Exam 1 - Pharmacology Review

The nurse is caring for a client who has been prescribed atropine preoperatively. The nurse understands the intended purpose for administering this preoperatively is to induce which effect? A. Reduce heart rate B. Elevate blood pressure C. Enhance sedation D. Decrease secretions

*D. Decrease secretions

Captopril is prescribed for a client. Which effect would the nurse anticipate? A. Increased urine output B. Decreased anxiety C. Improved sleep D. Decreased blood pressure

*D. Decreased blood pressure

A nurse is assessing a client with heart failure who is taking prescribed torsemide. Which clinical finding indicates effectiveness of the medication? A. Symmetrical pulses bilaterally B. Full strength to bilateral extremities C. Intact whisper test D. Absence of peripheral edema

*D. Absence of peripheral edema

The nurse is caring for a client who is receiving a continuous intravenous heparin infusion. The client's most recent activated partial thromboplastin time (aPTT) is 120 seconds. Which medication should the nurse plan to administer? A. Protamine B. Naloxone C. Vitamin K D. Enoxaparin

*A. Protamine

Which angiotensin-converting enzyme inhibitors (ACE inhibitors) are appropriate for a client with liver dysfunction? Select all that apply. One, some, or all responses may be correct. A. Ramipril B. Enalapril C. Quinapril C. Captopril D. Lisinopril

*C. Captopril *D. Lisinopril

A client with heart failure is being discharged with a new prescription for the angiotensin-converting enzyme (ACE) inhibitor captopril (Capoten). The nurse's discharge instructions should include reporting which problem to the healthcare provider? A. Weight loss. B. Dizziness. C. Muscle cramps. D. Dry mucous membranes.

*B. Dizziness.

A health care provider prescribes enalapril for a client. Which nursing action is important? A. Assess the client for hypokalemia. B. Monitor for adverse effects on renal function. C. Monitor the client's blood pressure during therapy. D. Assess the client for hypoglycemia.

*C. Monitor the client's blood pressure during therapy.

A client is receiving dexamethasone to treat acute exacerbation of asthma. For which side effect would the nurse monitor the client? A. Hyperkalemia B. Liver dysfunction C. Orthostatic hypotension D. Increased blood glucose

*D. Increased blood glucose

Which clinical finding indicates that a client taking digoxin may have developed digoxin toxicity? A. Constipation B. Decreased urination C. Cardiac dysrhythmias D. Metallic taste in the mouth

*C. Cardiac dysrhythmias

The nurse is teaching a client who has a new prescription for sublingual nitroglycerin. Which point should the nurse emphasize? A. Take the medication at the same time each day B. Rest in bed for an hour after taking medication C. Carry the nitroglycerine with you at all times D. Keep the medication bottle in the refrigerator

*C. Carry the nitroglycerine with you at all times

1) The nurse administers albuterol to a 4-year-old child. Which intervention would assist the nurse in evaluating the effectiveness of this medication? A. Auscultate breath sounds. B. Collect a sputum sample. C. Conduct a neurological examination. D. Palpate chest excursion.

*A. Auscultate breath sounds.

The nurse is providing discharge instructions to a client with a prescription for sublingual nitroglycerin. The nurse should inform the client to prepare for this most common side effect? A. Headache B. Depression C. Dry mouth D. Anorexia

*A. Headache

Which teaching would a nurse give to a client with a prescription for potassium supplements? A. To report any abdominal distress B. To use salt substitutes to season food C. To take the medication on an empty stomach D. To increase the dosage if muscle cramps occur

*A. To report any abdominal distress

The nurse is administering 40 mg of furosemide intravenously. Which sensation reported by the client would the nurse consider when determining that it is being administered too quickly? A. Full bladder B. Buzzing ears C. Fast heartbeat D. Numb arms and legs

*B. Buzzing ears

A child undergoing prolonged steroid therapy takes on a cushingoid appearance. The nurse would expect to find which of these manifestations during further assessment? Select all that apply. One, some, or all responses may be correct. A. Truncal obesity B. Thin extremities C. Increased linear growth D. Loss of hair on the body E. Decreased blood pressure

*A. Truncal obesity *B. Thin extremities

A client has primary open-angle glaucoma. Which ophthalmic preparation is indicated to manage this condition? A. Tetracaine B. Fluorescein C. Timolol maleate D.Atropine sulfate

*C. Timolol maleate

The nurse is providing education to the client prescribed montelukast for the treatment of asthma. What medication should the nurse instruct the client to avoid? A. Ibuprofen B. Prednisone C. Amoxicillin D. Formoterol

*A. Ibuprofen

A client is receiving furosemide to relieve edema. The nurse will monitor the client for which adverse effect? A. Hypernatremia B. Elevated blood urea nitrogen C. Hypokalemia D. Increase in the urine specific gravity

*C. Hypokalemia

Which adverse effect of imipramine requires further assessment and possible immediate medical intervention? A. Dry mouth B. Weight gain C. Blurred vision D. Urinary hesitancy

*D. Urinary hesitancy

A child who has nephrotic syndrome is prescribed steroid therapy. Which explanation would the nurse give the parents regarding the goal of this treatment? A. Prevents infection B. Stimulates diuresis C. Provides hemopoiesis D. Reduces blood pressure

B. Stimulates diuresis

A client has been taking rosuvastatin for six weeks as part of a treatment plan to reduce hyperlipidemia. The clinic nurse is reviewing and reinforcing information about the medication with the client. Which statements by the client indicates an understanding about the medication? Select all that apply. A. "I will need to call my doctor if I have any muscle weakness or pain, especially in my legs." B. "I will need to come back to have my liver and kidney labs checked." C. "I need to be careful when I get up because this medication can make my blood pressure drop." D. "I add some nuts and fresh fruit to my oatmeal in the morning and I can't remember when I last ate a steak." E. "This medication has to be taken first thing in the morning, before I eat breakfast."

*A. "I will need to call my doctor if I have any muscle weakness or pain, especially in my legs." *B. "I will need to come back to have my liver and kidney labs checked." *D. "I add some nuts and fresh fruit to my oatmeal in the morning and I can't remember when I last ate a steak."

The nurse is educating a client with end stage chronic obstructive pulmonary disease (COPD) about medication management. Which statement by the client indicates an understanding of the teaching? A. "I will use the albuterol in the nebulizer before my other inhalers each morning." B. "I can use my tiotropium inhaler if I get short of breath." C. "I will only use the fluticasone inhaler on the days I am really out of breath." D "The side effects of these medications will be less severe because I'm not taking them by mouth."

*A. "I will use the albuterol in the nebulizer before my other inhalers each morning."

Which information would the nurse include when preparing a teaching plan for a client prescribed sublingual nitroglycerin? A. "Place the tablet under the tongue or between the cheek and gums." B. "It takes 30 to 45 minutes for the nitroglycerin to achieve its effect." C. "If dizziness occurs, take a few deep breaths and lean the head back." D. "To facilitate absorption, drink a large glass of water after taking the medication."

*A. "Place the tablet under the tongue or between the cheek and gums."

Which statement regarding mealtime administration by a client who has arthritis and is prescribed corticosteroid medication indicates that the teaching was effective? A. "This will decrease gastric irritation." B. "This will serve as a reminder to take the medication." C. "The presence of food will enhance absorption." D. "The medication is ineffective in an acid medium."

*A. "This will decrease gastric irritation."

The nurse is teaching a school-aged child and family members about the use of inhalers prescribed for asthma. Which statement made by a family member indicates an understanding of the nurse's instructions? A. "We will keep a chart of daily peak flow meter results." B. "We can rely on our child's self-report of symptoms." C. "Monitoring our child's pulse rate is not necessary." D. "Skin color changes in our child is an early warning sign for airway constriction."

*A. "We will keep a chart of daily peak flow meter results."

*END OF ANS* To which nursing home resident could a nurse safely administer tricyclic antidepressants without questioning the health care provider's order? A. A client with mild hypertension B. A client with narrow-angle glaucoma C. A client with coronary artery disease (CAD) D. A client with benign prostatic hypertrophy (BPH)

*A. A client with mild hypertension

Which assessment will the nurse conduct before administering digoxin to a client? A. Apical heart rate B. Radial pulse C. Difference between carotid and radial pulses D. Difference between apical and radial pulses

*A. Apical heart rate

Which is an appropriate nursing action when caring for a client taking benazepril for hypertension? A. Assess for dizziness. B. Assess for dark, tarry stools. C. Administer the medication after meals. D. Monitor the electroencephalogram (EEG).

*A. Assess for dizziness.

Propranolol is prescribed for a client with coronary artery disease (CAD). The nurse should consult with the health care provider (HCP) before giving this medication when the client reports a history of which condition? A. Asthma B. Deep vein thrombosis C. Myocardial infarction D. Peptic ulcer disease

*A. Asthma

A nurse is providing dietary instructions to a client who is taking prescribed amiloride. Which information will the nurse include in the teaching? A. Avoid eating foods that are rich in potassium such as bananas B. It is important to control high-sodium foods such as canned soups C. Eat plenty of foods that contain calcium such as milk D. Choose foods that are high in iron content such as shellfish

*A. Avoid eating foods that are rich in potassium such as bananas

A client is receiving hydrochlorothiazide. Which physiological alteration will the nurse monitor to best determine the effectiveness of the client's hydrochlorothiazide therapy? A. Blood pressure B. Decreasing edema C. Serum potassium level D. Urine specific gravity

*A. Blood pressure

Which lifestyle advice does the nurse give to a client when oral digoxin therapy is initiated? Select all that apply. One, some, or all responses may be correct. A. Bran can decrease digoxin absorption. B. Digoxin should not be taken with hawthorn supplements. C. *Ginseng may cause a dangerous increase in digoxin levels in the blood. D. St. John's Wort can increase digoxin levels in the blood. E. Medications that lower serum potassium or magnesium can cause digoxin toxicity.

*A. Bran can decrease digoxin absorption. *B. Digoxin should not be taken with hawthorn supplements. *E. Medications that lower serum potassium or magnesium can cause digoxin toxicity.

A client with systemic lupus erythematosus is taking prednisone. Which foods would the nurse encourage the client to eat while receiving treatment to prevent hypokalemia? A. Broccoli B. Oatmeal C. Fried rice D. Cooked carrots

*A. Broccoli

Which food would the nurse encourage a client to eat while receiving treatment to prevent hypokalemia? A. Broccoli B. Oatmeal C. Fried rice D. Canned carrots

*A. Broccoli

The nurse is providing discharge education to a client with moderate persistent asthma. The nurse should instruct the client to administer which medication first? A. Bronchodilator B. Glucocorticoid C. Anticholinergic D. Mast cell stabilizer

*A. Bronchodilator

Which medications may be used to correct severe hyperkalemia resulting from intravenous (IV) administration? Select all that apply. One, some, or all responses may be correct. A. Calcium chloride B. Sodium chloride C. Calcium gluconate D. Sodium bicarbonate E. Dextrose solution with insulin

*A. Calcium chloride *C. Calcium gluconate *D. Sodium bicarbonate *E. Dextrose solution with insulin

Atenolol is prescribed for a client with moderate hypertension. Which information would the nurse include when teaching the client about this medication? Select all that apply. One, some, or all responses may be correct. A. Change to standing positions slowly. B. Take the medication before going to bed. C. Count the pulse before taking the medication. D. Mild weakness and fatigue are common side effects. E. It is safe to take over-the-counter (OTC) medications.

*A. Change to standing positions slowly. *C. Count the pulse before taking the medication. *D. Mild weakness and fatigue are common side effects.

The nurse is caring for a child receiving furosemide for pulmonary edema. Which nursing intervention(s) would the nurse implement? Select all that apply. One, some, or all responses may be correct. A. Checking the child's weight every day B. Administering the medication on an empty stomach C. Calculating the dose of medication as carefully as possible D. Exposing the child to sunlight for increasing periods E. Assessing the child regularly to help prevent electrolyte loss

*A. Checking the child's weight every day *C. Calculating the dose of medication as carefully as possible *E. Assessing the child regularly to help prevent electrolyte loss

During morning rounds, a healthcare provider informs a client with hypertension that a calcium channel blocker will be added to their treatment regimen. The nurse notes a new prescription for amiloride 10 mg PO daily. Which action does the nurse perform next? A. Clarify the prescription with the healthcare provider B. Educate the client on the new prescription C. Administer the medication with food D. Assess the client blood pressure

*A. Clarify the prescription with the healthcare provider

Following the administration of sublingual nitroglycerin to a client experiencing an acute anginal attack, which assessment finding indicates to the nurse that the desired effect has been achieved? A. Client states chest pain is relieved. B. Client's pulse decreases from 120 to 90. C. Client's systolic blood pressure decreases from 180 to 90. D. Client's SaO2 level increases from 92% to 96%.

*A. Client states chest pain is relieved.

A client has refused prescribed cortisone. The nurse continues to administer the cortisone while evading the client's questions. When the client later discovers that cortisone continued to be administered, the client decides to sue the nurse. Which elements must be considered in a legal action? Select all that apply. One, some, or all responses may be correct. A. Clients have a right to refuse treatment. B. Nurses are required to answer clients truthfully. C. The health care provider should have been notified. D. The client had insufficient knowledge to make such a decision. E. Legally prescribed medications are administered despite a client's objections.

*A. Clients have a right to refuse treatment. *B. Nurses are required to answer clients truthfully. *C. The health care provider should have been notified.

The client with congestive heart failure is receiving furosemide 80 mg once daily. Which data collection assessment would be performed to evaluate medication effectiveness? Select all that apply. One, some, or all responses may be correct. A. Daily weight B. Intake and output C. Monitor for edema D. Daily pulse oximetry E. Auscultate breath sounds

*A. Daily weight *B. Intake and output *C. Monitor for edema *D. Daily pulse oximetry *E. Auscultate breath sounds

A client with rheumatoid arthritis has been taking a corticosteroid medication for the past year. Prolonged use of corticosteroids puts this client at increased risk for which complication? A. Decreased white blood cells B. Increased C-reactive protein C. Increased sedimentation rate D. Decreased serum glucose levels

*A. Decreased white blood cells

An infant with congenital heart disease is prescribed digoxin and furosemide upon discharge. Which sign would the nurse instruct the parents to be alert for? A. Difficulty feeding with vomiting B. Cyanosis during periods of crying C. Daily naps lasting more than 3 hours D. A pulse rate faster than 100 beats/min

*A. Difficulty feeding with vomiting

A child being treated with cardiac medications developed vomiting, bradycardia, anorexia, and dysrhythmias. The nurse understands which medication toxicity is responsible for these symptoms? A. Digoxin B. Nesiritide C. Dobutamine D. Spironolactone

*A. Digoxin

A client who takes multiple medications complains of severe nausea, and the client's heartbeat is irregular and slow. The nurse determines that these signs and symptoms are toxic effects of which medication? A. Digoxin B. Captopril C. Furosemide D. Morphine sulfate

*A. Digoxin

The client with hypokalemia reports nausea, vomiting, and seeing a yellow light around objects. Which of the client's medications is the likely cause of the client's symptoms? A. Digoxin B. Furosemide C. Propranolol D. Spironolactone

*A. Digoxin

A client with left ventricular heart failure and supraventricular tachycardia is prescribed digoxin 0.25 mg daily. Which changes would the nurse expect to find if this medication is therapeutically effective? Select all that apply. One, some, or all responses may be correct. A. Diuresis B. Tachycardia C. Decreased edema D. Decreased pulse rate E. Reduced heart murmur F. Jugular vein distention

*A. Diuresis *C. Decreased edema *D. Decreased pulse rate

A client is receiving metoprolol. Which potential effect will the nurse teach the client to expect? A. Dizziness with strenuous activity B. Acceleration of the heart rate after eating a heavy meal C. Flushing sensations after taking the medication D. Pounding of the heart

*A. Dizziness with strenuous activity

A client with hypertension has received a prescription for metoprolol. Which information will the nurse include when teaching this client about metoprolol? A. Do not abruptly discontinue the medication. B. Consume alcoholic beverages in moderation. C. Report a heart rate of less than 70 beats per minute. D. Increase the medication dosage if chest pain occurs.

