MEDICAL SURGICAL (eaq) Practice for COPD + ASTHMA + RESPIRATORY + General PHARM
A client asks the nurse about how spironolactone (Aldactone) affects electrolytes in the body. What is the correct response by the nurse? a. "The drug causes the body to retain potassium." b. "The drug causes the body to release magnesium." c. "The drug causes the body to excrete potassium." d. "The drug causes the body to bind calcium."
A
A client has been prescribed milrinone (Primacor) for heart failure. How does this drug work? a. The drug increases the force of cardiac contractions and improves cardiac output. b. The drug decreases the volume of the cardiac output in order to reduce hypertension. c. The drug relaxes the myocardial muscle, decreasing the myocardial oxygen requirements. d. The drug inhibits cardiac irregularities, decreasing the sensation of palpitations
A
A client is diagnosed with Cushing's syndrome after long-term use of corticosteroids for rheumatoid arthritis. The client is confused and asks how this happened. Which is the nurse's best response? a. Cushing's is a result of high level of corticosteroids present in the body for a prolonged periods. b. Cushing's develops from adrenal or pituitary tumor. c. Cushing's originates from a rise of mineralcorticoid from the bone marrow. d. Cushing's begins with the growth of bone and spreads to the brain.
A
A client is diagnosed with a bacterial infection. Which lab results would be elevated? a. Neutrophils. b. Lymphocytes. c. Thrombocytes. d. Erythrocytes.
A
A client is newly prescribe Nifedipine (Procardia) to control blood pressure. What teaching would the nurse provide to the client? a. Weigh daily at the same time each day. b. Avoid crowds while taking this medication. c. Increase intake of calcium-containing foods. d. Take this medication only when blood pressure is elevated.
A
A client is newly prescribed verapamil (Calan) for hypertension. The client's family member monitors the client's blood pressure and administers the drug. What teaching would the nurse provide for the family member? a. If the blood pressure is 90/60 or below, contact the prescriber and do not give the medication. b. If the blood pressure is 90/60 or below, give the medication as ordered. c. If the blood pressure is greater than 140/90, give the client a double dose. d. If the blood pressure is 90/60 or below, skip the dose but restart the medication the next day.
A
A client who is taking an adrenergic antagonist for hypertension reports dizziness when first getting out of bed in the morning. The nurse should advise the client to: a. move slowly from the recumbent to the upright position. b. drink a full glass of water before rising to increase vascular circulatory volume. c. avoid sleeping in a prone position. d. stop taking the medication.
A
A nurse administers intravenous fluids to increase fluid volume for a client who is dehydrated. The intervention affects which part of cardiac output? a. Preload. b. Contractility. c. Afterload. d. Heart rate.
A
A nurse is preparing to administer a drug that enhances anti-diuretic hormone. What diagnostic test would the nurse review prior to administering this drug? a. Blood pressure. b. Daily weight. c. Oxygen saturation. d. Respirations.
A
A nurse is preparing to administer albuterol (Ventolin) per inhaler to a client diagnosed with acute asthma. The nurse monitors for which therapeutic effect? a. Increased breath sounds. b. Sedation. c. Decreased heart rate. d. Hypoactive bowel sounds.
A
A nurse is preparing to administer hydrochlorothiazide (Microzide) to a client. The nurse would notify the healthcare provider for which assessment finding? a. The client has an allergy to sulfonamides. b. The client has swelling in the feet. c. The client has elevated blood pressure. d. The client has a history of myocardial infarction.
A
A nurse is teaching the client newly prescribed furosemide (Lasix). What information would the nurse include in the teaching? a. Schedule doses to avoid sleep disturbance and nocturia. b. Evening dosages should be given close together for therapeutic effect. c. Take the medication 30 minutes before eating. d. Take the medication only if pedal edema is present.
A
A nurse would anticipate the client newly diagnosed with heart failure will receive a drug from which classification? a. ACE inhibitors. b. Loop diuretics. c. Cardiac glycoside. d. Beta-adrenergic blockers.
A
Cholinergic neurons release which neurotransmitter? a. Acetylcholine. b. Dopamine. c. Gamma aminobutyric (GABA). d. Glutamate.
