are postoperative. The client taking the following medications is at risk of delayed wound healing?
Prednisone Presdnisone is a corticosteroid that is associated with delayed wound healing. Clients who have arthritis often require high doses of prednisone to help resolve exacerbations
A nurse is assigned to care for several clients who are postoperative. The client taking which of the following medication is at risk of delayed wound healing?
Prednisone to treat persistent arthritis and exacerbations Prednisone is a corticosteroid that is associated with delayed would healing. Clients who have arthritis often require high doses of prednisone to help resolve exacerbations
A nurse is providing teaching to a client who has a chronic kidney failure with an AV fistula for hemodialysis and a new prescription for epoetin alfa. Which of the following TU effects of epoetin alfa should the nurse include in the teaching?
Promotes RBC production Epoetin alfa stimulates erythopoiesis in the bone marrow to increase RBC production and reduce anemia. Anemia is common in clients who have chronic kidney failure since erythropoietin is produced in the kidney.
A nurse is preparing to administer medication to a client. The nurse should understand that which of the following abbreviations indicates the greatest frequency of medication administration?
QID THis idicates the medication should be administered four time per day, which is the greatest frequency of the options provided.
A nurse is caring for a client who has cancer involving the lumber vertebrae and has been prescribed gabapentin. Which of the following TU effects should the nurse identify for the client who is taking the medication?
Reduced cramping, aching and burning neuropathic pain This medication is used for sharp darting pain. It can also decrease cramping aching and burning pain and suppress spontaneous neuronal firing that causes pain
A nurse is caring for a client with diabetic ketoacidosis who has a prescription for an IV infusion of insulin. The nurse should document that which of the following types of insulin was administered IV to treat ketoacidosis?
Regular Insulin Treatment for DKA is directed at correcting hyperglycemia and acidosis. Therefore, the client's insulin levels are restored with an initial IV bolus of regular insulin followed by continuous IV infusion
A nurse is providing teaching to a group of new parents about medications. The nurse should include that aspirin is a contraidnicated for children who have a viral infection due to the risk of developing which of the following adverse effects?
Ryes syndrome Aspirin should not be given to children due to the risk of developing Reye's syndrome
A nurse is assessing a client who is receiving a continuous morphine IV infusion and finds the client's respiratory rate has decreased from 20/min to 12/min. Which of the following actions should the nurse take?
Slow the rate of the infusion The nurse should decrease the infusion rate to reduce amount of morphine the client receives and limit the risk of respiratory depression.
A nurse is teaching a client who had chronic stable angina pectoris and a prescription for sublingual nitroglycerin tablets. What sequence of instructions should the nurse tell the client to use if he experiences chest pain?
Stop activity Place tablet under tongue Wait five minutes Call 911 if the pain is not relieved
A nurse is providing teaching to a client who has a new prescription for sertraline. The client asks the nurse if he should continue to take St. John's wort for depression. Which of the following instructions should the nurse give the client?
Stop taking the herbal supplement while taking the medication Taking the antidepressant sertraline and the herbal supplement St John's wort increases the client's risk of serotonin syndrome
A nurse is teaching a client who has type 2 diabetes mellitus about storing unopened vials of insulin. Which of the following pieces of information should the nurse include in the teaching?
Store vials in the refrigerator The nurse should tell the client to store unopened vials of insulin in the refrigerator. The client can use the unopened vials of insulin up to the printed expiration date
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 adverse effects?
Stress fractures Prednisone can cause demineralization of the bones and can lead to osteoporosis and stress fractures
A nurse is caring for a client who has a new diagnosis of oral candidiasis after taking tetracycline for 7 days. The nurse should recognize the candidiasis is the manifestation of which of the following adverse effects?
Superinfection can develop from fungal overgrowth due to the antibacterial effect of tetracycline. The nurse should monitor the client for manifestations of the superinfection such as soreness of the mouth and a swollen tongue.
A nurse in a community health clinic is assessing a new client who has a prescription for isoniazid and rifampin. Which of the following disorders should the nurse expect the client to have?
TB These are first line antituberular medications used to treat active TB.
A nurse is administering subcutaneous epinephrine for a client who is experiencing anaphylaxis. The nurse should monitor client for which of the follow adverse effects?
Tachycardia Adverse effects of epinephrine and adrenergic agonist can include tachycardia and disrhythmias due to cardiac stimulation.
A nurse is providing teaching to a client who has a new prescription for hydrochlorothiazide 50 mg PO daily to treat hypertension. Which of the following instructions should the nurse include?
Take hydroclorothiazide in the morning The client should take this medication in the morning to allow for diuresis during the day and to prevent nocturia
A nurse is preparing to administer an IM injection for a client. Which of the following factors should the nurse identify as a potential contraindication to administering the medication via the IM route?
The client is taking an anticoagulant Because of the risk for bleeding for the injection site, anticoagulant therapy is a contraindication to receiving medications via IM route
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 client's next dose of morphine
The client's respiratory rate is 10/min Morphine can cause respiratory depression. Therefore, if the client;s respiratory rate is less than 12/min, the nurse should withhold the next dose of morphine and notify provider
A nurse is teaching a client who has a prescription for chenodiol for the treatment of gallstones. Which of the following client statements indicates an understanding?