*A. Do not abruptly discontinue the medication.

The nurse is teaching a client about tricyclic antidepressants. Which potential side effects would the nurse include? Select all that apply. One, some, or all responses may be correct. A. Dry mouth B. Drowsiness C. Constipation D. Severe hypertension E. Orthostatic hypotension

*A. Dry mouth *B. Drowsiness *C. Constipation *E. Orthostatic hypotension

1) Which response to fludrocortisone will the nurse teach a client with adrenal insufficiency to report? Select all that apply. One, some, or all responses may be correct. A. Edema B. Rapid weight gain C. Fatigue in the afternoon D. Unpredictable changes in mood E. Increased frequency of urination

*A. Edema *B. Rapid weight gain

Which diuretic would the nurse anticipate administering to a client admitted with acute pulmonary edema? A. Furosemide B. Chlorothiazide C. Spironolactone D. Acetazolamide

*A. Furosemide

43) A client is scheduled for a craniotomy to remove a brain tumor. To prevent the development of cerebral edema after surgery, the nurse anticipates the use of medications from which class? A. Glucocorticoids B. Anticholinergics C. Anticonvulsants D. Antihypertensives

*A. Glucocorticoids

Which action describes a therapeutic effect of atenolol? A. Heart rate decreases B. Cardiac output increases C. Bronchospasm is relieved D. Pulse oximetry improves

*A. Heart rate decreases

A client is given a prescription for bumetanide. The nurse will teach the client to watch for symptoms of which condition? A. Hypokalemia B. Hyperchloremia C. Hypernatremia D. Hypoglycemia

*A. Hypokalemia

Which mechanism of action explains how hydrochlorothiazide increases urine output? A. Increases the excretion of sodium B. Increases the glomerular filtration rate C. Decreases the reabsorption of potassium D. Increases renal perfusion

*A. Increases the excretion of sodium

The nurse is caring for a child receiving prednisone. Which consideration is most important for the nurse to remember when administering adrenocorticosteroid therapy? A. It suppresses inflammation. B. It may produce hyperkalemia. C. Wound healing is accelerated. D. Antibody production increases.

*A. It suppresses inflammation.

The nurse is providing discharge instructions to an older adult client with heart failure. The client asks, "What is the purpose for taking the furosemide?" How should the nurse respond? A. It will help with decreasing fluid buildup in your lungs. B. It will help with reducing the risk for an irregular heart rhythm. C. It will protect your kidneys from chronic damage. D. It will reverse the damage to your heart muscle.

*A. It will help with decreasing fluid buildup in your lungs.

A client takes furosemide and digoxin for heart failure. Why would the nurse advise the client to drink a glass of orange juice every day? A. Maintaining potassium levels B. Preventing increased sodium levels C. Limiting the medications' synergistic effects D. Correcting the associated dehydration

*A. Maintaining potassium levels

*START OF CARDIOLOGY* Which nursing intervention is important when caring for clients receiving intravenous (IV) digoxin? Select all that apply. One, some, or all responses may be correct. A. Monitor the heart rate closely. B. Check the blood levels of digoxin. C. Administer the dose over 1 minute. D. Monitor the serum potassium level. E. Give the medication with other infusing medications.

*A. Monitor the heart rate closely. *B. Check the blood levels of digoxin. *D. Monitor the serum potassium level.

The nurse is teaching a nursing student about tricyclic antidepressant medications. Which statement made by the student indicates the need for further teaching? Select all that apply. One, some, or all responses may be correct. A. Nortriptyline is contraindicated in older adult clients. B. Desipramine is preferred for use in older adult clients. C. Imipramine is used as an adjunct in the treatment of childhood enuresis. D. Tricyclic antidepressant medications are prescribed for clients with seizure disorders. E. Tricyclic antidepressant medications are contraindicated in clients with a history of seizures.

*A. Nortriptyline is contraindicated in older adult clients. *D. Tricyclic antidepressant medications are prescribed for clients with seizure disorders.

Which instruction would the nurse give an unlicensed assistive personnel (UAP) to perform while caring for a client prescribed captopril? Select all that apply. One, some, or all responses may be correct. A. Obtain blood pressure. B. Measure intake and output. C. Weigh the client every morning. D. Notify the nurse if the client has a dry cough. E. Assist the client to change positions slowly.

*A. Obtain blood pressure. *B. Measure intake and output. *C. Weigh the client every morning. *D. Notify the nurse if the client has a dry cough. *E. Assist the client to change positions slowly.

Intravenous (IV) potassium is prescribed for a client with a diagnosis of hypokalemia. Which statement about administration of IV potassium is accurate? A. Oliguria is an indication for withholding IV potassium. B. Rapid infusion of potassium prevents burning at the IV site. C. Clients with severe deficits should be given IV push potassium. D. Average IV dosage of potassium should not exceed 60 mEq in 1 hour.

*A. Oliguria is an indication for withholding IV potassium.

Which principle explains how loop diuretics promote diuresis? A. Osmosis B. Filtration C. Diffusion D. Active transport

*A. Osmosis

Which statement accurately describes nortriptyline? Select all that apply. One, some, or all responses may be correct. A. Overdosage is often lethal. B. Constipation and urinary retention may occur. C. It is a selective serotonin reuptake inhibitor (SSRI). D. Weight gain is a common side effect.

*A. Overdosage is often lethal. *B. Constipation and urinary retention may occur. *D. Weight gain is a common side effect.

Sublingual nitroglycerin has been prescribed for a client with unstable angina. Which client response indicates that nitroglycerin is effective? A. Pain subsides as a result of arteriole and venous dilation. B. Pulse rate increases because the cardiac output has been stimulated. C. Sublingual area tingles because sensory nerves are being triggered. D. Capacity for activity improves as a response to increased collateral circulation.

*A. Pain subsides as a result of arteriole and venous dilation.

A client who has type 1 diabetes and chronic bronchitis is prescribed atenolol for the management of angina pectoris. Which clinical manifestation will alert the nurse to the fact that the client may be developing a life-threatening response to the medication? A. Paroxysmal nocturnal dyspnea B. Supraventricular tachycardia C. Malignant hypertension D. Hyperglycemia

*A. Paroxysmal nocturnal dyspnea

A pediatric client is prescribed an intravenous infusion of methylprednisolone. Which clinical manifestation requires immediate intervention during administration of the initial dose? A. Polyuria B. Tinnitus C. Drowsiness D. Hypotension

*A. Polyuria

A client is admitted to the hospital for a new onset of supraventricular tachycardia (SVT) and is prescribed digoxin. For which laboratory finding should the nurse notify the healthcare provider immediately? A. Potassium level of 3.1 mEq/L. B. Sodium level of 132 mEq/L. C. Calcium level of 8.6 mg/dL. D. Magnesium level of 1.2 mEq/L.

*A. Potassium level of 3.1 mEq/L.

An 80-year-old client who is taking digoxin reports nausea, vomiting, abdominal cramps and halo vision. Which laboratory result should the nurse evaluate first? A. Potassium levels B. Blood pH C. Magnesium levels D. Blood urea nitrogen

*A. Potassium levels

Which dietary choices will the nurse instruct the client taking spironolactone to avoid increasing? Select all that apply. One, some, or all responses may be correct. A. Potatoes B. Red meat C. Cantaloupe D. Wheat bread E. Flavored yogurt

*A. Potatoes *C. Cantaloupe

The nurse is caring for a client diagnosed with diabetic ketoacidosis who is receiving 50 mEq of sodium bicarbonate in 1 L of dextrose 5% in water via a central venous access device. The client has three new prescriptions for continuously infused medications. Which action is appropriate? A. Refer to an IV compatibility chart B. Request that an additional IV access be inserted C. Use a Y-site connector to infuse two medications in the same port D. Insert a peripheral intravenous access

*A. Refer to an IV compatibility chart

The nurse has administered sublingual nitroglycerin. Which outcome would the nurse use to determine the effectiveness of sublingual nitroglycerin? A. Relief of anginal pain B. Improved cardiac output C. Decreased blood pressure D. Ease in respiratory effort

*A. Relief of anginal pain

A nurse is reviewing a client's medical history. The client has been newly diagnosed with hypertension and has been prescribed oral losartan as treatment. The nurse will clarify the use of losartan if which comorbidity is noted in the client's medical record? A. Renal stenosis B. Hyperlipidemia C. Atrial fibrillation D. Diabetes

*A. Renal stenosis

A client is given a loading dose of digoxin and placed on a maintenance dose of digoxin 0.25 mg by mouth daily. Which responses would the nurse expect the client to exhibit when a therapeutic effect of digoxin is achieved? A. Resolution of heart failure B. Decreased anginal episodes C. Conversion of atrial fibrillation D. Decreased blood pressure

*A. Resolution of heart failure

The nurse is collecting the health history for a client who reports a sudden onset of generalized weakness and fatigue. The nurse notes the client has a new prescription for spironolactone. Which action should the nurse take first? A. Review the drug formulary for side effects B. Request the health care provider to stop the medication C. Notify the pharmacist of the findings D. Document the findings

*A. Review the drug formulary for side effects

The nurse is assessing a client with hypertension who reports experiencing dizziness after taking prescribed diltiazem. It is most important that the nurse assesses for which client characteristic? A. Schedule for taking medication B. Appearance of feet and ankles C. Activity and rest patterns D. Daily intake of potassium

*A. Schedule for taking medication

After abdominal surgery, a client is prescribed low molecular weight heparin (LMWH). During administration of the medication, the client asks the nurse the reason for the medication. Which is the best response for the nurse to provide the client? A. This medication is given to prevent blood clot formation. B. This medication enhances antibiotics to prevent infection. C. This medication dissolves clots that develop in the legs. D. This medication enhances the healing of wounds.

*A. This medication is given to prevent blood clot formation.

Which method would the nurse recommend when teaching the client with asthma how to determine if an inhaler is empty? A. Track the number of doses taken. B. Taste the medication when sprayed into the air. C. Shake the canister. D. Place the canister in water to see if it floats.

*A. Track the number of doses taken.

A client is prescribed albuterol to relieve severe asthma. Which adverse effects will the nurse instruct the client to anticipate? Select all that apply. One, some, or all responses may be correct. A. Tremors B. Lethargy C. Palpitations D. Bronchoconstriction E. Decreased pulse rate

*A. Tremors *C. Palpitations

Which medication class includes amitriptyline? A. Tricyclics B. Monoamine oxidase inhibitors (MAOIs) C. Selective serotonin reuptake inhibitors (SSRIs) D. Serotonin-norepinephrine reuptake inhibitors (SNRIs)

*A. Tricyclics

Which nursing assessment would performed by a nurse before administering intravenous (IV) infusion of potassium chloride (KCl) 40 mEq in 100 mL of 5% dextrose and water to be infused over 2 hours? Select all that apply. One, some, or all responses may be correct. A. Urinary output B. Deep tendon reflexes C. Last bowel movement D. Arterial blood gas results E. Last serum potassium level F. Patency of the intravenous access

*A. Urinary output *E. Last serum potassium level *F. Patency of the intravenous access

The nurse is transcribing a new prescription for spironolactone (Aldactone) for a client who receives an angiotensin-converting enzyme (ACE) inhibitor. Which action should the nurse implement? A. Verify both prescriptions with the healthcare provider. B. Report the medication interactions to the nurse manager. C. Hold the ACE inhibitor and give the new prescription. D. Transcribe and send the prescription to the pharmacy.

*A. Verify both prescriptions with the healthcare provider.

A health care provider prescribes digoxin for a client. The nurse teaches the client to be alert for which common early indication of acute digoxin toxicity? A. Vomiting B. Urticaria C. Photophobia D. Respiratory distress

*A. Vomiting

A child with nephrotic syndrome has been receiving prednisone for 1 week. Which information in the child's record indicates to the nurse that the medication has been effective? Select all that apply. One, some, or all responses may be correct. A. Weight loss B. Lower blood pH C. Decreased lethargy D. Increased urine output E. Decreased blood pressure

*A. Weight loss *C. Decreased lethargy *D. Increased urine output

A client is receiving furosemide to relieve edema. The nurse will monitor the client for which responses? Select all that apply. One, some, or all responses may be correct. A. Weight loss B. Negative nitrogen balance C. Increased urine specific gravity D. Excessive loss of potassium ions E. Pronounced retention of sodium ions

*A. Weight loss *D. Excessive loss of potassium ions

While receiving an adrenergic beta 2 agonist medication for asthma, the client complains of palpitations, chest pain, and a throbbing headache. Which nursing action is the most appropriate? A. Withhold the medication and notify the health care provider. B. Tell the client that these are expected side effects from the medicine. C. Give instructions to breathe slowly and deeply for several minutes. D. Explain that the effects are temporary and will subside as medication tolerance develops.

*A. Withhold the medication and notify the health care provider.

The nurse is preparing the 0900 dose of losartan (Cozaar), an angiotensin II receptor blocker (ARB), for a client with hypertension and heart failure. The nurse reviews the client's laboratory results and notes that the client's serum potassium level is 5.9 mEq/L. Which action should the nurse take first? A. Withhold the scheduled dose. B. Check the client's apical pulse. C. Notify the healthcare provider. D. Repeat the serum potassium level.

*A. Withhold the scheduled dose.

The nurse is providing information to a client about propranolol. Which statement by the client indicates the teaching has been effective? A. "I should expect to feel nervousness during the first few weeks." B. "I can have a heart attack if I stop this medication suddenly." C. "I could have an increase in my heart rate for a few weeks." D. "I may experience seizures if I stop the medication abruptly."

*B. "I can have a heart attack if I stop this medication suddenly."

The nurse is discharging a client on oral potassium replacement. Which of the following statements requires further teaching by the nurse? A. "I can still take my nonsteroidal anti-inflammatory medications occasionally for my arthritis pain." B. "I will continue to use salt substitutes to flavor my food." C. "I will take my furosemide first thing in the morning." D. "I will read the food labels for added potassium."

*B. "I will continue to use salt substitutes to flavor my food."