A
Medications that block beta 1 receptors affect blood pressure by which action in the kidneys? a. Suppressing the release of renin. b. Preventing the destruction of monoamine oxidase (MAO). c. Increasing the release of catecholamines. d. Promoting the production of norepinephrine
A
The client is started on propranolol (Inderal). Which is the most important action to include in the plan of care for this client related to this medication? a. Monitor apical pulse and blood pressure. b. Elevate the head of the bed during meals. c. Take the medication after meals. d. Consume foods high in potassium
A
The client taking atorvastatin (Lipitor) reports weakness and fatigue, pain in the shoulders, and aching joints. The nurse initially assesses the client for which condition? a. Rhabdomyolysis. b. Renal failure. c. Rheumatoid arthritis. d. Hepatic insufficiency
A
The nurse has just administered a dose of a calcium channel blocker drug to a client. After the initial dose, which measurement is the priority assessment? a. Blood pressure. b. Breath sounds. c. Pupil response. d. Skin integrity.
A
The nurse is administering a medication to a client with benign prostatic hyperplasia. The medication blocks alpha 1 receptors which promotes emptying the bladder. What other effect would the nurse anticipate from this medication? a. Decreased blood pressure. b. Slow heart rate. c. Urinary retention. d. Frequent urination.
A
The nurse is providing care for a client diagnosed with Parkinson's disease. The nurse anticipates the client will be treated with drugs that affect which neurotransmitter? a. Dopamine. b. Substance P. c. Acetylcholine. d. Glutamate.
A
The nurse knows that teaching a client about hydrochlorothiazide (HCTZ) has been successful when the client voices which statement? a. "I should report weight gain of two or more pounds in a day." b. "I will avoid salt substitutes and foods high in potassium." c. "If I miss a dose, I should take an extra dose to reduce my blood pressure." d. "This drug will help me lose weight."
A
What intervention would the nurse use when administering the first dose of prazosin (Minipres) in order to prevent adverse effects of the drug? a. Administer the first dose at bedtime. b. Administer the first dose with breakfast. c. Administer the first dose on an empty stomach. d. Administer the first dose in the early afternoon.
A
The nurse determines that the client understands an important principle in self-administration of hydralazine (Apresoline) when the client makes which statement? a. "I should not drive until I know how this drug will affect me." b. "I can stop taking this medication once I begin to feel better." c. "If I experience dizziness, I should take only half the dose." d. "I should avoid air travel while taking this medication."
A should be instructed not to engage in activities that may be hazardous
A nurse is administering a positive inotropic drug. The nurse monitors for which therapeutic effect? a. Increased blood pressure. b. Decreased urinary output. c. Cool extremities. d. Weak peripheral pulses.
A A positive inotropic drug increases contractility and therefore blood pressure.
The nurse should inform the client who is prescribed a nebulizer treatment with albuterol (Proventil) that a common adverse effect is: a. an increased heart rate with palpitations. b. a predisposition to infection. c. sedation. d. temporary dyspnea.
A Adverse effect may be heart rate elevation and palpitations (dose-related)
A client has been taking a thiazide diuretic for treatment of hypertension and has been prescribed hydrocortisone (Cortef) for a significant allergic reaction to shellfish. Which symptom should be immediately reported to the provider? a. Irregular heart rate and rhythm. b. Delayed wound healing. c. Weight loss of 2 to 3 lb. per week. d. Elevated serum lipid levels.
A An irregular heart rate and rhythm is a symptom of hypokalemia. Hydrocortisone given concurrently with diuretics such as thiazides, which cause loss of potassium, increases the risk of hypokalemia.
The nurse is providing care for a client diagnosed with Alzheimer's disease. The nurse anticipates the healthcare provider will prescribe a medication from which autonomic class? a. Cholinergic agonist. b. Beta-adrenergic agonist. c. Alpha-adrenergic blocker. d. Anticholinergic.
A Condition is treated with ACh (therefore need cholinergic agonist)
A nurse anticipates an order from which drug class for an African American client newly diagnosed with hypertension and no kidney disease? a. Thiazide diuretics. b. Loop diuretics. c. ACE inhibitors. d. Beta-adrenergic blockers
A Guidelines for the treatment of hypertension for black clients without kidney disease are thiazide diuretics and/or calcium channel blockers.
A client with asthma asks which of the prescribed medications should be used in the event of an acute episode of bronchospasm. The nurse will instruct the client to use: a. albuterol, a beta agonist bronchodilator, by inhalation. b. beclomethasone, a glucocorticoid anti-inflammatory drug, by inhalation. c. ipratropium, an anticholinergic bronchodilator, by inhalation. d. zafirlukast, a leukotriene modifier, by mouth.
