chapter 3 prep u - pharm

Which client is experiencing a secondary action of a medication?

A client who is drowsy after taking antihistamine

A client with a longstanding diagnosis of schizophrenia has taken antipsychotic drugs for several decades. For what adverse effect should the nurse assess?

The client reports feeling unusually drowsy and fatigued.

A client develops a cytotoxic reaction to a drug. What would the nurse expect to do?

discontinue the drug immediately as ordered

A client is experiencing central nervous system effects related to drug therapy. Which would be most important for the nurse to emphasize in the teaching plan?

safety measures

A client is believed to be developing neuroleptic malignant syndrome. What is the nurse's assessment priority?

temperature

A 70-year-old man who enjoys good health began taking low-dose aspirin several months ago based on recommendations that he read in a magazine article. During the man's most recent visit to his care provider, routine blood work was ordered and the results indicated an unprecedented rise in the man's serum creatinine and blood urea nitrogen (BUN) levels. How should a nurse best interpret these findings?

-Aspirin, one of the most commonly used drugs, is often linked to auditory ringing and eighth cranial nerve effects. -A drug used to treat some rheumatoid diseases can cause retinal damage and even blindness.

The nurse provides health education for a diverse group of clients. For which client should the nurse emphasize the risk of teratogenic drug effects?

20-year-old female client who has been diagnosed with a chlamydial infection

What client is experiencing an adverse effect that is a result of primary action?

A client taking anticoagulants who develops a gastrointestinal bleed

A client is suspected of having a liver injury as a result of drug therapy. What laboratory finding would best support this diagnosis?

Elevated aspartate aminotransferase (AST) level

A client began a new medication four days ago and presents with a temperature of 38.2° C (100.8 °F), dependent edema, and swollen cervical lymph nodes. The nurse has informed the client's provider, who has discontinued the medication. What subsequent intervention should the nurse prioritize?

Provide supportive care to manage fever and inflammation.

A client is on antibiotic therapy for an axillary abscess. The client has been outside working in the yard and observes a rash everywhere that is not covered by clothing. What should the client be told about this finding?

The client is having photosensitivity and this can occur even with brief exposure to the sun or UV rays

An elderly client has been taking a new medication for 2 months. During a follow-up visit, the client's son tells the nurse that he feels his mother's memory is getting worse. What concerns should the nurse have at this time?

This may be coincidental, and the memory loss may be attributed to changes with aging.

What is an example of a secondary action?

an antihistamine causes the client to experience drowsiness

A client with a serious Escherichia coli infection is being treated with gentamicin. When monitoring for potential adverse effects, the nurse should prioritize:

blood urea nitrogen and creatinine levels.

For several days, a client with hypertension has been inadvertently taking an excessive dose of spironolactone, a potassium-sparing diuretic. The client has presented to the emergency department with signs and symptoms that suggest hyperkalemia. What assessment should the nurse prioritize?

cardiac monitoring

A client diagnosed with cancer has been receiving antineoplastics for several weeks. What assessment finding should the nurse interpret as a possible indication of blood dyscrasia?

hemoglobin of 6.0 g/dL

When reviewing the medication list of a client being seen in the clinic, the nurse notes that the client is receiving glipizide. Based on the nurse's understanding, this drug is used to treat:

hyperglycemia

A client taking a beta blocker for hypertension tells the nurse he will no longer take the medication because it is causing an inability for him to maintain an erection. What is the best explanation for this issue by the nurse?

"This is an expected adverse effect of the medication, but it is very important that you continue to take it. We can talk about other methods for sexual expression."

A client with a recent history of peripheral edema has been taking hydrochlorothiazide 75 mg PO daily. The client reports increased appetite and restlessness to the nurse and inspection reveals warm, flushed skin. What is the nurse's best action?

Assess the client's blood glucose level

An instructor is preparing a class that describes the toxic effects of drugs. Which effect would the instructor expect to include?

Drugs cause unexpected or unacceptable reactions despite screening and testing.

A client develops bone marrow suppression related to a drug's effects. What would be most important for the nurse to do?