Which response would a nurse give to a client who takes furosemide and digoxin and reports that everything looks yellow? A. "This is related to your heart problems, not to the medication." B. "I will hold the medication until I consult with your health care provider." C. "It is a medication that is necessary, and that side effect is only temporary." D. "Take this dose, and when I see your health care provider, I will ask about it."

*B. "I will hold the medication until I consult with your health care provider."

Which instruction will the nurse include when performing discharge teaching to a client now receiving hydrocortisone by mouth after stabilization of an acute adrenal insufficiency? A. "Eat a diet high in sodium." B. "Take the medication with food." C. "Maintain the same dose indefinitely." D. "Eliminate a dose if side effects occur."

*B. "Take the medication with food."

The nurse is teaching a client with asthma about albuterol. How should the nurse best describe the action of this medication? A. "The medication is given to reduce secretions that block airways." B. "The medication will help to relax smooth muscles in the airways." C. "The medication will stimulate the respiratory center in the brain." D. "The medication will help to prevent pneumonia."

*B. "The medication will help to relax smooth muscles in the airways."

Immediately after a bilateral adrenalectomy, a client is receiving corticosteroids that are to be continued after discharge from the hospital. Which statement by the client indicates to the nurse that additional education is needed? A. 'I need to have periodic tests of my blood for glucose.' B. 'I am glad that I only have to take the medication once a day.' C. 'I must take the medicine with meals.' D. 'I should tell my health care provider if I am overly restless or have trouble sleeping.'

*B. 'I am glad that I only have to take the medication once a day.'

Pyridostigmine bromide is prescribed for a client with myasthenia gravis. The nurse evaluates that the medication regimen is understood when the client makes which statement? A. 'I will take the medication on an empty stomach.' B. 'I need to set an alarm so I take the medication on time.' C. 'It will be important to check my heart rate before taking the medication.' D. 'I should monitor for an increase in blood pressure after taking the medication.'

*B. 'I need to set an alarm so I take the medication on time.'

The health care provider prescribes neostigmine for a client with myasthenia gravis. Which client statement indicates understanding regarding medication management plans? A. 'I must keep the medication in a container in the refrigerator.' B. 'I should take the medication at the exact time that is listed on the prescription.' C. 'I will plan to take the medication between meals.' D. 'I expect that the onset of the medication's action will occur several hours after I take it.'

*B. 'I should take the medication at the exact time that is listed on the prescription.'

A client who takes furosemide and digoxin reports to the nurse that everything looks yellow. Which response by the nurse is most appropriate? A. 'This is related to your heart problems, not to the medication.' B. 'I will hold the medication until I consult with your health care provider.' C. 'It is a medication that is necessary, and that side effect is only temporary.' D. 'Take this dose, and when I see your health care provider, I will ask about it.'

*B. 'I will hold the medication until I consult with your health care provider.'

Which instruction would the nurse include in a teaching plan for nitroglycerin patches? A. 'Apply the patch on a distal extremity.' B. 'Remove a previous patch before applying the next one.' C. 'Massage the area gently after applying the patch to the skin.' D. 'Apply a warm compress to the site before attaching the patch.'

*B. 'Remove a previous patch before applying the next one.'

A depressed client has been prescribed a tricyclic antidepressant. Which time period indicates how long it usually takes before the client notices a significant change in the depression? A. 4 to 6 days B. 2 to 4 weeks C. 5 to 6 weeks D. 12 to 16 hours

*B. 2 to 4 weeks

A client is scheduled for an adrenalectomy. Which action would the nurse expect in the plan of care? A. Provide a low-protein diet. B. Administer parenteral corticosteroids. C. Collect a preoperative 24-hour urine specimen. D. Withhold all medications 48 hours before surgery.

*B. Administer parenteral corticosteroids.

The nurse is teaching a client with stable angina about their new prescription for nitroglycerin transdermal patch. Which instructions should the nurse include? Select all that apply. A. Remove the patch if ankle edema occurs B. Apply the patch to a hairless area of the body C. Notify your provider for persistent dizziness or any fainting episode D. Apply a second patch with chest pain E. Plan for patch-free time, usually overnight F. Rotate the application area

*B. Apply the patch to a hairless area of the body *C. Notify your provider for persistent dizziness or any fainting episode *E. Plan for patch-free time, usually overnight *F. Rotate the application area

The nurse is preparing to administer diltiazem to a client with heart disease. Which action should the nurse take first? A. Assess the client's lung sounds and monitor for wheezing B. Assess the client's blood pressure and apical pulse C. Assess the client's urine output and potassium level D. Auscultate the abdomen for bowel sounds

*B. Assess the client's blood pressure and apical pulse

The healthcare provider prescribes digitalis (Digoxin) for a client diagnosed with heart failure. Which intervention should the nurse implement prior to administering the digoxin? A. Observe respiratory rate and depth. B. Assess the serum potassium level. C. Obtain the client's blood pressure. D. Monitor the serum glucose level.

*B. Assess the serum potassium level.

The nurse has administered fentanyl, atropine, cefazolin and benzocaine to a client for an endoscopic procedure. The nurse is monitoring the client and notes that the heart rate has increased from the pre-procedure baseline. The nurse knows that which of the following medications is most likely responsible for the client's increased heart rate? A. Fentanyl B. Atropine C. Cefazolin D. Benzocaine

*B. Atropine

A client is admitted to the hospital with a diagnosis of heart failure and acute pulmonary edema. The health care provider prescribes furosemide 40 mg intravenous (IV) stat to be repeated in 1 hour. Which nursing action will best evaluate the effectiveness of the furosemide in managing the client's condition? A. Performing daily weights B. Auscultating breath sounds C. Monitoring intake and output D. Assessing for dependent edema

*B. Auscultating breath sounds

A primary health care provider prescribes atenolol 20 mg by mouth four times a day. Which information is important for the nurse to include in the discharge teaching plan for this client? A. Drink alcoholic beverages in moderation. B. Avoid abruptly discontinuing the medication. C. Increase the medication if chest pain develops. D. Report a pulse rate less than 70 beats/minute.

*B. Avoid abruptly discontinuing the medication.

To prevent excessive bruising when administering subcutaneous heparin, which technique will the nurse employ? A. Administer the injection via the Z-track technique. B. Avoid massaging the injection site after the injection. C. Use 2 mL of sterile normal saline to dilute the heparin. D. Inject the medication into the vastus lateralis muscle in the thigh.

*B. Avoid massaging the injection site after the injection.

Which instructions will the nurse include in the teaching plan for a client who will be taking simvastatin? Select all that apply. One, some, or all responses may be correct. A. Increase dietary intake of potassium. B. Avoid prolonged exposure to the sun. C. Schedule regular ophthalmic examinations. D. Take the medication at least half an hour before meals. E. Contact your health care provider if skin becomes gray-bronze.

*B. Avoid prolonged exposure to the sun. *C. Schedule regular ophthalmic examinations. *E. Contact your health care provider if skin becomes gray-bronze.

The nurse is reviewing prescribed medications with a client. Which information should the nurse reinforce about captopril? A. Take the medication with meals. B. Avoid using salt substitutes. C. Restrict fluids to 1000 mL/day. D. Avoid green leafy vegetables.

*B. Avoid using salt substitutes.

A client with myasthenia gravis has been receiving neostigmine and asks about its action. Which information would the nurse consider when formulating a response? A. Stimulates the cerebral cortex B. Blocks the action of cholinesterase C. Replaces deficient neurotransmitters D. Accelerates transmission along neural sheaths

*B. Blocks the action of cholinesterase

A client with hypertensive heart disease who had an acute episode of heart failure is to be discharged on a regimen of metoprolol and digoxin. Which outcome would the nurse anticipate when metoprolol is administered with digoxin? A. Headaches B. Bradycardia C. Hypertension D. Junctional tachycardia

*B. Bradycardia

A nurse is reviewing new prescriptions for a client diagnosed with heart failure. The nurse notes captopril 25mg PO. Which action does the nurse perform next? A. Administer the medication before meals B. Clarify the prescription with the healthcare provider C. Take the client weight D. Check the client latest creatinine level

*B. Clarify the prescription with the healthcare provider

The nurse is preparing to administer prescribed digoxin to client with atrial fibrillation. The nurse notes the packaging for the medication is provided in a different route than prescribed. Which action should the nurse take? A. Administer the medication as ordered B. Consult the pharmacist regarding the error C. Alert the charge nurse to the medication error D. Alert the charge nurse to the medication error D. Contact the health care provider

*B. Consult the pharmacist regarding the error

A beclomethasone inhaler would be prescribed for which purpose? A. Prevents atelectasis B. Decreases inflammation C. Relaxes smooth muscle in the airways D. Reduces bacteria in the respiratory tract

*B. Decreases inflammation

Which goal is the priority for a client with asthma who has a prescription for an inhaled bronchodilator? A. Is able to obtain pulse oximeter readings B. Demonstrates use of a metered-dose inhaler C. Knows the health care provider's office hours D. Can identify triggers that may cause wheezing

*B. Demonstrates use of a metered-dose inhaler

The home care nurse is reviewing the medical record of a new client with a history of chronic obstructive pulmonary disease, atrial fibrillation and gout. After reviewing the client's medication list, for which medications should the nurse arrange to monitor blood levels? Select all that apply. A. Beclomethasone B. Digoxin C. Theophylline D. Allopurinol E. Montelukast

*B. Digoxin *C. Theophylline

The nitrate isosorbide dinitrate is prescribed for a client with angina. Which instruction should the nurse include in this client's discharge teaching plan? A. Quit taking the medication if dizziness occurs. B. Do not get up quickly. Always rise slowly. C. Take the medication with food only. D. Increase your intake of potassium-rich foods.

*B. Do not get up quickly. Always rise slowly.

Hypertension develops in a school-age child with acute glomerulonephritis. Which medication would the nurse anticipate providing teaching for? A. Digoxin B. Furosemide C. Diazepam D. Phenytoin

*B. Furosemide

Which intervention would the nurse implement for a client admitted for an exacerbation of asthma? A. Determine the client's emotional state. B. Give prescribed medications to promote bronchiolar dilation. C. Provide education about the effect of a family history. D. Encourage the client to use an incentive spirometer routinely.

*B. Give prescribed medications to promote bronchiolar dilation.

A client prescribed atenolol has a blood pressure of 120/68 mmHg, displaying a sinus bradycardia with a rate of 58 beats/minute, and a P-R interval of 0.24. Which action should the nurse take? A. Lower the head of the bed and assess the client for orthostatic vital sign changes. B. Give the medication as prescribed and continue to monitor the client. C. Prepare to administer atropine sulfate IV push. D. Hold the prescribed dose and contact the healthcare provider.

*B. Give the medication as prescribed and continue to monitor the client.

The nurse is assisting a client who is taking amlodipine with meal planning. Which fluid selected by the client would require follow up by the nurse? A. Black coffee B. Grapefruit juice C. Green tea D. Chocolate Milk

*B. Grapefruit juice

Which food would the nurse instruct a client taking diltiazem to avoid? Select all that apply. One, some, or all responses may be correct. A. Alcohol B. Grapefruit juice C. Cheddar cheese D. Summer sausage E. Dark green vegetables

*B. Grapefruit juice

*START OF RESPIRATORY* 1) Which action would be the most appropriate way for the nurse to evaluate a child's understanding of how to use an inhaler? A. Asking questions about using the inhaler B. Having the child demonstrate inhaler use C. Explaining how the inhaler will be used at home D. Having the child tell the nurse about the technique that was learned

*B. Having the child demonstrate inhaler use

The anticholinesterase medication pyridostigmine is prescribed for the client with myasthenia gravis. When providing medication teaching, the nurse explains that the client should expect a decrease in which function? A. Bowel function B. Heart rate C. Skeletal muscle contraction D. Urinary frequency

*B. Heart rate

11) The nurse is preparing to administer an albuterol nebulizer treatment to a patient with asthma. Which assessment finding should be brought to the health care provider's attention prior to administering the medication? A. Temperature of 101°F (38.3°C) B. Heart rate of 116 bpm C. Respiratory rate of 28 D. Lower extremity edema

*B. Heart rate of 116 bpm

A nurse is providing education to a client about newly prescribed diltiazem. Which statement will the nurse include in the teaching? A. Skip the dose if your systolic blood pressure is less than 120 mmHg B. Hold the dose if your heart rate is less than 50 beats/min C. Call your healthcare provider if you experience any fever D. Notify your healthcare provider if you notice any weight loss

*B. Hold the dose if your heart rate is less than 50 beats/min

A hospitalized 8-month-old infant is receiving digoxin to treat Tetralogy of Fallot. Prior to administering the next dose of the medication, the parent reports that the baby vomited one time, just after breakfast. The infant's heart rate is 92 bpm. What action should the nurse take? A. Give the scheduled dose after the client is done eating lunch. B. Hold the medication and notify the primary health care provider. C. Reduce the next dose by half and then resume the normal medication schedule. D. Double the next dose to make up for the medication lost from vomiting.

*B. Hold the medication and notify the primary health care provider.

A client with cirrhosis of the liver has been taking chlorothiazide. The provider adds spironolactone to the client's medication regimen to prevent which condition? A. Hyponatremia B. Hypokalemia C. Ascites D. Peripheral neuropathy

*B. Hypokalemia

A client presents to the emergency department with chest pain. A myocardial infarction is suspected, and 500 mL of 5% dextrose in water (D 5W) with 50 mg of nitroglycerin intravenously (IV) has been prescribed. The nurse will monitor the client for which common side effect of nitroglycerin? A. Bradycardia B. Hypotension C. Nausea and vomiting D. Leg cramps

*B. Hypotension

An 11-year-old client reports having bedwetting issues (enuresis). Which medication would the nurse anticipate when developing a teaching plan ? A. Alprazolam B. Imipramine C. Lithium salts d. Clomipramine

*B. Imipramine

A client presents to the clinic for a follow-up appointment after starting pyridostigmine for management of myasthenia gravis. Which new client problems are adverse effects of pyridostigmine? Select all that apply. One, some, or all responses may be correct. A. Respiratory depression B. Increased urinary frequency C. Diplopia D. Muscle twitching E. Diarrhea

*B. Increased urinary frequency *D. Muscle twitching *E. Diarrhea

The nurse is teaching the parents of a child prescribed a high dose of oral prednisone for asthma. Which information is critical for the nurse to include when teaching about this medication? A. It protects against infection. B. It should be stopped gradually. C. An early growth spurt may occur. D. A moon-shaped face will develop.

*B. It should be stopped gradually.

The client diagnosed with heart failure is prescribed oral digoxin. What is the priority nursing assessment for this medication? A. Monitor serum electrolytes and creatinine B. Measure apical pulse prior to administration C. Maintain accurate intake and output ratios D. Monitor blood pressure every 4 hours

*B. Measure apical pulse prior to administration

When a client with type 1 diabetes develops heart failure, digoxin is prescribed. Which nursing action is important to include when planning care? A. Administer the digoxin 1 hour after the client's morning insulin. B. Monitor the client for cardiac dysrhythmias. C. Monitor for increased risk of hyperglycemia. D. Increase digoxin dosage if insulin requirements are increased.