A Others would not cause bronchodilation fast enough
A 4-year-old child with respiratory distress secondary to asthma has an order for a nebulizer treatment. The type of medication most likely to be given for asthma management is a: a. beta agonist. b. beta antagonist. c. corticosteroid. d. leukotriene modifier
A The others would not have rapid bronchodilation required to combat asthma attack; Beta agonists given to children under 5 for asthma attacks!
A nurse is teaching a client with heart failure about beta-adrenergic drug therapy. What would the nurse include in this teaching? Select all that apply. a. The dosage must be gradually adjusted over time to a beneficial dose. b. The client may not notice significant improvement during early therapy. c. The drug may require changes to many other drugs the client is taking. d. The drug has significant benefit in reducing mortality from heart failure. e. The drug will require extensive lifestyle changes.
A ,B, and D
. A nurse is planning to care for a client with hypertension who is being treated with antihypertensive medications and diuretics. Which food from the hospital menu would be poor choices? Select all that apply. a. Frankfurters. b. Corned beef. c. Dry cereal. d. Glass of low fat milk. e. Mashed potatoes.
A and B Frankfurters, corned beef, and sauerkraut are high in sodium content and would be poor choices for a client with primary hypertension.
An older adult client with chronic bronchitis has been receiving low-dose therapy with dexamethasone for several months to reduce the inflammation occurring secondary to the bronchitis. What teaching should this client receive to reduce the risk of osteoporosis related to dexamethasone use? Select all that apply. a. Perform weight-bearing exercises at least three to four times weekly. b. Increase dietary intake of calcium- and vitamin D-rich foods. c. Remain sedentary except during periods of exercise. d. Increase fluid intake, including carbonated sodas, but avoid alcohol. e. Request a prescription for a bisphosphonate drug from the provider.
A and B Sedentary NOT recommended Carbonated sodas actually increase risk of osteoporosis
The nurse should monitor the client who is taking beclomethasone (Qvar) for evidence of: (select all that apply) a. Infection. b. Hyperglycemia. c. Urinary retention. d. Tachycardia. e. Photophobia.
A and B: reduces inflammatory and immune response (infection risk) and can increase glucose level (hyperglycemia risk)
A nurse is preparing to administer verapamil (Calan) to a client. The nurse would notify the healthcare provider of which finding prior to administering the drug? Select all that apply. a. Bradycardia. b. Tachycardia. c. Hypotension. d. Tinnitus. e. Hypertension.
A and C: medication causes cardiac depression hence the bradycardia and hypotension; the other answers not correct because the medication is INDICATED for them (they are not adverse effects)
A client is receiving felodipine (Plendil) for hypertension. In the care plan, the nurse includes the need to monitor the client for which adverse effect? a. Rash and chills. b. Increased urinary output. c. Weight loss. d. Reflex tachycardia.
D
Hydralazine (Apresoline) is prescribed for each of these clients. A nurse would question the order for which clients? Select all that apply. a. The client with lupus. b. The client with acute heart failure. c. The client with hypertensive emergency. d. The client with renal impairment. e. The client with hypertension.
A and D Clients with lupus should not receive hydralazine, as the drug can worsen symptoms. The drug is used with caution in clients with renal impairment because this drug is excreted by the kidneys.
What health teaching should the nurse provide for a client receiving calcium channel blockers? Select all that apply. a. Avoid driving and performing other activities requiring mental alertness until the effects of the drug are known. b. Maintain adequate fluid and fiber intake to facilitate stool passage. c. Report weight gain of 2 kg per week. d. Rise slowly from prolonged periods of sitting or lying down. e. Immediately stop taking the medication if sexual dysfunction is noted.
A, B, C, and D
A nurse is teaching the client about foods high in plant sterols. Which foods would the nurse include in this teaching? Select all that apply. a. Oatmeal. b. Brown rice. c. Butter. d. Corn. e. Orange juice.
A, B, and D
The nurse is caring for a client receiving gemfibrozil (Lopid) for hyperlipidemia. The nurse would validate the order with the prescriber if the client reported a history of which of the following? Select all that apply. a. Gallbladder disease. b. Angina. c. Hypertension. d. Diabetes. e. Renal disease.
A, D, and E
A nurse is preparing to administer a drug that affects erythropoietin. What diagnostic test results would the nurse review? a. Platelets. b. Red blood cells. c. White blood cells. d. Atrial natriuretic peptide
B
A nurse is teaching a client prescribed beta2-receptor agonists about food choices. Which food choice by the client indicates further teaching is necessary? a. Sweet potatoes. b. Iced tea. c. Citrus fruits. d. Egg-based products.