Parkinsonian symptoms

The nurse should have basic knowledge of drug classifications in order to administer medications safely to clients. What drug information is instrumental in determining nursing actions following drug administration?

adverse effects

Upon assessment after giving oral penicillin, the nurse notes that a client has dilated pupils, increased blood pressure, and increased heart rate. The nurse would document these findings as which type of drug allergic reaction?

anaphylactic

The nurse would assess a client receiving which medication for possible superinfection?

antibiotics

The nurse is caring for a client with a drug allergy and understands the allergy is the result of the client developing:

antibodies

Preoperative atropine belongs to what classification of drugs?

anticholinergic

The nurse administers chloroquine to a client to treat rheumatoid disease. The client has been taking this medication for several years. What assessment should the nurse prioritize?

assessment of visual acuity

What changes due to aging in the geriatric client may affect excretion and promote accumulation of drugs in the body?

decreased GFR

A client develops stomatitis from drug therapy. Which measure would be most appropriate for the nurse to suggest?

frequent rinsing with cool liquids

The nurse has begun the intravenous infusion of the first dose of a client's prescribed antibiotic. A few minutes later, the client is diaphoretic, gasping for breath and has a heart rate of 145 beats per minute. After calling for help, what is the nurse's priority action?

protecting and maintaining the patency of the client's airway

Which skin condition would be most likely to cause increased systemic absorption of a topical medication?

severe sunburn

What information from the Kardex is likely to have the greatest implication in educating the client about antihistamine administration?

the client's profession

What would the nurse expect the prescribing health care provider to order for a client with a delayed allergic reaction?

topical corticosteroid

The nurse is providing for a client who is being treated for a Pseudomonas infection in the intensive care unit. The client's medication regimen includes gentamicin 75 mg IV t.i.d. When monitoring the client for adverse effects, what assessment should the nurse prioritize?

urine output and creatinine clearance

Many drugs can affect the functioning of the nerves in the periphery and central nervous system. Which are examples of potential neurologic effects of drugs? (Select all that apply.)

-neuroleptic malignant syndrome -Parkinson-like syndrome -atropine-like (anticholinergic) effects

When administering drug therapy for a client, how can the nurse ensure beneficial outcomes? (Select all that apply.)

-maximize therapeutic effects, minimize adverse effects and drug interactions, provide appropriate drug education for the client and family

Many drugs that reach the developing fetus or embryo can cause death or congenital defects. What are examples of congenital defects? Select all that apply.

-skeletal and limb abnormalities -central nervous system alterations -heart defects

Many drugs, if taken during pregnancy, can cause adverse effects to the fetus. It is important for nurses to teach women the potential risks of fetal drug exposure. What are some potential risks? (Select all that apply.)

blindness, CNS defects, heart anomalies, limb deformities, facial defects

Which drug classification is used to treat superinfections?

antifungals

The nurse's assessment of a client reveals that the client has been greatly exceeding recommended safe doses of acetaminophen for the past week. When reviewing the client's laboratory results for indications of toxicity, what finding should the nurse prioritize?

aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels

A recent nursing graduate is preparing to enter the workforce. What principle should guide the nurse's administration of medications?

drugs can cause unexpected reactions

A client with an anxiety disorder has been prescribed alprazolam 0.5 mg PO t.i.d. During a follow-up assessment, the client tells the nurse that the medication causes drowsiness that interferes with the client's work performance. What is the nurse's best action?

educate the client about strategies for managing this primary action

Which prescribed medications should the nurse administer to an adult having an anaphylactic reaction?

epinephrine

A client is being seen in the emergency department for a sprained ankle and is given a drug to relieve pain. When a second dose of the pain medication is given, the client develops redness of the skin, itching, and swelling at the site of injection of the drug. The most likely cause of this response is

an allergic response

A nurse is administering gentamicin, an antibiotic that is ototoxic. Which report or sign would indicate that the client is suffering from ototoxicity?

buzzing or ringing sound

A client is receiving a drug to lower blood glucose level. What would lead the nurse to suspect that the client's blood glucose level was too low?

cold, clammy skin

A client comes to the clinic reporting of a ringing sound in the ears and dizziness. When the nurse takes the client's history, the nurse discovers that the client has been taking several ibuprofen every day for various discomforts. What does the nurse understand has occurred with this client?