*B. Monitor the client for cardiac dysrhythmias.

The client is discharged from the hospital with a new prescription for furosemide. During a follow-up visit one week later, the nurse notes the following findings. Which finding is most important to report to the health care provider? A. Constipation B. Muscle cramps C. Occasional lightheadedness D. Increased urine production

*B. Muscle cramps

The nurse is reviewing medication instructions with a client who is taking digoxin. The nurse should reinforce to the client to report which of the following side effects? A. Rash, dyspnea, edema B. Nausea, vomiting, fatigue C. Hunger, dizziness, diaphoresis D. Polyuria, thirst, dry skin

*B. Nausea, vomiting, fatigue

A nurse has administered sublingual nitroglycerin to a client in the emergency department. Which clinical finding indicates an adverse response to the medication? A. Persistent chest pain B. Orthostatic hypotension C. Decreased heart rate D. Labored breathing

*B. Orthostatic hypotension

The nurse is evaluating the effectiveness of therapy for a client who received albuterol via nebulizer during an acute episode of shortness of breath due to asthma. Which finding is the best indicator that the therapy was effective? A. Accessory muscle use has decreased. B. Oxygen saturation is greater than 90%. C. Respiratory rate is 16 breaths/minute. D. No wheezes are audible.

*B. Oxygen saturation is greater than 90%.

A client has a prescription for a sublingual nitroglycerin tablet. Which technique will the nurse teach the client to use? A. Place the pill inside the cheek and let it dissolve. B. Place the pill under the tongue and let it dissolve. C. Chew the pill thoroughly and then swallow it. D. Swallow the pill with a full glass of water.

*B. Place the pill under the tongue and let it dissolve.

When the nurse is administering intravenous potassium to a client with hypokalemia, which finding is most important to communicate to the health care provider? A. U waves on cardiac monitor B. QRS duration of 0.28 seconds C. Decreased bowel sounds D. Weakened grip strength

*B. QRS duration of 0.28 seconds

Which information from the client's history would the nurse identify as a risk factor for developing osteoporosis? A. Takes estrogen therapy B. Receives long-term steroid therapy C. Has a history of hypoparathyroidism D.Engages in strenuous physical activity

*B. Receives long-term steroid therapy

A client with rheumatoid arthritis asks the nurse why it is necessary to inject hydrocortisone into the knee joint. Which reason would the nurse include in a response to this question? A. Lubricates the joint B. Reduces inflammation C. Provides physiotherapy D. Prevents ankylosis of the joint

*B. Reduces inflammation

A client with heart failure is prescribed spironolactone (Aldactone). Which information is most important for the nurse to provide to the client about diet modifications? A. Do not add salt to foods during preparation. B. Refrain for eating foods high in potassium. C. Restrict fluid intake to 1000 ml per day. D. Increase intake of milk and milk products.

*B. Refrain for eating foods high in potassium.

A health care provider prescribes metaproterenol for a client. For which therapeutic effect would the nurse monitor the client? A. Induced sedation B. Relaxed bronchial spasm C. Decreased blood pressure D. Productive cough

*B. Relaxed bronchial spasm

A client with chronic obstructive pulmonary disease (COPD) is receiving aminophylline 25 mg/hour intravenously (IV). Which finding would be associated with side effects of this medication? A. Flushing and headache B. Restlessness and palpitations C. Decreased urine volume D. Pruritus

*B. Restlessness and palpitations

The nurse is teaching the client how to properly use a dry powder capsule inhaler. How should the nurse instruct the client to use this type of inhaler? A. Shake inhaler before putting it in mouth B. Seal lips tightly around mouthpiece and inhale rapidly and deeply C. Rinse mouthpiece in hot soapy water after using D. Breathe in medicine slowly and deeply for about 3-5 seconds

*B. Seal lips tightly around mouthpiece and inhale rapidly and deeply

The nurse is preparing to administer digoxin to a client with recurring atrial fibrillation. Which laboratory value should be of highest concern for the nurse? A. Hemoglobin 9.4 g/dL B. Serum potassium 3.1 mEq/L C. Serum creatinine 1.9 mg/dL D. B-type natriuretic peptide 140 pg/mL

*B. Serum potassium 3.1 mEq/L

A client who recently started receiving oral corticosteroids for a severe allergic reaction is instructed that the dosage will be reduced gradually until all medication is stopped at the end of 2 weeks. Which reason would the nurse provide for this gradual reduction in dosage? A. Discontinuing the medication too fast will cause the allergic reaction to reappear. B. Slow reduction of the medication will prevent a physiological crisis because the adrenal glands are suppressed. C. The health care provider is attempting to determine the minimal dose that will be effective for the allergy. D. Sudden cessation of the medication will cause development of serious side effects, such as moon face and fluid retention.

*B. Slow reduction of the medication will prevent a physiological crisis because the adrenal glands are suppressed.

The nurse is providing discharge education to a client who will be starting daily atenolol for the treatment of hypertension. Which side effect is most important for the client to notify their health care provider about? A. Decreased libido B. Slow, irregular heart rate C. Dizziness in the morning D. Decreased exercise tolerance

*B. Slow, irregular heart rate

A client who is on long-term corticosteroid therapy after an adrenalectomy is admitted to the surgical intensive care unit after being involved in a motor vehicle crash. Which statement is an important concern for client safety? A. The dosage of steroids will have to be tapered down slowly to prevent acute adrenal crisis. B. Steroid therapy will need to be increased to avert a life-threatening crisis. C. Osteoporosis secondary to long-term corticosteroids increases fracture risk. D. The client is at risk for Cushing syndrome if taking long-term corticosteroid therapy.

*B. Steroid therapy will need to be increased to avert a life-threatening crisis.

A client with midsternal pain presents to the emergency department. Vital signs are stable. Which form of nitroglycerin would the nurse anticipate giving initially? A. Oral capsule B. Sublingual spray C. Intravenous solution D. Transdermal patch

*B. Sublingual spray

Which information will the nurse include when teaching a client about potassium chloride effervescent tablets? A. Chew the tablet completely. B. Take the medication with food. C. Take the medication at bedtime. D. Use warm water to dissolve the tablet.

*B. Take the medication with food.

20) Which nursing assessment is important for a school-age child undergoing long-term steroid therapy? A. Monitoring pulse for irregularities B. Testing of stools for occult blood C. Inspection of urine for mucous threads D. Check of oral mucous membranes for ulcers

*B. Testing of stools for occult blood

The nurse is caring for a client after cardiac surgery who has been prescribed protamine sulfate. Which finding indicates that the treatment is having the intended effect? A. The international normalized ratio (INR) is trending down. B. The bleeding from the surgical site has slowed. C. The client reports decreased chest pain. D. The respiratory rate is increased.

*B. The bleeding from the surgical site has slowed.

A client with myasthenia gravis begins taking pyridostigmine. Two days later, the client develops loose stools and increased salivation. Which conclusion would the nurse make about these new developments? A. The client is experiencing a myasthenic crisis. B. The medication is causing cholinergic side effects. C. The medication is triggering a paradoxical reaction. D. The client is exhibiting toxic effects of the medication.

*B. The medication is causing cholinergic side effects.

Which conclusion would the nurse make about the development of loose stools and increased salivation two days after a client with myasthenia gravis begins taking pyridostigmine? A. The client is experiencing a myasthenic crisis. B. The medication is causing cholinergic side effects. C. The medication is triggering a paradoxical reaction. D. The client is exhibiting toxic effects of the medication.

*B. The medication is causing cholinergic side effects.

The nurse is providing discharge education to a client newly diagnosed with chronic obstructive pulmonary disease. The client is prescribed the diskus inhaler fluticasone propionate and salmeterol. The client asks, "How will I know when the inhaler is empty?" How should the nurse respond? A. Shake the canister to detect any fluid movement B. The number of doses that remain will be on the inhaler C. Drop the canister in water to observe floating D. Estimate how many doses are usually in the canister

*B. The number of doses that remain will be on the inhaler

Which criterion is an indicator that the nitroglycerin sublingual tablets have lost their potency? A. Sublingual tingling is experienced. B. The tablets are more than 3 months old. C. The headache is less severe. D. Onset of relief is delayed.

*B. The tablets are more than 3 months old.

The nurse is discharging a client with a new prescription for tiotropium to help manage the symptoms of chronic obstructive pulmonary disease. What information should the nurse include in the discharge teaching? A. It may be a few days before you feel the full effects of tiotropium. B. This medication cannot be used to relieve sudden breathing problems. C. Be sure to swallow the capsules with a full glass of water. D. A common side effect is nausea and loose stools.

*B. This medication cannot be used to relieve sudden breathing problems.

Intravenous furosemide has been prescribed for a client with severe edema and hypertension. Which subjective clinical manifestations lead the nurse to suspect that the furosemide is infusing too rapidly? Select all that apply. One, some, or all responses may be correct. A. Hunger B. Tinnitus C. Weakness D. Leg cramps E. Excess salivation

*B. Tinnitus *C. Weakness *D. Leg cramps

A client presents with extensive lesions caused by psoriasis. Which intervention would the nurse anticipate providing teaching on? A. Advising sunscreen and special clothing B. Topical application of steroids C. Potassium permanganate baths D. Débridement of necrotic plaques

*B. Topical application of steroids

Which intervention would the nurse anticipate providing teaching on when a client presents with extensive lesions caused by psoriasis? A. Advising sunscreen and special clothing B. Topical application of steroids C. Potassium permanganate baths D. Débridement of necrotic plaques

*B. Topical application of steroids

Which clinical indicator would the nurse monitor to determine if the client's simvastatin is effective? A. Heart rate B. Triglycerides C. Blood pressure D. International normalized ratio (INR)

*B. Triglycerides

The health care provider prescribes a cholinergic medication to treat a client's urinary problem. Which effect would the nurse anticipate? A. Urinary frequency decreases. B. Urinary retention is prevented. C. Pain is controlled. D. Urinary urgency decreases.

*B. Urinary retention is prevented.

Cholinergic agonists are prescribed for which type of urinary condition? A. Kidney stones B. Urine retention C. Spastic bladder D. Urinary tract infections

*B. Urine retention

The nurse is monitoring a 6-year-old child for toxicity precipitated by digoxin. Which sign of digoxin toxicity would the nurse monitor for? A. Oliguria B. Vomiting C. Tachypnea D. Splenomegaly

*B. Vomiting

The nurse is providing care for a client prescribed propranolol. Which symptoms should the nurse report to the healthcare provider immediately? A. Headache, hypertension, and blurred vision. B. Wheezing, hypotension, and AV block. C. Vomiting, dilated pupils, and papilledema. D. Tinnitus, muscle weakness, and tachypnea.

*B. Wheezing, hypotension, and AV block.

When teaching a client about digoxin, which symptom will the nurse include as a reason to withhold the digoxin? A. Fatigue B. Yellow vision C. Persistent hiccups D. Increased urinary output

*B. Yellow vision

The nurse is reinforcing the correct use of a metered-dose inhaler (MDI) for a client newly-diagnosed with asthma. The client asks, "how will I know the canister is empty?" What is the best response by the nurse? A. "Contact your pharmacy to find out when to obtain a refill." B. "Drop the canister in water to observe if it floats." C. "Count the number of doses as the inhaler is used." D. "Shake the canister and listen for any fluid movement."

*C. "Count the number of doses as the inhaler is used."

A nurse is teaching a client with asthma about the correct use of the fluticasone inhaler. Which statement, if made by the client, would indicate that the teaching was effective? A. "The inhaler can be used when I feel short of breath." B. "If I forget a dose, I will double the next dose." C. "I should rinse my mouth after using the inhaler." D. "I should not use a spacer with my inhaler."

*C. "I should rinse my mouth after using the inhaler."

A 42-year-old male client diagnosed with hypertension tells the nurse he no longer wants to take the prescribed propranolol. Which client statement best explains the reason why he does not want to take this medication? A. "I have difficulty falling asleep." B. "I'm having problems with my stomach." C. "I'm experiencing decreased sex drive." D. "I feel so tired all the time."

*C. "I'm experiencing decreased sex drive."

Which information would the nurse provide when administering the first dose of prednisone prescribed to a client with an exacerbation of colitis? A. "Prednisone protects you from getting an infection." B. "The medication may cause weight loss by decreasing your appetite." C. "Prednisone is not curative but does cause a suppression of the inflammatory process." D. "The medication is relatively slow in precipitating a response but is effective in reducing symptoms."

*C. "Prednisone is not curative but does cause a suppression of the inflammatory process."

A nurse is teaching a client with stable angina about newly prescribed SL nitroglycerin. Which statement should the nurse include in the teaching? A. "Take this medication after each meal and at bedtime." B. "Take one tablet 30 minutes before any physical activity." C. "Take one tablet immediately when you experience chest pain." D. "Take this medication with 8 ounces of water."

*C. "Take one tablet immediately when you experience chest pain."

Which information is most important for the nurse to teach a client prescribed an antihypertensive medication to be taken once in the morning and a 2-gram sodium diet? A. "Avoid adding salt to cooked foods." B. "Use less salt when preparing foods." C. "Take your medicine exactly as prescribed." D. "Measure your blood pressure every morning."

*C. "Take your medicine exactly as prescribed."

The nurse is talking with a client who was admitted with an acute myocardial infarction due to coronary artery disease. The clients asks what the purpose for the prescribed carvedilol is. How should the nurse respond? A. "A beta blocker will prevent postural hypotension." B. "Most people develop hypertension after a heart attack." C. "This drug will decrease the workload on your heart." D. "Beta blockers will help to increase your heart rate."

*C. "This drug will decrease the workload on your heart."

The nurse is teaching a pediatric client and family about prescribed albuterol sulfate extended-release tablets. Which statement should be included? A. If you cannot swallow the tablet, it is ok to chew it B. This medication can cause restlessness C. "This medication can cause restlessness." C. Rinse your mouth after taking this medication D. Oral albuterol can cause an increase in urination

*C. "This medication can cause restlessness."

Which instructions about the use of nitroglycerin to prevent angina will the nurse provide to a client? A. 'At the point when pain first occurs, place two tablets under the tongue.' B. 'Place one tablet under the tongue before activity, and swallow another if pain occurs.' C. 'Before physical activity, place one tablet under the tongue, and repeat the dose in 5 minutes if pain occurs.' D. 'Place one tablet under the tongue when pain occurs and use an additional tablet after the attack to prevent recurrence.'

*C. 'Before physical activity, place one tablet under the tongue, and repeat the dose in 5 minutes if pain occurs.'

Which instruction would the nurse include when teaching the client about sublingual nitroglycerin? A. 'Once the tablet is dissolved, spit out the saliva.' B. 'Take tablets 3 minutes apart up to a maximum of five tablets.' C. 'Common side effects include headache and low blood pressure.' D. 'Once opened, the tablets should be refrigerated to prevent deterioration.'

*C. 'Common side effects include headache and low blood pressure.'

