Introduction to Pharm ATI Module

A nurse is teaching a client about the adverse effects of digoxin. Which of the following statements should the nurse include in the teaching?

"Contact your provider if adverse effects occur." Adverse effects can be severe and life-threatening. The client should contact their provider if adverse effects occur.

A nurse is teaching a client about naproxen enteric-coated tablets. Which of the following statements should the nurse include in the teaching?

"Do not crush or chew the tablet." Drugs that irritate the stomach are often covered with an enteric coating that does not dissolve until the drug enters the alkaline environment of the small intestine. Clients should not crush or chew enteric-coated drugs because this will damage the enteric coating.

A nurse is teaching a client who has a prescription for a drug that has a receptor agonist effect. Which of the following information should the nurse include in the teaching?

"This will increase the effects of normal cellular functions." Agonist drugs bind to cell receptors in the body and are targeted to a specific type of receptor. When they attach to the receptors, they perform the same action as a hormone or chemical would, increasing the effects of that hormone or chemical. For example, pharmacological insulin is administered to clients who have little to no insulin to mimic insulin's effects in the body.

A nurse is caring for a client who has a new prescription for a drug. After receiving the first dose of the drug, the client experiences anaphylaxis. The nurse should identify that anaphylaxis represents which of the following results of the drug?

Adverse effect Adverse effects are the unintended and unexpected effects of a drug, which can range from mildly annoying to life-threatening, such as an anaphylactic reaction.

A nurse is caring for a client who is newly admitted to the facility for chest pain. At which of the following times should the nurse begin teaching about drugs and discharge planning?

As soon as possible Instruction should start at the beginning of care and when the client is receptive to learning.

A nurse is preparing to administer a drug to a client. In which of the following sections of a drug handbook should the nurse look to determine if the client can receive the drug?

Contraindications The nurse should review the contraindications section in the drug handbook to determine if a client can receive the drug. This section lists pre-existing diseases or clinical situations that could make it unsafe to administer a drug.

A nurse is caring for a client who is having difficulty remembering to take their prescribed drug three times each day. The nurse should identify that which of the following alternate forms of the drug can help to promote adherence to the prescribed dosage?

Extended-release tablet Extended-release tablets release the drug over an extended period of time. Clients can take them less frequently.

A nurse is providing teaching to a pregnant client who is taking Captopril, an ACE inhibitor, to treat hypertension. The nurse informs the client that captopril is a teratogenic drug. The nurse should explain that teratogenic drugs can cause which of the following?

Fetal malformation Teratogenic drugs can cause birth defects. Clients who are pregnant should not take these drugs.

A nurse is preparing to administer a drug to a client. In which of the following sections of a drug handbook should the nurse look to determine if the drug has more than one use?

Indications The indications section provides information on conditions and diseases for which the drug is used.

When reviewing a list of drugs in a drug handbook, a nurse can identify the generic name for a drug in which of the following ways?

It begins with a lower-case letter. Generic names are not capitalized. The brand, or trade name, is a drug's commercial name and is capitalized.

A nurse is caring for a client who was prescribed an antidepressant based on its ability to prevent the reuptake of neurotransmitters. The nurse should identify that which of the following terms describes why this drug was prescribed for the client?

Pharmacologic action The nurse should identify that the mechanism of action of a drug on the body to achieve the desired effect is referred to as pharmacologic action.

A nurse is reviewing a drug handbook prior to administering a drug to a client who has kidney disease. The handbook states that the drug can be administered but identifies certain risks. Which of the following terms describes these risks?

Precautions A precaution includes disease states, such as kidney disease, or clinical situations in which use of a drug involves particular risks or dosage modification might be necessary.

A nurse is caring for a client who is receiving nitroglycerin IV and is switching to the oral form of the drug. The nurse should identify that the oral dose will be higher than the IV dose for which of the following reasons?

The oral form has decreased bioavailability because of the first-pass effect. Oral doses are often larger than IV doses of the same drug because of the first-pass effect by the liver, which reduces the bioavailability of the drug. Enzymes in the liver metabolize drugs, making less of the drug available for use by the body.

A nurse is caring for a client who is taking diphenhyrdramine for insomnia and reports drowsiness. The nurse should identify that drowsiness indicates which of the following?