B
A nurse is teaching the client with heart failure about digoxin. What would the nurse include in this teaching? a. Take the drug in the morning before rising. b. Monitor the pulse daily prior to taking the drug. c. Discontinue the drug if the pulse rate is 70 beats per minute. d. Eat a diet high in bran fiber and calcium.
B
A client asks the nurse how the heart heals after a myocardial infarction. What is the correct response by the nurse? a. "The heart heals by replacing damaged cells with new cells." b. "Scar tissue replaces the damaged area in the heart." c. "White blood cells remove the damaged heart tissue." d. "Platelets cause a clot to form and prevent further damage."
B
A client is newly prescribed nifedipine (Procardia) for hypertension. The client also is prescribed digoxin. The nurse monitors the client for which adverse effect? a. Weight gain. b. Bradycardia. c. Reflex tachycardia. d. Rapid drop in blood pressure
B
A client is receiving cholestyramine (Questran) for elevated low-density lipoprotein levels. The provider monitors the client for which adverse effect? a. Orange-colored urine. b. Abdominal pain. c. Sore throat and fever. d. Decreased capillary refill.
B
A client is receiving lisinopril (Prinivil) for hypertension. The nurse should ask the client about a history of which condition? a. Gallbladder disease. b. Angioedema. c. Chronic back pain. d. Recent viral infection.
B
A client with a visual disturbance is having an ophthalmic examination. The client received an alpha1-receptor agonist prior to the examination. Which assessment finding indicates the drug is effective? a. Pupil constriction. b. Pupil dilation. c. Conjunctiva discoloration. d. Conjunctiva dilation.
B
A nurse is assessing the client newly diagnosed with a disorder that affects the SA node in the heart. Which assessment finding is consistent with this disorder? a. Decreased intake and output. b. Irregular heart rate. c. Increased blood pressure. d. Warm extremities.
B
The client asks the nurse, "Why am I receiving both fibric acid and a statin?" What is the correct response by the nurse? a. "The drugs together produce a decline in drug toxicity and adverse effects." b. "This combination produces a greater decline in triglyceride levels." c. "Research shows this combination has better client adherence to the therapeutic regimen." d. "Clients who take this drug combination have quicker reduction of high-density lipoprotein levels."
B
The nurse determines that a client does not understand important principles in the self administration of alpha1-adrenergic antagonists when the client makes which statement? a. "I should sit on the side of the bed before standing up when getting out of bed." b. "Taking my medication is all I need to do to control my hypertension." c. "I will keep a journal of my blood pressure readings until I return for follow-up." d. "Before bedtime is the best time to take this medication."
B
The nurse determines that the client understands an important principle in self-administration of nifedipine (Procardia) when the client makes which statement? a. "The use of antacids when taking the medication will enhance absorption." b. "Grapefruit juice may enhance the absorption of nifedipine." c. "If I miss a dose, I should take two nifedipine capsules when I remember." d. "This drug will make my birth control pills ineffective."
B
The nurse is caring for a client with chronic hypertension. The client is receiving losartan (Cozaar) daily. Which manifestations would the nurse conclude are adverse effects of this medication? a. Irritability and insomnia. b. Headache and dizziness. c. Sleepiness and slurred speech. d. Pruritus and rash.
B
The nurse is teaching a group of clients with cardiac conditions who are taking diuretic therapy. What information would the nurse provide concerning furosemide (Lasix)? a. Avoid consuming large amounts of cabbage, cauliflower, and kale. b. Rise slowly from sitting or lying positions. c. Count their pulse for 1 full minute before taking the medication. d. Restrict fluid intake to no more than 1,000 mL in a 24-hour period.
B
The nurse suspects a client is experiencing angina pectoris when the client experiences which manifestation? a. The client is short of breath. b. The client reports chest pain with exercise. c. The client is dizzy when standing up. d. The client reports an occasional irregular heartbeat.
B
What substance allows message transmission from one cell to another cell? a. Synaptic cleft. b. Neurotransmitter. c. Muscarinic. d. Nicotinic.