The health care provider prescribes isosorbide dinitrate 10 mg for a client with chronic angina pectoris. The client asks the nurse why the isosorbide dinitrate is prescribed. How will the nurse respond? A. 'It prevents excessive blood clotting.' B. 'It suppresses irritability in the ventricles.' C. 'It decreases cardiac oxygen demand.' D. 'The inotropic action increases the force of contraction of the heart.'

*C. 'It decreases cardiac oxygen demand.'

A client with chronic obstructive pulmonary disease prepares to take a medication that is delivered via a nebulizer. Which instruction would the nurse provide when teaching about use of the nebulizer? A. 'Hold your breath, spray the medication into your mouth, then inhale deeply.' B. 'Depress the canister as you inhale deeply, then hold your breath for at least 10 seconds.' C. 'Seal your lips around the mouthpiece and breathe in and out, taking slow, deep breaths.' D. 'Inhale the medication from the nebulizer, remove the mouthpiece to exhale and then repeat.'

*C. 'Seal your lips around the mouthpiece and breathe in and out, taking slow, deep breaths.'

The clinic nurse receives a call from the mother of an infant prescribed digoxin. The mother reports she forgot whether she gave the morning dose of digoxin. Which response by the nurse is most appropriate? A. 'Give the next dose immediately.' B. 'Wait 2 hours before giving the medication.' C. 'Skip this dose and give it at the next prescribed time.' D. 'Take the baby's pulse and give the medication if it's more than 90 beats/min.'

*C. 'Skip this dose and give it at the next prescribed time.'

A client with hypertension is prescribed an angiotensin II receptor blocker (ARB). Which instructions will the nurse provide about this medication? Select all that apply. One, some, or all responses may be correct. A. 'Monitor the blood pressure daily.' B. 'Stop treatment if a cough develops.' C. 'Stop the medication if swelling of the mouth, lips, or face develops.' D. 'Have blood drawn for potassium levels 2 weeks after starting the medication.'

*C. 'Stop the medication if swelling of the mouth, lips, or face develops.' *D. 'Have blood drawn for potassium levels 2 weeks after starting the medication.'

Which instruction would the nurse give to clients prescribed psychotropic medications who are experiencing anticholinergic-like side effects? A. 'Restrict fluid intake.' B. 'Eat a diet high in carbohydrates.' C. 'Suck on sugar-free hard candies.' D. 'Avoid products that contain aspirin.'

*C. 'Suck on sugar-free hard candies.'

The nurse is caring for a client who is experiencing excessive bleeding after receiving unfractionated heparin sodium. Which orders should the nurse anticipate from the health care provider? Select all that apply. A. Administer vitamin K. B. Obtain prothrombin time (PT)/international normalized ratio (INR). C. Administer protamine sulfate. D. Obtain activated partial thromboplastin time (aPTT). E. Change prescription to enoxaparin.

*C. Administer protamine sulfate. * D. Obtain activated partial thromboplastin time (aPTT).

A client's dose of isosorbide dinitrate (Imdur) is increased from 40 mg to 60 mg PO daily. When the client reports the onset of a headache prior to the next scheduled dose, which action should the nurse implement? A. Hold the next scheduled dose of Imdur 60 mg and administer a PRN dose of acetaminophen (Tylenol). B. Administer the 40 mg of Imdur and then contact the healthcare provider. C. Administer the 60 mg dose of Imdur and a PRN dose of acetaminophen (Tylenol). D. Do not administer the next dose of Imdur or any acetaminophen until notifying the healthcare provider.

*C. Administer the 60 mg dose of Imdur and a PRN dose of acetaminophen (Tylenol).

A client with a history of asthma is admitted for a minor surgical procedure. Preoperatively, the peak flow is measured at 480 liters/minute. Postoperatively, the client reports chest tightness and the peak flow is now 200 liters/minute. What should the nurse do first? A. Notify both the surgeon and primary care provider B. Repeat the peak flow reading in 30 minutes C. Administer the PRN dose of albuterol D. Apply oxygen at two liters per nasal cannula

*C. Administer the PRN dose of albuterol

A client prescribed albuterol tablets reports nausea every evening with the 9:00 p.m. dose. Which action should the nurse perform to alleviate this side effect? A. Change the time of the dose. B. Hold the 9 p.m. dose. C. Administer the dose with a snack. D. Offer an antiemetic with the dose.

*C. Administer the dose with a snack.

The inpatient hospital nurse is caring for a client with hypokalemia. The health care provider prescribed a potassium intravenous (IV) infusion of 40 mEq potassium chloride in 250 mL normal saline to be infused over 4 hours. The nurse receives the infusion from the pharmacy. Which action should the nurse take next? A. Confirm patency of the peripheral venous access device and start the infusion Confirm patency of the peripheral venous access device and start the infusion B. Notify the health care provider of the inappropriate dose of the prescribed IV potassium Notify the health care provider of the inappropriate dose of the prescribed IV potassium C. Ask another nurse to verify the prescription, IV solution and serum potassium level D. Ask another nurse to witness the addition of the prescribed potassium to the IV solution

*C. Ask another nurse to verify the prescription, IV solution and serum potassium level

A client with an intravenous (IV) infusion containing 40 mEq of potassium reports a stinging pain at the IV site. Which actions will the nurse take? Select all that apply. One, some, or all responses may be correct. A. Restart the IV in a different vein. B. Assist the client through guided imagery. C. Assess the IV site. D. Ask the health care provider for pain medication. E. Verify that the potassium is adequately diluted and not infusing too rapidly.

*C. Assess the IV site. *E. Verify that the potassium is adequately diluted and not infusing too rapidly.

1) The nurse is preparing to discharge a client who presented to the emergency room for an acute asthma attack. The nurse notes that upon discharge the health care provider has prescribed theophylline 300 mg orally to be taken daily at 9:00 AM. The nurse will teach the client to take the medication on which schedule? A. One hour before or 2 hours after eating B. At bedtime C. At the specific time prescribed D. Daily until symptoms are gone

*C. At the specific time prescribed

A client who is receiving atenolol for hypertension frequently reports feeling dizzy. Which effect of atenolol is responsible for this response? A. Depleting acetylcholine B. Stimulating histamine release C. Blocking the adrenergic response D.Decreasing adrenal release of epinephrine

*C. Blocking the adrenergic response

A nurse is assessing a client who started taking prescribed olmesartan 2 weeks ago. Which finding indicates an expected response to the medication? A. Heart rate of 85 beats/min B. Urinary output of 45 ml/hr C. Blood pressure of 125/79 mmHg D. Respiratory rate of 20 breaths/min

*C. Blood pressure of 125/79 mmHg

A client is prescribed digoxin 0.25 mg by mouth daily. The health care provider has written a new order to give metoprolol tartrate 25 mg twice a day by mouth. In assessing the client prior to administering the medications, which finding should the nurse report to the health care provider? A. Urine output of 50 mL/hour B. Respiratory rate of 16 C. Blood pressure of 94/60 D.Heart rate of 76 BPM

*C. Blood pressure of 94/60

The nurse is monitoring a 4-month-old infant who is prescribed digoxin. The infant's blood pressure is 92/78 mm Hg; resting pulse is 78 beats per minute; respirations are 28 breaths per minute; and serum potassium level is 4.8 mEq/L. The infant is irritable and has vomited twice since receiving the morning dose of digoxin. Which finding is most indicative of digoxin toxicity? A. Irritability B. Vomiting C. Bradycardia D. Dyspnea

*C. Bradycardia

Which medication may be useful in managing hypertension in a child with acute glomerulonephritis? A. Digoxin B. Diazepam C. Captopril D.Phenytoin

*C. Captopril

A client who had a myocardial infarction receives a prescription for a nitroglycerin patch. Which statement would the nurse identify as the purpose of the nitroglycerin patch? A. Decreased heart rate lowers cardiac output. B. Increased cardiac output increases oxygen demand. C. Decreased cardiac preload reduces cardiac workload. D. Peripheral venous and arterial constriction increases peripheral resistance.

*C. Decreased cardiac preload reduces cardiac workload.

A beta blocker is prescribed for the client with persistent ventricular tachycardia. Which response indicates that the beta blocker is working effectively? A. Decreased anxiety B. Reduced chest pain C. Decreased heart rate D. Increased blood pressure

*C. Decreased heart rate

A client with myasthenia gravis is to receive immunosuppressive therapy with corticosteroids. Which mechanism of action assures the nurse that this therapy will be effective? A. Inhibits the breakdown of acetylcholine at the neuromuscular junction B. Stimulates the production of acetylcholine at the neuromuscular junction C. Decreases the production of autoantibodies that attack acetylcholine receptors D. Promotes the removal of autoantibodies that impair the transmission of impulses

*C. Decreases the production of autoantibodies that attack acetylcholine receptors

Amlodipine is prescribed for a client with hypertension. Which response to the medication will the nurse instruct the client to report to the health care provider? A. Blurred vision B. Dizziness on rising C. Difficulty breathing D. Excessive urination

*C. Difficulty breathing

A nurse is preparing to administer morning medications to a client with heart failure. The morning lab values are: sodium 142 mEq/L (142 mmol/L), potassium 2.9 mEq/L (2.9 mmol/L), digoxin level 1.4 ng/mL. Which of the following medications should the nurse not administer until after speaking with the health care provider? A. Spironolactone B. Carvedilol (Coreg) C. Digoxin (Lanoxin) D. Ferrous sulfate

*C. Digoxin (Lanoxin)

The nurse is caring for a client who was recently prescribed atropine as a treatment for symptomatic bradycardia. Which condition should the nurse question as a contraindication when taking this medication? A. Urinary incontinence B. Right-sided heart failure C. Glaucoma D. Increased intracranial pressure

*C. Glaucoma

The nurse is reviewing the medical record of a client who received a new prescription for benztropine. For which condition in the client's record should the nurse clarify the prescription with the health care provider? A. Cataracts B. Schizophrenia C. Glaucoma D. Parkinson's disease

*C. Glaucoma

The healthcare provider prescribes a beta-1 agonist medication to be administered. The nurse should anticipate the medication to be prescribed for a client diagnosed with which condition? A. Glaucoma. B. Hypertension. C. Heart failure. D. Asthma.

*C. Heart failure.

A client with supraventricular tachycardia (SVT) has a heart rate of 170 beats/minute. After treatment with diltiazem, which assessment indicates to the nurse that the diltiazem is effective? A. Increased urine output B. Blood pressure of 90/60 mm Hg C. Heart rate of 98 beats/minute D. No longer complaining of heart palpations

*C. Heart rate of 98 beats/minute

A client with cirrhosis of the liver develops ascites, and the health care provider prescribes spironolactone. The nurse will monitor the client for which adverse medication effect? A. Bruising B. Tachycardia C. Hyperkalemia D. Hypoglycemia

*C. Hyperkalemia

The nurse is caring for a client diagnosed with heart failure who will begin treatment with digoxin. Which therapeutic effect would the nurse expect to find after administering this medication? A. Decreased chest pain with decreased blood pressure B. Increased heart rate with increased respirations C. Improved respiratory status with increased urinary output D. Diaphoresis with decreased urinary output

*C. Improved respiratory status with increased urinary output

Which times for the medication schedule would a nurse teach when corticosteroid therapy is prescribed for a client with an exacerbation of ulcerative colitis? A. At bedtime with a snack B. Three times a day with meals C. In the early morning with food D. One hour before or 2 hours after eating

*C. In the early morning with food

Digoxin is prescribed for a client. Which therapeutic effect of digoxin would the nurse expect? A. Decreased cardiac output B. Decreased stroke volume of the heart C. Increased contractile force of the myocardium D. Increased electrical conduction through the atrioventricular (AV) node

*C. Increased contractile force of the myocardium

The nurse is teaching a client about newly prescribed inhaled budesonide. The nurse should teach the client to report which finding to the healthcare provider? A. Rounded face B. Bradycardia C. Increased thirst D. Cough

*C. Increased thirst

A client who is 34 weeks gestation is diagnosed with a pulmonary embolism. Which of these medications should the nurse plan to administer? A. Oral low-dose aspirin B. Oral warfarin C. Intravenous heparin D. Subcutaneous enoxaparin

*C. Intravenous heparin

The nurse is caring for a client prescribed furosemide and digoxin for the treatment of heart failure. The client reports seeing halos and bright lights. Which laboratory result would be anticipated? A. Low sodium level B. Low digitalis level C. Low potassium level D. Low serum osmolality

*C. Low potassium level

A client who was prescribed atorvastatin (Lipitor) one month ago calls the triage nurse at the clinic complaining of muscle pain and weakness in his legs. Which statement reflects the correct drug-specific teaching the nurse should provide to this client? A. Increase consumption of potassium-rich foods since low potassium levels can cause muscle spasms. B. Have serum electrolytes checked at the next scheduled appointment to assess hyponatremia, a cause of cramping. C. Make an appointment to see the healthcare provider, because muscle pain may be an indication of a serious side effect. D. Be sure to consume a low-cholesterol diet while taking the drug to enhance the effectiveness of the drug.

*C. Make an appointment to see the healthcare provider, because muscle pain may be an indication of a serious side effect.

The nurse incorrectly administers carvedilol (Coreg) to a client with an order for benztropine (Cogentin). What is the priority nursing intervention after making this medication error? A. Complete an incident report B. Notify the nurse manager C. Monitor the client's blood pressure D. Notify the health care provider

*C. Monitor the client's blood pressure

The nurse is caring for a client who is being treated for heart failure. After completing the medication reconciliation process, the nurse notes that the prescriber has added lisinopril 5mg orally bid. Which medication from the list below should the nurse question due to possible drug-to-drug interaction with lisinopril? A. Metoprolol B. Glipizide C. Naproxen D. Enoxaparin

*C. Naproxen

An 80-year-old client with depression requires the prescription of antidepressant medication. Which tricyclic antidepressant medication causes fewer complications in older clients? A. Doxepin B. Amoxapine C. Nortriptyline D. Trimipramine

*C. Nortriptyline

A client hospitalized for uncontrolled hypertension and chest pain was started on a daily diuretic 2 days ago upon admission, with prescriptions for a daily basic metabolic panel. The client's potassium level this morning is 2.7 mEq/L (2.7 mmol/L). Which action will the nurse take next? A. Send another blood sample to the laboratory to retest the serum potassium level. B. Notify the health care provider that the potassium level is above normal. C. Notify the health care provider that the potassium level is below normal. D. No action is required because the potassium level is within normal limits.

*C. Notify the health care provider that the potassium level is below normal.

The nurse is providing teaching to the client prescribed albuterol for the management of asthma. The nurse is including reportable side effects in the teaching plan. Which of the following side effects is the priority? A. Nervousness B. Headache C. Palpitations D. Muscle aches

*C. Palpitations

55) A male client receiving prolonged steroid therapy complains of always being thirsty and urinating frequently. Which is the nurse's initial action? A. Have the client assessed for an enlarged prostate. B. Obtain a urine specimen from the client to test for ketonuria. C. Perform a finger stick to test the client's blood glucose level. D. Assess the client's lower extremities for the presence of pitting edema.