Therapeutic effect Drowsiness is a therapeutic effect of diphenhydramine for a client who is taking the drug to treat insomnia.

A nurse is reviewing drugs in a drug reference. The nurse should identify that drugs in the same class share which of the following similarities?

They have similar mechanisms of actions. Drugs in the same class often share similar mechanisms of action, as well as assessment guidelines, interactions, and precautions.

A nurse is preparing to teach a client about a newly prescribed drug. Prior to providing teaching, the nurse should review the precautions section of a drug handbook for which of the following reasons?

To determine if dosage modification is indicated The precautions section includes diseases or clinical situations in which drug use involves particular risks or dosage modification might be necessary, such as the presence of a client condition or restrictions due to the client's age.

A nurse is obtaining a client's health history. The client reports no allergies but has experienced mild itching while taking amoxicillin in the past. Which of the following response should the nurse make?

"Itching can indicate a hypersensitivity to amoxicillin." Itching can be an indication of drug hypersensitivity, and a more severe allergic reaction can develop with future exposures. The client might be allergic to amoxicillin and other penicillins.

A nurse is caring for a client who has a history of renal insufficiency and is taking lithium. The nurse should monitor the client for which of the following?

Drug toxicity Drug toxicity develops when the amount of a drug that is taken is greater than its rate of excretion, and it results in the drug accumulating in the body. A client who has renal insufficiency might have delayed or impaired excretion of the drug. The drug dosage should be reduced if toxicity occurs.

A nurse is speaking to a client who is taking sertraline and reports drinking grapefruit juice. The nurse explains that grapefruit juice inhibits an enzyme in the liver that is used to metabolize sertraline. The nurse should recognize the client's risk for which of the following?

Drug toxicity Grapefruit juice can cause increased levels of certain drugs, such as sertraline, which can lead to drug toxicity. Clients should avoid drinking grapefruit juice while taking these drugs.

A nurse is preparing to teach a client how to take care of a newly created colostomy. The nurse should identify that which of the following factors can decrease the client's ability to learn? (Select all that apply)

Impaired cognitive level is correct. A lack of understanding due to impaired cognitive and developmental levels can decrease the client's ability to learn. The nurse should adjust instructional methods to accommodate the client's developmental or cognitive level.Language barrier is correct. If the nurse and the client speak different languages, this can affect the client's ability to learn. The nurse should provide written information in the language the client speaks and make arrangements for finding an interpreter if necessary.Discomfort is correct. A client who is uncomfortable is not able to learn optimally. The nurse should ensure that the client is comfortable prior to giving instructions.Repetition of teaching is incorrect. Repeating important facts frequently and allowing clients to practice new skills often enhances learning. Unreadiness to learn is correct. A client's readiness to learn is an essential part of the client's ability to learn. For example, a client who is experiencing denial or distress is not ready to learn.

A nurse is providing teaching for a client who has a new prescription for a drug with a high potential for toxicity. Which of the following information should the nurse include? (select all that apply)

MY ANSWER Periodic laboratory tests are essential to measure serum drug levels is correct. Clients who are taking drugs that have a high potential for toxicity should undergo regular monitoring of serum drug levels to be certain the drug level stays within the therapeutic range.Monitoring for indications of toxicity is important is correct. Drugs that have a high potential for toxicity can quickly build up to toxic levels in the blood, resulting in effects that can be irreversible or life-threatening. Therefore, the nurse should monitor for manifestations of toxicity particular to the drug the client is taking.Taking the drug with an inducing agent will increase the possibility of toxicity is incorrect. Inducing agents are drugs that have the effect of increasing the metabolism of drugs they are combined with, thereby reducing their efficacy and blood levels. Inducing agents can be prescribed to allow clients to take a lower dose of a drug, so the chances of drug toxicity are lessened. Taking the smallest effective dose is crucial is correct. It is optimal to use the lowest effective dose of a drug to achieve therapeutic effects because doing so helps minimize the risk for toxicity. Increasing fluid intake is recommended to avoid toxicity is incorrect. Increasing fluids will not reduce the risk for drug toxicity. Increasing fluids can change the urine's specific gravity, but it will not alter glomerular filtration, passive tubular reabsorption, or active tubular secretion, which are the three mechanisms by which drugs are excreted renally.