oxytocin from the ibuprofen

The nurse is caring for a client with hypertension who was prescribed a loop diuretic one week ago. The client reports malaise and weakness and the nurse's assessment reveals an irregular heart rate. The nurse should prioritize assessment of the client's:

potassium levels

The nurse at a campus medical clinic is administering a new medication to a 22-year-old female client. The nurse should educate the client about what potential risk of drug therapy?

teratogenicity

A newly admitting client has signs and symptoms of an infection and the nurse anticipates that the client will be prescribed antibiotics. What assessment should the nurse prioritize when determining the client's risk for an excessive drug response due to impaired excretion?

The client's blood urea nitrogen level and creatinine clearance rate

A client with urinary urgency and frequency has been prescribed an anticholinergic medication. The nurse should educate the client about what potential adverse effects related to secondary actions?

decreased bowel motility

One of the most common occurrences in drug therapy is the development of adverse effects from simple overdose. In such cases, the client suffers from effects that are merely an extension of the desired effect. Which are examples of this primary action? (Select all that apply.)

dizziness after starting an antihypertensive, spontaneous bleeding after taking an anticoagulant

A client is diagnosed with hypercholesterolemia and is prescribed a statin. As part of client education, the nurse should teach the client to avoid eating:

grapefruit

A client with recurrent urinary tract infections was prescribed sulfamethoxazole-trimethoprim and experienced an allergic reaction. The client states, "I don't understand. I had a two-day course of the same drug last year with no problems." What is the nurse's best response?

"Allergic reactions happen after your body has been sensitized to a drug in the past."

The nurse is assessing a client who is being admitted to the healthcare facility. When asked about allergies, the client states, "I'm allergic to penicillin." What is the nurse's best initial response?

"do you remember what happened the last time you received penicillin"

The nurse is assessing a community-dwelling client with a history of rheumatoid arthritis. During the interview, the client states, "The last few months, I have this ringing in my ears that I just cannot seem to get away from." What assessment question should the nurse ask?

"have you been taking aspirin on a regular basis"

The nurse administers penicillin to a client and monitors the client for an adverse reaction despite the fact that the client claimed not to be allergic to penicillin. What is the rationale for checking for adverse reactions? {Select all that apply.}

-A person can be allergic to any medication at any time. -Medications can react with over-the-counter medications to cause toxicity. -Medications can react with herbal supplements to cause adverse reactions. -Medications can react with other medications prescribed for the client

A client is being discharged from the emergency department (ED) after being treated for an anaphylactic reaction to shrimp the client ate for dinner. The client asks the nurse to explain food reactions. Which would be correct responses? Select all that apply.

-Ananphylactic reactions involve an antibody that causes the release of histamine. -Histamines produce immediate reactions. -Anaphylactic reactions can lead to respiratory distress and even respiratory arrest

Drugs can affect the special senses, including the eyes and ears. Alterations in seeing and hearing can pose safety problems for clients. What are examples of sensory effects of drugs? Select all that apply.

-Aspirin, one of the most commonly used drugs, is often linked to auditory ringing and eighth cranial nerve effects. -A drug used to treat some rheumatoid diseases can cause retinal damage and even blindness. -Aspirin, one of the most commonly used drugs, is often linked to auditory ringing and eighth cranial nerve effects

How does knowledge of a drug's adverse effects impact the care provided by the nurse? (Select all that apply.)

-Drug teaching can address signs and symptoms the client should be alert for. -Assessments include monitoring for expected or common adverse effects. -Baseline can be established to help identify adverse effects that occur.

What would the nurse expect to assess in a client experiencing an anaphylactic reaction? (Select all that apply.)

-dilated pupils -feeling of panic -difficulty breathing

A client is suspected to have nephrotoxicity from administration of a nephrotoxic medication. What laboratory results may indicate renal damage related to the administration of this medication? (Select all that apply.)

-elevated BUN, creatinine, and potassium

Which symptoms are indicators that the client is having an anaphylactic reaction? (Select all that apply.)