The nurse should identify that chenodiol is hepatotoxic and can injure the liver. Periodic liver function tests are required during treatment. This medication is contraindicated in clients who have preexisting liver condition.
A nurse is caring for a client who has sever asthma and allergic rhinitis. The client is taking theophylline. Which of the following medications should the nurse identify as being incompatible with theophylline?
The nurse should identify that safirlukast is a leukotriene receptor antagonist prescribed for asthma maintenance. Concurrent use of safirlukast along with theophylline suppresses the metabolism of theophylline which can lead to toxicity.
A nurse is preparing a continuous IV infusion of erythromycin lactobionate for a client who has a bordetella pertussis infection. Which of the following actions should the nurse take to minimize risk of thrombophlebitis?
The nurse should infuse erythromycin slowly to minimize the risk of thrombophlebitis, which is an inflammatory process resulting from the formation a blood clot in a vein. These blood clots usually form in the legs.
A nurse is preparing to administer an otic medication to an adult client. Which of the following actions should the nurse take?
The nurse should pull the pinna of the client's ear upward and outward so the nurse can instill the medication into the client's ear canal.
A nurse suspects that a client is having an allergic reaction to a medication. Which of the following factors should the nurse identify as increasing the likelihood of an allergic reaction to the medication?
The patient has had a previous exposure to the medication Once the immune system has developed sensitization to a medication, a subsequent exposure to that same medication, the more intense the reaction will likely be
A nurse is preparing to administer 100 units of insulin glargine and 4 units of NPH insulin subQ to a client. Which of the following actions should the nurse plan to take?
Use separate syringes for administering insulin glargine and NPH insulin. Nurses should not mix insulins.
A nurse is providing discharge teaching to a client who has angina pectoris and a new presciption of verapamil. The client tells the nurse, "My brother takes verapamil for high blood pressure, do you think this is a mistake?" Which of the following statements should the nurse make?
Verapamil is used to treat both high blood pressure and angina. Verapamil is a calcium channel blocker that is used for hypertension and anginal pain because of its ability to dilate arteries and decrease afterload.
A nurse is assessing a client who has heart failure and is receiving digoxin. Which of the following findings should indicate to the nurse the client is experiencing digoxin toxicity?
Visual disturbances The nurse should recognize that nausea, vomiting, abdominal discomfort, fatigue and visual disturbances are common manifestations that can indicate that the client is experiencing toxicity.
A nurse is caring for a client who is 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.
Vitamin K The nurse should anticipate the provider to prescribe vitamin K for a client who has an INR of 6.2. Vitamin K antagonizes warfarin's actions which can revers warfarin induced inhibition of clotting factor synthesis
A nurse is providing a teaching to a client with new diagnosis of heart failure who has a prescription for furoseminde. Which of the following statements should the nurse include in the teaching?
You should eat foods that are high in potassium while taking this medication Furosemide is a high-ceiling loop diuretic that depletes potassium, sodium, magnesium and water
A nurse is providing a teaching about antiretroviral medication therapy to a client who has a new diagnosis of AIDS. Which of the following statements should the nurse include in the teaching?
You should take antiretroviral medications on a routine schedule The client needs to take the medication exactly as prescribed and avoid delaying or skipping any doses which can result in medication resistance
An 18-month old toddler who has kawasaki disease. The child is receiving IV immune globulin (IVIG). The guardian asks the nurse to administer the child's schedules measles, mumps and rubella (MMR) vaccine before discharge. Which of the following responses should the nurse provide?
Your child will not be able to receive the MMR vaccine for at least three months after discharge. The nurse should explain that IVIG given for treatment of KD contains antibodies that can interfere with the action of live-virus vaccines like MMR. The immunization should be postponed for 3-6 months.
A nurse is preparing to administer furosemide 4 mg/kg/day PO divided into two equal doses daily to a toddler who weighs 22 lb. How many mg should the nurse administer per dose?
amount in pounds/2.2 22/2.2 = 10kg 4mgx10kg= 40mg/day divided into two equal doses: 40/2=20
A nurse is preparing to administer lacted Ringer's 1,000 mL IV infused over 8 hours. The frop factor of the manual IV tubing is 10gtt/mL. How many gtt/min should the nurse deliver?
amount of med/time in min 1000mL/480min=2.083ml/min Take this and multiply is by 10 gtt/mL 2.083x10=20.83 Round to 21
A nurse is providing teaching to a client who is scheduled to start taking hydrochlorothiazide for hypertension. The nurse instructs the client to eat foods that are rich in potassium. Which of the following statements by the client indicates understanding of the teaching?
"This medication can cause a loss of potassium" Hydrochlorothiazide can result in hypokalemia caused by excessive potassium excretion from the kidneys. The client should supplement his diet with potassium-rich foods to avoid the occurrence of hypokalemia. Foods that are high in potassium include bananas, raisins, backed potatoes, pumpkin and milk
A nurse is caring for a client who receives gastrostomy tube feeding and insulin. The client is scheduled to receive a tube feeding at 0700. At which of the following times should the nurse plan to administer insulin lipro SubQ?
0645 Lispro is a rapid acting insulin with an onset of 15 minutes.