*C. Perform a finger stick to test the client's blood glucose level.

Which action will a nurse take when a male client receiving prolonged steroid therapy complains of always being thirsty and urinating frequently? A. Have the client assessed for an enlarged prostate. B. Obtain a urine specimen from the client to test for ketonuria. C. Perform a finger stick to test the client's blood glucose level. D. Assess the client's lower extremities for the presence of pitting edema.

*C. Perform a finger stick to test the client's blood glucose level.

The nurse is administering spironolactone for a client diagnosed with cirrhosis of the liver and ascites. Which electrolyte should the nurse anticipate to be spared when giving this medication? A. Sodium B. Phosphate C. Potassium D. Albumin

*C. Potassium

The client who was admitted with exacerbation of ulcerative colitis has developed hyperglycemia. Which medication that the client was prescribed most likely caused this adverse drug effect? A. Dicyclomine B. Acetaminophen C. Prednisone D. Diphenoxylate/atropine

*C. Prednisone

7) A child recovering from a severe asthma attack is given oral prednisone 15 mg twice daily. Which intervention would be a priority for the nurse? A. Having the child rest as much as possible B. Checking the child's eosinophil count daily C. Preventing exposure of the child to infection E. Offering sips of water when administering the medication

*C. Preventing exposure of the child to infection

The nurse is admitting a client to the hospital with findings of liver failure and ascites. A health care provider (HCP) orders spironolactone. The nurse understands that the pharmacological effects of the medication, are which of the following? A. Combines safely with antihypertensives B. Depletes potassium reserves C. Promotes sodium and chloride excretion D. Increases aldosterone levels

*C. Promotes sodium and chloride excretion

A health care provider prescribes dexamethasone for a client with head trauma. The nurse recognizes that it reduces swelling in the brain by which process? A. Acts as a hyperosmotic diuretic B. Increases resistance to infection C. Reduces the inflammatory response of tissues D. Decreases the formation of cerebrospinal fluid

*C. Reduces the inflammatory response of tissues

The nurse provides client teaching on the administration of a topical steroid application to a basal cell carcinoma surgical site. The nurse evaluates the teaching as effective when the client identifies which action as the primary purpose of the medication? A. Preventing infection of the wound B. Increasing fluid loss from the skin C. Reducing inflammation at the surgical site D. Limiting itching around the area of the lesion

*C. Reducing inflammation at the surgical site

Which action is the primary purpose of a topical steroid application to a basal cell carcinoma surgical site? A. Preventing infection of the wound B. Increasing fluid loss from the skin C. Reducing inflammation at the surgical site D. Limiting itching around the area of the lesion

*C. Reducing inflammation at the surgical site

Which action would the nurse perform when administering fluticasone propionate to a client with asthma? Select all that apply. One, some, or all responses may be correct. A. Assessing heart rate and rhythm B. Monitoring liver function blood tests C. Rinsing the oral cavity with water after use D. Obtaining blood glucose levels before meals E. Giving stool softeners to prevent constipation

*C. Rinsing the oral cavity with water after use

The nurse is providing discharge medication teaching to a client who will be taking furosemide and digoxin after discharge from the hospital. Which information is important for the nurse to include in the teaching plan? A. Maintenance of a low-potassium diet B. Avoidance of foods high in cholesterol C. Signs and symptoms of digoxin toxicity D. Importance of monitoring output

*C. Signs and symptoms of digoxin toxicity

A health care provider in the emergency department identifies that a client is in cardiogenic shock. Which type of medication is indicated for management of this condition? A. Loop diuretic B. Cardiac glycoside C. Sympathomimetic D. Alpha-adrenergic blocker

*C. Sympathomimetic

The nurse administers albuterol to a child with asthma. Which common side effect would the nurse monitor for in the child? A. Flushing B. Dyspnea C. Tachycardia D. Hypotension

*C. Tachycardia

The nurse is monitoring a client who is taking prescribed nitroglycerin for angina. Which finding indicates the medication has a therapeutic effect? A. The client blood pressure is 150/80 mm/Hg. B. The client heart rate is 110. C. The client reports a decrease in chest pressure. D. The client reports a headache.

*C. The client reports a decrease in chest pressure.

A charge nurse is observing a staff nurse prepare 1 ml of intravenous digoxin for a client with heart failure. After the staff nurse prepares the medication, the nurse notices precipitate in the syringe. Which action by the staff nurse likely caused this reaction? A. D5W was used as the diluent. B. The medication was not allowed to reach room temperature. C. The medication was added to 1 mL of diluent. D. Air was not inserted into the vial.

*C. The medication was added to 1 mL of diluent.

The nurse is teaching a client diagnosed with depression about a new prescription of nortriptyline. What information would be essential for the nurse to emphasize about this medication? A. Episodes of diarrhea can be expected B. The medication must be stored in the refrigerator C. The use of alcohol should be avoided D. Symptom relief occurs in a few days

*C. The use of alcohol should be avoided

A health care provider prescribes a diuretic for a client with hypertension. Which mechanism of action explains how diuretics reduce blood pressure? A. They facilitate vasodilation. B. They promotes smooth muscle relaxation. C. They reduce the circulating blood volume. D. They block the sympathetic nervous system.

*C. They reduce the circulating blood volume.

Which assessment would be brought to the health care provider's attention before administration of intravenous potassium chloride? A. Progressively worsening muscle weakness B. Poor tissue turgor with tenting C. Urinary output of 200 mL during the previous 8 hours D. Oral fluid intake of 300 mL during the previous 12 hours

*C. Urinary output of 200 mL during the previous 8 hours

The nurse is reviewing medication instructions with parents of an infant receiving digoxin and spironolactone. Which parental response indicates instructions have been understood? A. Activity should be restricted. B. Orange juice should be given daily. C. Vomiting should be reported to the health care provider. D. Anti-inflammatory medications should be avoided.

*C. Vomiting should be reported to the health care provider.

Which side effect of prolonged cortisone therapy for adrenal insufficiency would the nurse teach the client and family to expect? Select all that apply. One, some, or all responses may be correct. A. Oliguria B. Anorexia C. Weakness D. Moon face E. Weight gain F. Nervousness

*C. Weakness *D. Moon face *E. Weight gain

A client with angina has been instructed about the use of sublingual nitroglycerin. Which statement by the client indicates the need for additional teaching? A. "I'll call the health care provider if pain continues after three tablets five minutes apart." B. "I will rest briefly right after taking one tablet." C. "I understand that the medication should be kept in the dark bottle." D. "I can swallow two or three tablets at once if I have severe pain."

*D. "I can swallow two or three tablets at once if I have severe pain."

The nurse is preparing a client with rheumatoid arthritis (RA) for discharge to an assisted living facility. Which statement about the prescribed oral glucocorticoid is correct? A. "The medication will reverse the joint deterioration of RA." B. "You will be taking the medication for several years." C. "It is normal to experience some memory loss or hallucinations." D. "The medication will be gradually tapered off over 5 to 7 days."

*D. "The medication will be gradually tapered off over 5 to 7 days."

Which client statements indicate that the teaching about furosemide is understood? Select all that apply. One, some, or all responses may be correct. A. 'It may take 2 or 3 days for this medication to take effect.' B. 'I should wear dark glasses when outdoors during the day.' C. 'I should avoid lying flat in bed.' D. 'I need to change my position slowly.' E. 'I should eat more food that is high in potassium.'

*D. 'I need to change my position slowly.' *E. 'I should eat more food that is high in potassium.'

Sublingual nitroglycerin is prescribed for a client with a history of a myocardial infarction and atrial tachycardia. The nurse instructs the client about the prophylactic use of these tablets. Which statement by the client indicates the teaching was effective? A. 'I should take the medicine three times a day.' B. 'I will be sure to take my pulse after I have exercised.' C. 'It will be important to avoid activities that can cause angina.' D. 'I should take one tablet before attempting activity that has caused angina.'

*D. 'I should take one tablet before attempting activity that has caused angina.'

A client diagnosed with a transient ischemic attack (TIA) related to hypertension is discharged with a prescription of hydrochlorothiazide. Which instruction would the nurse include when teaching about this medication? A. 'Resume regular eating habits.' B. 'Drink a protein supplement daily.' C. 'Avoid eating foods high in insoluble fiber.' D. 'Increase the intake of potassium-rich foods.'

*D. 'Increase the intake of potassium-rich foods.'

The nurse provides medication discharge instructions to a client who received a prescription for digoxin. Which statement by the client leads the nurse to conclude that the teaching was effective? A. 'I will avoid foods high in potassium.' B. 'I must increase my intake of vitamin K.' C. 'I should adjust the dosage according to my activities.' D. 'It will be important to check my pulse rate daily.'

*D. 'It will be important to check my pulse rate daily.'

A female client receiving cortisone therapy for adrenal insufficiency expresses concern that she is developing facial hair. How would the nurse respond? A. 'It is just another sign of adrenal insufficiency.' B. 'This side effect will disappear after therapy.' C. 'This is not important as long as you are feeling better.' D. 'The medication contains a hormone that causes male characteristics.'

*D. 'The medication contains a hormone that causes male characteristics.'

A client has been receiving digoxin. The client calls the clinic and complains of 'yellow vision.' Which response would the nurse provide? A. 'This is related to your illness rather than to your medication.' B. 'This is an expected side effect; you will become accustomed to it over time.' C. 'This side effect is only temporary. You should continue the medication.' D. 'The medication may need to be discontinued. Come to the clinic this afternoon.'

*D. 'The medication may need to be discontinued. Come to the clinic this afternoon.'

A nurse is teaching an 80-year-old client how to use a metered dose inhaler. The nurse is concerned that the client is unable to coordinate the release of the medication during the inhalation phase. Which intervention should improve the delivery of the medication? A. Ask a family member to assist the client with the inhaler. B. Request a home health nurse to visit the client at home. C. Use nebulized treatments at home instead. D. Add a spacer device to the inhaler canister.

*D. Add a spacer device to the inhaler canister.

Which explanation would the nurse provide for administering prednisone to a client with an exacerbation of colitis? A. The client will be protected from getting an infection. B. Symptoms associated with the colitis will decrease slowly over time. C. Although the medication causes anorexia, weight loss may not occur. D. Although the medication decreases intestinal inflammation, it will not cure the colitis.

*D. Although the medication decreases intestinal inflammation, it will not cure the colitis.

A client who has atrial fibrillation with rapid ventricular response is started on a continuous heparin infusion. Which clinical finding enables the nurse to conclude that the heparin therapy is effective? A. Atrial fibrillation converts to a sinus rhythm. B. The heart rate is stabilized at 70 to 90 beats per minute. C. The international normalized ratio (INR) is within normal range. D. An activated partial thromboplastin time (aPTT) is twice the usual value.

*D. An activated partial thromboplastin time (aPTT) is twice the usual value.

A client with the diagnosis of primary hypertension is started on a regimen of hydrochlorothiazide. Which information will the nurse include when providing instructions regarding this medication? A. A common side effect is decreased sexual libido. B. One dose should be omitted if dizziness occurs when standing up. C. The client should adjust the dosage daily based on the client's blood pressure. D. An antihypertensive medication will likely be required for the remainder of life.

*D. An antihypertensive medication will likely be required for the remainder of life.

A client taking multiple medications for hypertension develops a persistent, hacking cough. Which antihypertensive medication class would the nurse identify as the likely cause of the cough? A. Thiazide diuretics B. Calcium channel blockers C. Direct renin inhibitors D. Angiotensin-converting enzyme (ACE) inhibitors

*D. Angiotensin-converting enzyme (ACE) inhibitors

The nurse is preparing to administer digoxin to a client admitted for acute decompensated heart failure. Which action is the priority before giving this drug? A. Monitor oxygen saturation on room air B. Assess the client's weight and compare to the baseline C. Auscultate the lungs for crackles in the bases D. Assess the apical pulse for a full minute

*D. Assess the apical pulse for a full minute

A client was prescribed furosemide. The nurse would instruct the client to include which food in the diet? A. Liver B. Apples C. Cabbage D. Bananas

*D. Bananas

Which complication is an adverse effect of cortisone therapy? A. Hypoglycemia B. Severe anorexia C. Anaphylactic shock D. Behavioral changes

*D. Behavioral changes

A client receiving fluphenazine decanoate develops dystonia/extrapyramidal side effect early in therapy. Which medication would the nurse anticipate administering to reverse this side effect? A. Nafarelin B. Fluoxetine C. Trandolapril D. Benztropine

*D. Benztropine

A client develops extrapyramidal effects after taking a neuroleptic medication, and the nurse notes extrapyramidal effects. Which medication can limit these side effects? A. Zolpidem B. Hydroxyzine C. Dantrolene D. Benztropine mesylate

*D. Benztropine mesylate

The nurse on a cardiac unit is caring for a client who is receiving nitroglycerin intravenously for unstable angina. During administration of the medication, which assessment is the priority? A. Respiratory rate B. Cardiac enzymes C. Cardiac rhythm D. Blood pressure

*D. Blood pressure

The nurse working in an intensive care unit is caring for a client diagnosed with acute angina. The client is receiving an intravenous infusion of nitroglycerin. What is the priority assessment for this client? A. Heart rate B. Neurologic status C. Urine output D. Blood pressure

*D. Blood pressure

Which client response indicates to the nurse that a vasodilator medication is effective? A. Absence of adventitious breath sounds B. Increase in the daily amount of urine produced C. Pulse rate decreases from 110 to 75 beats/minute D. Blood pressure changes from 154/90 to 126/72 mm Hg

*D. Blood pressure changes from 154/90 to 126/72 mm Hg

Which change in data indicates to the nurse that the desired effect of the angiotensin II receptor antagonist valsartan has been achieved? A. Dependent edema reduced from +3 to +1. B. Serum HDL increased from 35 to 55 mg/dL. C. Pulse rate reduced from 150 to 90 beats/minute. D. Blood pressure reduced from 160/90 mmHg to 130/80 mmHg.

*D. Blood pressure reduced from 160/90 mmHg to 130/80 mmHg.

A client is prescribed furosemide and digoxin for heart failure. The nurse should monitor the client for which potential adverse drug effect? A. Pulmonary hypertension B. Acute arterial occlusion C. Acute kidney injury D. Cardiac dysrhythmias

*D. Cardiac dysrhythmias

A client receives a cardiac glycoside, a diuretic, an angiotensin-converting enzyme (ACE) inhibitor, and a vasodilator. The client's apical pulse rate is 44 beats/minute. The nurse concludes that the decreased heart rate is caused by which medication? A. Diuretic/furosemide B. Vasodilator/nitroglycerin C. ACE inhibitor/ "ace" to -pril D. Cardiac glycoside/digoxin

*D. Cardiac glycoside/digoxin

Which advice would the nurse include in a teaching plan to reduce the side effects of diltiazem? A. Lie down after meals. B. Avoid dairy products in diet. C. Take the medication with an antacid. D. Change slowly from sitting to standing.

*D. Change slowly from sitting to standing.

How would the nurse determine if a client is experiencing the therapeutic effect of valsartan? A. Check a lipid profile. B. Assess an apical pulse. C. Measure urinary output.11 D. Check the blood pressure.