-hives -difficulty breathing -panicked feeling

One of the most common occurrences in drug therapy is the development of adverse effects from simple overdose. In such cases, the client suffers from effects that are merely an extension of the desired effect. Which are examples of this primary action? Select all that apply.

-spontaneous bleeding after taking warfarin -dizziness after starting amlodipine

What would lead the nurse to suspect that a client has developed a blood dyscrasia related to drug therapy? (Select all that apply.)

-thrombocytopenia -anemia -sore throat

The nurse is conducting an admission assessment of a new client. When asked about any food or drug allergies, the client states that the client is allergic to tetracycline. What action should the nurse next perform?

Ask the client, "What happens when you take a dose of tetracycline?"

A client with a diagnosis of bipolar disorder has begun lithium therapy. What is the primary rationale for the nurse's instructions regarding the need for regular monitoring of the client's serum drug levels?

It is necessary to ensure that the client's drug levels are therapeutic but not toxic.

A client who is being treated for cancer developed a serum sickness reaction. The care team has been notified, and the client is being stabilized. What is the nurse's priority action?

Monitor laboratory blood values.

A hospital client began taking a newly prescribed antihypertensive 12 hours ago and has developed a full body rash with edema and pruritis. What is the nurse's best action?

Promptly inform the prescriber of the client's status

A client receiving drug therapy develops numbness and tingling in the extremities and muscle cramps. What assessment should the nurse perform?

Review the client's most recent potassium level.

A client with lymphoma is scheduled to begin chemotherapy tomorrow. When providing health education for the client regarding the risk for stomatitis, what should the nurse teach the client?

Techniques for providing safe and effective mouth care

The nurse is caring for a client who is receiving an antidiabetic agent. What assessment finding should the nurse attribute to a possible adverse reaction?

The man may be experiencing nephrotoxic effects of aspirin

The nurse is assessing a number of clients on the acute medicine unit. What client is most likely experiencing an adverse effect from the primary action of the medication?

a client taking antihypertensives who reports dizziness upon standing

The nurse is caring for a client receiving an aminoglycoside (antibiotic) that can be nephrotoxic. Which will alert the nurse that the client may be experiencing nephrotoxicity?

a decrease in urine output

A client exhibits muscular tremors, drooling, gait changes, and spasms. When reviewing the client's medication history, which would the nurse most likely find?

antipsychotic agent

The nurse is assessing a new client who states being allergic to nonsteroidal anti-inflammatories (NSAIDs. What subsequent assessment should the nurse prioritize?

asking the client what the client's response is to taking NSAIDs

What would the nurse include in the teaching plan for a client who is to receive a drug that is associated with anticholinergic effects?

be sure to drink plenty of fluids to prevent dehydration

A client is four months' pregnant. She works in the chemical unit of a research department and is responsible for handling various chemicals. Her gynecologist advised her not to expose herself to chemical or industrial vapors and specific drugs. These restrictions are advised because exposure to industrial vapors could:

damage the immature nervous system of the fetus

A client comes to the clinic reporting tinnitus and difficulty hearing. What medication in the client's current regimen should the nurse suspect as causing the symptoms?

erythromycin

A nurse is instructing a client concerning a newly prescribed drug. What should be included to help improve client compliance and safety?

measures to alleviate any discomfort associated with adverse effects

A client with a history of schizophrenia has developed severe drug-induced parkinsonism from treatment with antipsychotic medications. What nursing diagnosis should the nurse identify?

risk for aspiration related to impaired swallowing

When instructing a client who is taking an antibiotic about the possibility of nausea and diarrhea, the nurse understands that these effects are examples of:

secondary actions

A client, prescribed a drug that has an exceptionally narrow margin of safety, should be educated about the need for what intervention?

serum drug level monitoring

All drugs have adverse reactions when taken. Organ and tissue damage is one such adverse reaction. Which is an example of organ and tissue damage caused by a drug?

stevens-johnson syndrome

Many drugs that reach the developing fetus or embryo can cause death or congenital defects, which can include skeletal and limb abnormalities, central nervous system alterations, heart defects, and the like. What is the name of the adverse reaction that can cause birth defects?

teratogenicity