B
A 2-year-old client with contact dermatitis from poison oak is being treated with topical hydrocortisone ointment by his mother. What health teaching would be most appropriate? a. Mix the ointment with cornstarch to decrease the itching. b. Apply the ointment sparingly. c. Apply the preparation after a very warm bath. d. Use sterile technique when applying the ointment
B Trying to avoid toxicity
A healthcare provider has ordered verapamil (Calan) for each of these clients. The nurse should question the order for which client? a. A client with atrial dysrhythmias. b. A client who has had intracranial surgery. c. A client who has hypertension. d. A client with angina.
B Verapamil is contraindicated in clients undergoing intracranial surgery.
A health care provider has ordered a corticosteroid for each of these clients. The nurse should question the order for a client with: a. allergic disorders. b. peptic ulcer disease. c. asthma. d. active infections.
B they reduce prostaglandin synthesis -prostaglandins protect against high acidity; don't want to give corticosteroid to PUD pts
Which assessment findings discovered by the nurse would be expected adverse effects associated with niacin therapy? Select all that apply. a. Fever and chills. b. Intense flushing and hot flashes. c. Tingling of the fingers and toes. d. Dry mucous membranes. e. Hypoglycemia.
B and C Intense flushing and hot flashes occur in almost every client who is taking niacin. Tingling of the extremities may also occur.
A client is prescribed a beta-adrenergic blocker for out-client treatment of hypertension. The nurse monitors this client for which adverse effects? Select all that apply. a. Anorexia. b. Slow heart rate. c. Hypoglycemia. d. Decreased libido. e. Thrombocytopenia.
B, C, and D
A medication that activates muscarinic receptors will have which effect on the body? Select all that apply. a. Dilated pupils. b. Decreased heart rate. c. Smooth muscle stimulation. d. Increased peristalsis. e. Constricted blood vessels.
B, C, and D Targeting cells of parasympathetic NS
The sympathetic nervous system produces which effects when it is activated? Select all that apply. a. Digestion. b. Bronchi dilate. c. Heart rate increases. d. Slowed respirations. e. Pupils dilate.
B, C, and E
A client diagnosed with Raynaud's disease is prescribed an alpha-adrenergic antagonist to relieve symptoms. The client asks the nurse how this drug will help the symptoms. What is the correct response by the nurse? a. "The drug decreases excess blood flow to the extremities by lowering heart rate." b. "The drug improves oxygenation at the cellular level by improving blood oxygen levels." c. "The drug helps relieve vasospasms that affect blood flow to the affected areas." d. "The drug dilates venous blood vessels that provide blood flow to the affected areas."
C
A client was recently admitted for an exacerbation of COPD. The prescriber has ordered cromolyn (Intal). The client asks the nurse how the medication works. Which is the nurse's best response? a. The drug is a methylxanthine, relaxing bronchial smooth muscle. b. The drug is a corticosteroid, reducing inflammation and the immune response. c. The drug is a mast cell stabilizer, preventing the inflammatory process in the lungs. d. The drug is a leukotriene modifier, by blocking inflammation by blocking leukotriene receptors.
C
A health care provider has ordered nifedipine (Procardia XL) for each of these clients. A nurse will most closely monitor which client for drug-related problems? a. A client who is admitted for an appendectomy in the morning. b. A client who is receiving renal dialysis three times per week. c. A client who develops pulmonary edema in the intensive care unit. d. A client who receives psychotropic drugs for bipolar disease.
C
A nurse has just administered a dose of an angiotensin II receptor blocker to a client. After the initial dose, which measurement is the priority assessment? a. Level of consciousness. b. Heart rate. c. Blood pressure. d. Body temperature
C
A nurse is preparing to administer dopamine (Intropin) to a client. What assessment finding would indicate a therapeutic effect? a. The client's heart rate has elevated. b. The client's pupils have constricted. c. The client's blood pressure has increased. d. The client's kidneys are making less urine.
C
A nurse is teaching the client newly prescribed nitroglycerin topical ointment about the drug. What would the nurse include in this teaching? a. Keep the medication in the refrigerator. b. Only take this medication when chest pain is severe. c. Remove the old paste before applying the next dose. d. Apply the ointment on the chest wall only.
C
The client's orders for albuterol (Proventil) have been changed from inhaled to oral form of the medication. What effect does the nurse anticipate this will have for the client? a. The client will have more adverse effects from the drug. b. The client will need fewer doses per day of the drug. c. The client will have slower response to the drug. d. The client will have a poorer response to the drug
C
The nurse determines that the client understands self-administration of sublingual nitroglycerin when the client makes which statement? a. "I should take this drug to help prevent angina." b. "I can take up to six pills until my chest pain goes away." c. "I won't get full effect of the drug if my mouth is dry." d. "I can keep extra doses in my automobile."