*D. Check the blood pressure.

A nurse is providing care to an older adult client with newly diagnosed heart failure. The nurse receives a prescription for digoxin PO 1.5 mg daily. Which action does the nurse perform next? A. Instruct the client to take the heart rate before administration B. Educate the client on the purpose of digoxin C. Administer the medication to the client D. Clarify the prescription with the healthcare provider

*D. Clarify the prescription with the healthcare provider

A client with myasthenia gravis is receiving pyridostigmine bromide to control symptoms. Recently, the client has begun experiencing increased difficulty in swallowing. Which nursing action is effective in preventing aspiration of food? A. Place a tracheostomy set in the client's room. B. Assess respiratory status after meals. C. Request for the diet to be changed from soft to clear liquids. D. Coordinate mealtimes with the peak effect of the medication.

*D. Coordinate mealtimes with the peak effect of the medication.

The nurse is caring for a client who has been taking furosemide for the past week. Which manifestation would indicate that the client may be experiencing a negative side effect? A. Edema of the ankles B. Gastric irritability C. Weight gain of five pounds D. Decreased appetite

*D. Decreased appetite

The nurse is monitoring the client who is taking newly prescribed antihypertensive medication. Which finding should indicate to the nurse that the client might be experiencing an allergic reaction to the medication? A. Mild decrease in blood pressure B. Increased urine output C. Left-sided weakness D. Development of a rash

*D. Development of a rash

The nurse admits a client with tumor-induced spinal cord compression. Which medication should the nurse anticipate to be prescribed to offer the best palliative treatment for this client? A. Morphine sulfate. B. Ibuprofen. C. Amitriptyline. D. Dexamethasone.

*D. Dexamethasone.

A client has been given a prescription for furosemide 40 mg every day in conjunction with digoxin. Which concern would prompt the nurse to ask the health care provider about potassium supplements? A. Digoxin causes significant potassium depletion. B. The liver destroys potassium as digoxin is detoxified. C. Lasix requires adequate serum potassium to promote diuresis. D. Digoxin toxicity occurs rapidly in the presence of hypokalemia.

*D. Digoxin toxicity occurs rapidly in the presence of hypokalemia.

A nurse is assessing a client receiving intravenous potassium chloride. The client verbalizes pain to the IV site. The site appears swollen and is warm to touch. Which action does the nurse perform? A. Decrease the rate of the infusion B. Apply ice to the IV access site C. Inform the client that this is an expected finding D. Discontinue the IV catheter

*D. Discontinue the IV catheter

The nurse is assessing a postpartum client who is taking labetalol. Which client report should the nurse identify as a potential adverse effect of the medication? A. Nausea B. Ankle edema C. Abdominal pain D. Dizziness

*D. Dizziness

Which instructions will the nurse give a client for whom nitroglycerin tablets are prescribed? A. Limit the number of tablets to four per day. B. Discontinue the medication if a headache develops. C. Increase the number of tablets if dizziness is experienced. D. Ensure that the medication is stored in its original dark container.

*D. Ensure that the medication is stored in its original dark container.

A nurse is preparing to administer prescribed maintenance dose of digoxin to a client who has heart failure. Which action should the nurse to take? A. Withhold the medication if the heart rate is above 100/min B. Instruct the client to eat foods that are low in potassium C. Measure apical pulse rate for 30 seconds before administration D. Evaluate the client for nausea, vomiting, and anorexia

*D. Evaluate the client for nausea, vomiting, and anorexia

A client begins treatment with pyridostigmine bromide therapy for myasthenia gravis. Which action would the nurse perform in administration of the medication? A. Administer the medication after meals. B. Administer the medication on an empty stomach. C. Evaluate the client's psychological responses between medication doses. D. Evaluate the client's muscle strength every hour after the medication is given.

*D. Evaluate the client's muscle strength every hour after the medication is given.

Which action would the nurse perform when beginning pyridostigmine bromide therapy for a client with myasthenia gravis? A. Administer the medication after meals. B. Administer the medication on an empty stomach. C. Evaluate the client's psychological responses between medication doses. D. Evaluate the client's muscle strength every hour after the medication is given.

*D. Evaluate the client's muscle strength every hour after the medication is given.

A client who has been diagnosed with Raynaud's disease and hypertension is prescribed nifedipine. For which side effect should the nurse monitor the client? A. Cyanosis of the lips B. Decreased urine output C. Increased pain in fingers D. Facial flushing

*D. Facial flushing

A school-age child is admitted with hypertensive acute glomerulonephritis. Which medication would the nurse anticipate being prescribed initially in addition to hydralazine? A. Digoxin B. Alprazolam C. Phenytoin D. Furosemide

*D. Furosemide

After the nurse provides education about hydrochlorothiazide, the client will agree to notify the health care provider regarding the development of which symptom? A. Insomnia B. Nasal congestion C. Increased thirst D. Generalized weakness

*D. Generalized weakness

A health care provider prescribes simvastatin 20 mg daily for elevated cholesterol and triglyceride levels for a female client. Which advice is important for the nurse to teach when the client initially takes the medication? A. Take the medication with breakfast. B. Have liver function tests every 6 months. C. Wear sunscreen to prevent photosensitivity reactions. D. Inform the health care provider if you wish to become pregnant.

*D. Inform the health care provider if you wish to become pregnant.

The nurse provides instructions about how to use a metered-dose inhaler (MDI) to a client with chronic obstructive pulmonary disease. The nurse concludes that additional teaching is needed when the client demonstrates which technique? A. Places the tip of the inhaler just past the lips B. Holds the inspired breath for at least 3 seconds C. Activates the inhaler during inspiration D. Inhales rapidly with the lips sealed around the nebulizer opening

*D. Inhales rapidly with the lips sealed around the nebulizer opening

A client receiving corticosteroid therapy states, 'I have difficulty controlling my temper, which is so unlike me, and I don't know why this is happening.' How will the nurse respond? A. Tell the client it is nothing to worry about. B. Reassure that everyone does this at times. C. Instruct the client to attempt to avoid situations that cause irritation. D. Inquire about mood swings.

*D. Inquire about mood swings.

When a client is receiving dexamethasone for adrenocortical insufficiency, which action would the nurse take to monitor for an adverse effect of the medication? A. Auscultate for bowel sounds. B. Assess deep tendon reflexes. C. Culture respiratory secretions. D. Measure blood glucose levels.

*D. Measure blood glucose levels.

Long-term corticosteroid therapy has been initiated for a client with myasthenia gravis who experiences inadequate symptomatic control with pyridostigmine bromide. Which action is important for the nurse to take? A. Request a high-sodium diet. B. Establish protective isolation. C. Decrease the client's total daily fluid intake. D. Monitor the client for an exacerbation of symptoms.

*D. Monitor the client for an exacerbation of symptoms.

The nurse administers sodium polystyrene sulfonate to a client with chronic renal failure. Which finding provides evidence that the intervention is effective? A. Pruritus decreases. B. Mental status improves. C. Sodium decreases to 137 mEq/L (137 mmol/L). D. Potassium decreases to 4.2 mEq/L (4.2 mmol/L).

*D. Potassium decreases to 4.2 mEq/L (4.2 mmol/L).

Which reason would an intravenous infusion of 5% dextrose with 0.45% sodium chloride and 20 mEq of potassium be prescribed for a client with a nasogastric (NG) tube set to low intermittent suction? A. Prevent constipation B. Prevent dehydration C. Prevent vomiting D. Prevent electrolyte imbalance

*D. Prevent electrolyte imbalance

Which effect explains the purpose for gradual dosage reduction of glucocorticoids such as dexamethasone? A. Builds glycogen stores in the muscles B. Produces antibodies by the immune system C. Allows the increased intracranial pressure to return to normal D. Promotes return of cortisone production by the adrenal glands

*D. Promotes return of cortisone production by the adrenal glands

Sodium nitroprusside is prescribed for a client with a blood pressure of 260/120 mm Hg. The nurse recalls that sodium nitroprusside decreases blood pressure by which mechanism? A. Decreasing the heart rate B. Increasing cardiac output C. Increasing peripheral resistance D. Relaxing venous and arterial smooth muscles

*D. Relaxing venous and arterial smooth muscles

Which advice will the nurse include when teaching a client about digoxin for left ventricular failure? A. Sleep flat in bed. B. Follow a low-potassium diet. C. Take the pulse three times a day. D. Report increasing fatigue.

*D. Report increasing fatigue.

The nurse is caring for a client who has taken atenolol for 2 years. The healthcare provider recently changed the medication to enalapril to manage the client's blood pressure. Which instruction should the nurse provide the client regarding the new medication? A. Take the medication at bedtime. B. Report presence of increased bruising. C. Check pulse before taking medication. D. Rise slowly when getting out of bed or chair.

*D. Rise slowly when getting out of bed or chair.

A client is admitted to the hospital for an adrenalectomy. When teaching the client about the prescribed medications, which advice will the nurse emphasize? A. Medication therapy will be given in conjunction with insulin. B. Once regulated, the dosage will remain the same for life. C. Medications will need to be held for surgery or other invasive procedures. D. Salt intake may have to be restricted.

*D. Salt intake may have to be restricted.

A client with heart failure is to receive digoxin. Which therapeutic effect is associated with this medication? A. Reduces edema B. Increases cardiac conduction C. Increases rate of ventricular contractions D. Slows and strengthens cardiac contractions

*D. Slows and strengthens cardiac contractions

When a client's cells are deprived of oxygen during a cardiac arrest, which medication corrects for deleterious effects of anaerobic energy production? A. Regular insulin B. Calcium gluconate C. Potassium chloride D. Sodium bicarbonate

*D. Sodium bicarbonate

Which outcome would the nurse expect when caring for a child receiving adrenocorticosteroid therapy? A. Accelerated wound healing B. Development of hyperkalemia C. Increased antibody production D. Suppressed inflammatory process

*D. Suppressed inflammatory process

A client received 40 mg of furosemide by mouth at 10 am. Which information is most important for the nurse to provide to the next nurse in the change-of-shift report? A. The client lost two pounds in the last 24 hours. B. The client is to receive another dose of furosemide at 10 pm. C. The client's potassium level was 4.0 mEq/L prior to administration. D. The client's urine output was 1500 mL over nine hours.

*D. The client's urine output was 1500 mL over nine hours.

A client is scheduled for a bilateral adrenalectomy. Which rationale describes why steroids are administered to the client? A. To foster accumulation of glycogen in the liver B. To increase the inflammatory action to promote healing C. To facilitate urinary excretion of salt and water after surgery D. To compensate for sudden lack of these hormones after surgery

*D. To compensate for sudden lack of these hormones after surgery

The spouse of a client with an intracranial hemorrhage asks the nurse, 'Why aren't they administering an anticoagulant?' How will the nurse respond? A. 'It is not advisable because bleeding will increase.' B. 'If necessary, it will be started to enhance circulation.' C. 'If necessary, it will be started to prevent pulmonary thrombosis.' D. 'It is inadvisable because it masks the effects of the hemorrhage.'

*A. 'It is not advisable because bleeding will increase.'

The nurse is teaching a client diagnosed with asthma about the medication albuterol. Which statement by the nurse demonstrates appropriate teaching? A. "Call your doctor's office if you need to use the drug more often." B. "Use this medication at bedtime to promote rest." C. "Use this medication after other asthma inhalers." D. "Discontinue the inhaler if you feel dizzy."

*A. "Call your doctor's office if you need to use the drug more often."

A 6-year-old child with asthma is prescribed an inhaled corticosteroid. The nurse would conclude the mother understands teaching about the medication side effects when the mother makes which statement? A. 'I'll watch for frequent urination.' B. 'I'll check for white patches in the mouth.' C. 'I'll be alert for short episodes of not breathing.' D. 'I'll monitor for an increased blood glucose level.'

B. 'I'll check for white patches in the mouth.'

The nurse is educating a client about how to use a metered-dose inhaler with spacer. Place each step in the correct order by entering the numbers in order. 1. Breathe out slowly 2. Breathe in deeply 3. Release the medication into the spacer 4. Remove the mouthpiece from the lips 5. Hold breath for 10 seconds

Correct Answer: 32451

A child is prescribed fluticasone after an acute asthma attack. Which instruction would the nurse give the family about the administration of this medication? A. 'Fluticasone needs to be taken with food or milk.' B. 'Fluticasone is primarily used to treat acute asthma attacks.' C. 'The child should suck on hard candy to help relieve dry mouth.' D. 'Watch for white patches in the mouth and report to the health care provider.'

D. 'Watch for white patches in the mouth and report to the health care provider.'

Upon admission to the emergency center, an adult client with acute status asthmaticus is prescribed this series of medications. In which order should the nurse administer the prescribed medications? (Arrange from first to last.) A. Prednisone (Deltasone) orally. B. Gentamicin (Garamycin) IM. C. Albuterol (Proventil) puffs. D. Salmeterol (Serevent Diskus).

The correct order is: Albuterol (Proventil) puffs. Salmeterol (Serevent Diskus). Prednisone (Deltasone) orally. Gentamicin (Garamycin) IM.

Which ophthalmic solution is contraindicated for clients with glaucoma? A. Timolol B. Atropine C. Pilocarpine D. Epinephrine

*B. Atropine

A client is receiving methylprednisolone 40 mg IV daily. The nurse should monitor which laboratory value closely? A. Serum glucose. B. Serum calcium. C. Red blood cells. D. Serum potassium.

*A. Serum glucose.

Which instruction regarding nutrition will the nurse give a client discharged after a short hospitalization for an episode of a transient ischemic attack (TIA) related to hypertension who is on a regimen that includes chlorothiazide? A. "Eat more dark green, leafy vegetables such as spinach." B. "Substitute a potassium-based salt substitute for table salt." C. "Return to previous eating habits." D. "Increase intake of dairy products."

*A. "Eat more dark green, leafy vegetables such as spinach."

The nurse is observing a new graduate nurse preparing to administer bumetanide 4 mg orally to a client with heart failure. Which client finding requires the nurse to intervene immediately? A. The client's most recent serum potassium level is 2.9 mEq or mmol/L. B. The client has crackles in both lung bases. C. The client has 4+ pitting edema in both lower legs. D. The client's most recent blood pressure is 96/60 mmHg.

*A. The client's most recent serum potassium level is 2.9 mEq or mmol/L.

The nurse administers a parenteral preparation of potassium slowly to avoid which complication? A. Metabolic acidosis B. Cardiac arrest C. Seizure activity D. Respiratory depression

*B. Cardiac arrest

Valsartan, an angiotensin II receptor antagonist, is prescribed for a client. The nurse will monitor the client for which adverse effect? A. Constipation B. Hyperkalemia C. Hypertension D. Change in visual acuity

*B. Hyperkalemia

Which medication requires the nurse to monitor the client for signs of hyperkalemia? A. Furosemide B. Metolazone C. Spironolactone D. Hydrochlorothiazide

*C. Spironolactone

Which side effect would the nurse assess for in a child receiving prednisone? A. Alopecia B. Anorexia C. Weight loss D. Mood changes

*D. Mood changes

Pyridostigmine is prescribed for a client with myasthenia gravis. Why would the nurse instruct the client to take pyridostigmine about 1 hour before meals? A. This timing limits first pass metabolism. B. Taking it on an empty stomach increases absorption. C. Taking it before meals decreases gastric irritation. D. Taking it before meals improves the ability to chew.