A nurse is caring for a client who is postpartum and breastfeeding. The client asks the nurse about the effects that taking over-the-counter drugs will have on her newborn. Which of the following should the nurse consider when recommending a drug for the client? Select all that apply.

The newborn's weight is correct. The nurse should consider the weight of the newborn when recommending a drug for a client who is breastfeeding. The lower the newborn's weight, the greater the effects of the drug absorbed via breastmilk will be to the newborn.How much breast milk the newborn consumes each day is correct. The nurse should consider the amount of breast milk the newborn consumes per day when recommending a drug for a client who is breastfeeding. The more breast milk the newborn consumes, the more of the drug is likely to be absorbed into the newborn's circulation.Whether or not the benefits to the client outweigh the risks to the newborn is correct. The nurse should weigh the benefits against the risks when recommending a drug for a client who is breastfeeding. If the benefits will be minimal, it is generally not worth the risk to the newborn.The properties of the drug is correct. The nurse should consider the properties of the drug when recommending a drug for a client who is breastfeeding. Certain drugs can transfer more easily into breast milk, depending on properties like fat solubility.The route of administration of the drug is incorrect. Over-the-counter drugs are available in various enteral and topical forms. Any drug, regardless of route, that has the potential for systemic absorption poses a potential risk to a newborn who is being breastfed.

A nurse is caring for a client who is taking acetaminophen and codeine for pain relief. These analgesic drugs interact with one another to cause an additive effect. The nurse should identify that which of the following are characteristics of additive drug interactions? (Select all that apply)

Clients can achieve desired effects with the use of lower dosages is correct. When two or more drugs are given at the same time and have similar actions, an additive effect will occur. Clients can take some drugs together for their additive effects, so they can take lower doses of each drug. Taking the two drugs together can reduce the effects of one or both drugs is incorrect. Drugs that interact together to cause reduced effects are antagonistic. Taking the two drugs together can potentiate the effects of one or both drugs is incorrect. Drugs that interact together to cause greatly increased effects are synergistic. The two drugs can produce an action neither would have produced alone is incorrect. Two drugs given together can produce a unique effect neither would have produced when taken alone. However, this is not an additive effect. Both drugs have similar actions is correct. Additive effects occur when two or more drugs with similar actions are taken at the same time.

A nurse is caring for a client who arrived at an emergency department following a bee sting. Which of the following findings indicate an anaphylactic reaction? (Select all that apply.)

Low blood pressure is correct. Anaphylaxis is an immediate and life-threatening allergic response, manifesting as bronchospasm, laryngeal edema, and a rapid drop in blood pressure. Immediate treatment with epinephrine and IV fluids is imperative. Wheezing is correct. Anaphylaxis is an immediate and life-threatening allergic response, manifesting as bronchospasm, laryngeal edema, and a rapid drop in blood pressure. Wheezing is an indication of bronchospasm and is treated using bronchodilators. Bradycardia is incorrect. Tachycardia, rather than bradycardia, is an indication of anaphylaxis. Peripheral edema is incorrect. Angioedema, or facial swelling, rather than peripheral edema, is an indication of anaphylaxis. Difficulty swallowing is correct. Anaphylaxis is an immediate and life-threatening allergic response, manifesting as bronchospasm, laryngeal edema, and a rapid drop in blood pressure. Difficulty swallowing is an indication of laryngeal edema and, therefore, anaphylaxis.

A nurse is obtaining a client's health history and discovers that the client takes loratadine, an over-the-counter drug. The nurse should identify that which of the following is correct regarding over-the-counter drugs? (Select all that apply).

They do not require the supervision of a nurse is correct. Over-the-counter drugs do not require a prescription or the supervision of a nurse. They can interact with other drugs is correct. Many over-the-counter drugs interact with other drugs. They should be included in the client's drug history assessment is correct. Over-the-counter drugs are often omitted from the drug history assessment, but they should be included. Nurses should ask specific questions about over-the-counter drugs and herbal remedies. They are less effective than prescription drugs is incorrect. Over-the-counter drugs can be as effective as prescription drugs. This varies with the individual client and drug. They do not cause toxicity is incorrect. Over-the-counter drugs can cause toxicity in clients who have certain conditions or if clients take them in excess.