*D. Taking it before meals improves the ability to chew.

A client with Parkinson's disease is prescribed benztropine (Cogentin). For which of the following should the nurse call the health care provider immediately? A. The client is complaining of dizziness when standing up. B. The client is exhibiting bradykinesia and slurred speech. C. The client's heart rate increased from 80 to 95 beats per minute. D. The client has a history of primary angle-closure glaucoma.

*D. The client has a history of primary angle-closure glaucoma.

List in order the steps the nurse teaches the client to follow when using a metered-dose inhaler (MDI). 1. Shake the inhaler for 30 seconds. 2. Exhale slowly and deeply to empty the air from the lungs. 3. Hold the inhaler upright in the mouth. 4. Start breathing in and press down on the inhaler once.

Answer: 1,2,3,4

Which instruction would the nurse include when teaching about hydrochlorothiazide given to a client diagnosed with a transient ischemic attack (TIA) related to hypertension? A. "Resume regular eating habits." B. "Drink a protein supplement daily." C. "Avoid eating foods high in insoluble fiber." D. "Increase the intake of potassium-rich foods."

D. *"Increase the intake of potassium-rich foods."

A client develops a deep vein thrombophlebitis in her leg 3 weeks after giving birth and is admitted for anticoagulant therapy. The nurse would anticipate developing a teaching plan for which anticoagulant? A. Heparin B. Warfarin C. Clopidogrel D. Enoxaparin

*A. Heparin

The client has been treated with long-term glucocorticoid therapy. While completing the physical assessment, which finding should the nurse expect? A. Jaundice B. Peripheral edema C. Buffalo hump D. Increased muscle mass

*C. Buffalo hump

A client is admitted to the hospital for an adrenalectomy. Before the client's replacement steroid therapy is regulated fully, the nurse will monitor the client for which complication? A. Hypotension B. Hypokalemia C. Hypernatremia D. Hyperglycemia

*A. Hypotension

Which symptom would the nurse expect to decrease in response to corticosteroid therapy prescribed for a client with multiple sclerosis? A. Emotional lability B. Muscular contractions C. Pain in the extremities D. Visual impairment

*D. Visual impairment

Which medication is unsafe to administer as an intravenous (IV) bolus? A. Saline flush B. Potassium chloride C. Naloxone D. Adenosine

*B. Potassium chloride

Dexamethasone has been prescribed for a client after a craniotomy for a brain tumor. Which physiological response is responsible for this medication's therapeutic effect? A. Reduced cell growth B. Reduced cerebral edema C. Increased renal reabsorption D. Increased response to sedation

*B. Reduced cerebral edema

Which pain characteristic would the nurse expect to observe when a client is experiencing anginal pain? A. Unchanged by rest B. Precipitated by light activity C. Described as a knifelike sharpness D.Relieved by sublingual nitroglycerin

*D. Relieved by sublingual nitroglycerin

One week after being hospitalized for an acute myocardial infarction, a client reports nausea and loss of appetite. Which of the client's prescribed medications would be withheld and the health care provider notified? A. Digoxin B. Propranolol C. Furosemide D. Spironolactone

*A. Digoxin

The nurse is providing care for a client admitted to the hospital with a diagnosis of digoxin toxicity. The client reports more than usual urine output over the previous 48 hours, because of the prescribed diuretic. Which assessment finding does the nurse anticipate? A. Muscle weakness or cramping B. Blood in the urine C. Hypertension D. Tinnitus

*A. Muscle weakness or cramping

Digoxin is prescribed for a client with heart failure. The nurse will assess for which signs and symptoms that indicate digoxin toxicity? Select all that apply. One, some, or all responses may be correct. Nausea Yellow vision Irregular pulse Increased urine output Heart rate of 64 beats/minute

*A. Nausea *B. Yellow vision *C. Irregular pulse

A client with acute myocardial infarction is admitted to the coronary care unit. Which medication should the nurse administer to lessen the workload of the heart by decreasing the cardiac preload and afterload? A. Nitroglycerin. B. Propranolol C. Morphine. D. Captopril

*A. Nitroglycerin.

Hydrocortisone is prescribed for a client with Addison's disease. Which response is a therapeutic effect of this medication? A. Supports a better response to stress B. Promotes a decrease in blood pressure C. Decreases episodes of shortness of breath D. Controls an excessive loss of potassium

*A. Supports a better response to stress

A client is discharged with a prescription for sustained-release nitroglycerin. Which information will the nurse provide to the client? A. Swallow the capsule whole. B. Take the medication with milk. C. Place the capsule under the tongue. D. Crush the capsule and mix with soft food.

*A. Swallow the capsule whole.

Which nursing action is appropriate when administering imipramine? A. Telling the client steroids will not be prescribed B. Warning the client not to eat cheese C. Monitoring the client for increased tolerance D. Having the client checked for increased intraocular pressure

*D. Having the client checked for increased intraocular pressure

A client with a myocardial infarction receives intravenous nitroglycerin to relieve pain. The nurse will assess for which medication side effect? A. Nausea B. Delirium C. Bradycardia D. Hypotension

*D. Hypotension

Potassium supplements are prescribed for a client receiving diuretic therapy. Which client statement indicates that the teaching about potassium supplements is understood? A. 'I will report any abdominal distress.' B. 'I should use salt substitutes with my food.' C. 'The medication must be taken on an empty stomach.' D. 'The dosage is correct if my urine output increases.'

*A. 'I will report any abdominal distress.''

The health care provider prescribes atenolol for a client with angina. Which potential side effect will the nurse mention when instructing the client about this medication? A. Headache B. Tachycardia C. Constipation D. Hypotension

*D. Hypotension

The nurse is caring for a child undergoing chemotherapy for acute lymphoid leukemia. The parents ask why the child needs prednisone. Which response by the nurse would be correct? A. 'It decreases inflammation.' B. 'It suppresses the production of lymphocytes.' C. 'It increases appetite and a sense of well-being.' D. 'It may decrease skin irritation and edema.'

*A. 'It decreases inflammation.'

Which increased risk would the nurse consider when assessing a client with diabetes who is receiving long-term corticosteroid therapy and is admitted with leg ulcers? A. Weight loss B. Hypoglycemia C. Decreased blood pressure D. Inadequate wound healing

*D. Inadequate wound healing

A 65-year-old client is receiving amitriptyline. Which recommendation will the nurse make to the client concerning this medication? A. 'Obtain a complete cholesterol and lipid profile.' B. 'Have an eye examination to check for glaucoma.' C. 'Check your temperature daily for nighttime increases.' D. 'Watch for excessive sweating and possible weight loss.'

*B. 'Have an eye examination to check for glaucoma.'

The nurse is preparing to administer metoprolol to a client with a history of hypertension. Which of the following data is the priority for the nurse to review prior to administration? A. Potassium level B. Most recent heart rate C. Creatinine level D. Respiratory rate

*B. Most recent heart rate

Which nursing diagnosis is important to include in the plan of care for a client receiving the angiotensin-2 receptor antagonist irbesartan (Avapro)? A. Fluid volume deficit. B. Risk for infection. C. Risk for injury. D. Impaired sleep patterns.

*C. Risk for injury.

A health care provider prescribes furosemide for a client with hypervolemia. The nurse recalls that furosemide exerts its effects in which part of the renal system? A. Distal tubule B. Collecting duct C. Glomerulus of the nephron D. Loop of Henle

*D. Loop of Henle

The nurse is educating a client on self-administration of a fluticasone inhaler. What statement indicates an understanding of the teaching? A. I will rinse my mouth with water after using the inhaler B. Disinfectant wipes can be used to clean the spacer C. I need to wait 15 minutes between puffs D. This inhaler should be used before the others

*A. I will rinse my mouth with water after using the inhaler

The nurse provides instruction when the beta-blocker (BB) atenolol is prescribed for a client with moderate hypertension. Which client statement indicates to the nurse that further teaching is needed? A. 'I must take the medication before going to bed.' B. 'This medication will make me feel drowsy.' C. 'I need to count my pulse before taking the medication.' D. 'I will move slowly when changing positions from sitting to standing.'

*A. 'I must take the medication before going to bed.'

The nurse is caring for a client who received digoxin-specific immune fab. Which finding indicates the treatment is having the intended effect? A. Increased heart rate B. Decreased potassium levels C. Decreased blood pressure D.Increased serum digoxin levels

*A. Increased heart rate

The nurse teaches a client about cortisone therapy. Which statements made by the client indicate the need for further teaching? Select all that apply. One, some, or all responses may be correct. A. 'I should take 3 tablets at a time.' B. 'I should take the tablet twice a week.' C. 'I should take the tablet on an empty stomach.' D. 'I should take the tablet with a meal.'

*A. 'I should take 3 tablets at a time.' *B. 'I should take the tablet twice a week.' *C. 'I should take the tablet on an empty stomach.'

According to developmental norms for a 5-year-old child, the nurse would hold digoxin if an apical heart rate falls below which number? A. 70 beats/min B. 80 beats/min C. 90 beats/min D. 100 beats/min

*A. 70 beats/min

A client recently diagnosed with heart failure has been prescribed digoxin and furosemide. Which of the following foods should the nurse teach the client to eat at least one serving a day? A. Blueberries B. Wheat cereal C. Tomato juice D. Pear nectar

*C. Tomato juice

Nortriptyline is prescribed for a depressed client. Which time period identifies when the nurse would expect a therapeutic response? A. 1 to 3 days B. 12 to 24 hours C. 30 minutes to 2 hours D. 2 to 3 weeks

*D. 2 to 3 weeks

A client is prescribed heparin therapy for a deep vein thrombosis (DVT). Which laboratory value should the nurse monitor closely? A. D-dimer B Platelet count C. Activated partial thromboplastin time D. Bleeding time

*C. Activated partial thromboplastin time

The nurse administers a dose of metoprolol for a client. Which assessment is most important for the nurse to obtain? A. Temperature. B. Lung sounds. C. Blood pressure. D. Urinary output.

*C. Blood pressure.

During a procedure, the client's heart rate drops to 38 beats/min. Which medication is indicated to treat bradycardia? A. Digoxin B. Lidocaine C. Amiodarone D. Atropine sulfate

*D. Atropine sulfate

The nurse prepares discharge instructions for a client who will take enalapril for hypertension. Which instruction would the nurse include in the client's teaching? A. 'Change to a standing position slowly.' B. 'This may color your urine green.' C. 'The medication may cause a sore throat for the first few days.' D. 'Schedule blood tests weekly for the first 2 months.'

*A. 'Change to a standing position slowly.'

Hydrochlorothiazide (HCTZ) has been prescribed for a client with hypertension. The client reports hearing that furosemide is more effective and requests a prescription change. How will the nurse respond? A. 'HCTZ has fewer side effects.' B. 'HCTZ does not cause dizziness.' C. 'HCTZ is only taken when needed.' D. 'HCTZ does not cause dehydration.'

*A. 'HCTZ has fewer side effects.'

Which client statement indicates understanding of the side effects of nitroglycerin ointment? A. 'I may experience a headache.' B. 'Confusion is a common adverse effect.' C. 'A slow pulse rate in an expected side effect.' D. 'Increased blood pressure readings may occur initially.'

*A. 'I may experience a headache.'

Furosemide has been prescribed as part of the medical regimen for a client with hypertension. Which client statement indicates a need for medication education? A. 'This can decrease my vitamin K level.' B. 'I will take the medication in the morning.' C. 'I will contact my health care provider if I notice muscle weakness.' D. 'I plan to take the medication even when my blood pressure is normal.'

*A. 'This can decrease my vitamin K level.'

Nitroglycerin sublingual tablets are prescribed for a client with the diagnosis of angina. The nurse advises the client to anticipate pain relief will begin within which period of time? A. 1 to 3 minutes B. 4 to 5 seconds C. 30 to 45 seconds D. 10 to 15 minutes

*A. 1 to 3 minutes

The nurse is preparing a teaching plan for a client prescribed nitroglycerin sublingual. Which would the nurse include in the teaching? A. 'Place the tablet under the tongue or between the cheek and gums.' B. 'It takes 30 to 45 minutes for the nitroglycerin to achieve its effect.' C. 'If dizziness occurs, take a few deep breaths and lean the head back.' D. 'To facilitate absorption, drink a large glass of water after taking the medication.'

*A. 'Place the tablet under the tongue or between the cheek and gums.'

A client is started on long-term corticosteroid therapy for an autoimmune disorder. Which statement by the client indicates the need for more teaching by the nurse? A. "For 1 week each month I will stop taking the medication." B. "I will keep a record of my weight each week." C. "The medication needs to be taken with food." D. "I will be sure to eat foods that are high in potassium."

*A. "For 1 week each month I will stop taking the medication."

The nurse is providing discharge education to a client diagnosed with coronary artery disease. The client is prescribed to use a nitroglycerin transdermal patch at home. Which statement by the client indicates a correct understanding of safe medication administration? A. "I will remove the old patch and cleanse the area before applying a new patch." B. "This drug can lead to hypertension. So, I will monitor my blood pressure at home." C. "I will keep a record of chest pain occurrences now that I have this patch." D. "I can place this patch on broken skin. It will absorb better."

*A. "I will remove the old patch and cleanse the area before applying a new patch."

The nurse is preparing to apply nitroglycerin ointment. Before applying the ointment, which action will the nurse take? A. Assess the client's pulse rate. B. Prepare the site with an alcohol swab. C. Shave the client's chest in the area for application. D. Use the dose measuring application paper and spread the ointment in a thin layer to the prescribed amount.

*D. Use the dose measuring application paper and spread the ointment in a thin layer to the prescribed amount.

A client with coronary artery disease who is taking digoxin (Lanoxin) receives a new prescription for atorvastatin (Lipitor). Two weeks after initiation of the Lipitor prescription, the nurse assesses the client. Which finding requires the most immediate intervention? A. Heartburn. B. Headache. C. Constipation. D. Vomiting.

*D. Vomiting.

The nurse is caring for a client who is scheduled for a bilateral adrenalectomy. Which medication would the nurse expect to be prescribed for this client? Methimazole Regular insulin Pituitary extract Hydrocortisone

*Hydrocortisone

Which sign of hypokalemia will the nurse monitor for in a client receiving furosemide? Chvostek sign Muscle weakness Anxious behavior Abdominal cramping

*Muscle weakness

Which instruction will the nurse include in a teaching plan for a client taking a calcium channel blocker such as nifedipine? Select all that apply. One, some, or all responses may be correct. Reduce calcium intake. Report peripheral edema. Expect temporary hair loss. Avoid drinking grapefruit juice. Change to a standing position slowly.

*Report peripheral edema. *Avoid drinking grapefruit juice. *Change to a standing position slowly.