C
The nurse is concerned a client taking digoxin (Lanoxin) for heart failure is experiencing an overdose. Which assessment findings would support this concern? a. The client has weak peripheral pulses. b. The client has an increased urinary output. c. The client is experiencing nausea and vomiting. d. The client is experiencing diarrhea.
C
What is the primary function of autonomic drugs? a. Autonomic drugs are used to treat disorders of the autonomic nervous system. b. Autonomic drugs are used to treat disorders found only in the central nervous system. c. Autonomic drugs treat disorders in the target organs served by the autonomic nervous system. d. Autonomic drugs treat disorders found only in the peripheral nervous system.
C
Which drug should be included in the therapeutic management of a client receiving niacin? a. Diphenhydramine capsule 1 hour after administration. b. Liquid antacid 30 mL taken at the same time as the niacin. c. Aspirin tablet 30 minutes prior to administration. d. Acetaminophen caplet 2 hours prior to administration.
C
Calcium channel blockers affect which part of cardiac output? a. Preload. b. Contractility. c. Afterload. d. Heart rate.
C Calcium channel blockers dilate blood vessels and therefore affect afterload
A client with asthma asks which of the prescribed medications should be used in to prevent an asthma attack. The nurse will instruct the client to use: a. albuterol (Proventil). b. theophylline (Theo-Dur). c. cromolyn (Intal). d. aminophylline.
C A, B, and D are incorrect because albuterol is a bronchodilator used to relieve and prevent bronchospasm; the other two used to be treatment of choice for management, now only used if pt unresponsive to beta agonists and corticosteroids
A client who has been taking dexamethasone for rheumatoid arthritis was unable to take the drug for several days due to an intestinal virus. The client seeks treatment in the emergency department for complaints of severe nausea, vomiting, lethargy, fever, and hypotension. What drug does the nurse anticipate will be given to this client? a. Fludrocortisone. b. Ketoconazole (Nizoral). c. Hydrocortisone (Solu-Cortef). d. Metyrapone (Metopirone).
C Experiencing symptoms of acute adrenal insufficiency since unable to take drug for a few days and should be given IV hydrocortisone
Despite repeated demonstrations of proper use by the nurse, the client is unable to return a proper demonstration on the training inhaler. The client is becoming frustrated. What is the best action for the nurse to take? a. Encourage the client to keep practicing just a little longer. b. Notify the health care provider that the client is incompetent. c. Provide a spacer for use with the inhaler d. Switch to an oral form of a beta agonist
C It is an immediate solution Spacers are very helpful (hold cloud of medication)
A client diagnosed with liver diseases asks the nurse why he/she bruises easily. What is the best response by the nurse? a. "The liver makes platelets that help with clotting." b. "Bruising is often due to poor nutrition." c. "Several clotting factors are made by the liver." d. "Clients with liver disease often also have clotting disorders."
C Liver disease pt prone to bruising and bleeding since impaired synthesis of clotting factors by liver
A nurse is teaching a client about hydrochlorothiazide (Microzide). What would the nurse include in this teaching? a. "There are no limitations on the amount of salt and fluid intake." b. "Ingest vitamin K-rich foods daily, such as green, leafy vegetables and broccoli." c. "Report muscle cramps or weakness to the health care provider." d. "Antihypertensive drugs taken concurrently may produce sleepiness."
C Muscle cramps and weakness may indicate hypokalemia and should be reported to the health care provider
A 60-year-old man is prescribed ipratropium (Atrovent) for the treatment of COPD. Which statement is included in the teaching plan? a. Tell the client to avoid caffeine in the diet. b. Assess for liver pain. c. Advise the client to report the inability to urinate. d. Monitor for the development of diarrhea.
C With ipratropium: may have risk of urinary retention which should be notified to the doctor
A client is prescribed beclomethasone (Beconase AQ, Qvar), a glucocorticoid inhaler. Education by the nurse will include: a. "Check your heart rate because this may cause tachycardia." b. "Limit your coffee intake while on this drug." c. "Rinse your mouth out well after each use." d. "You may feel shaky and nervous after using this drug."
C (clean out any residue) No need to limit caffeine intake when on this medication Doesn't cause tachycardia or shaky/nervousness
The client received digoxin 0.125 mg orally daily at 1000. At what time should a serum digoxin level be collected? a. 0900 hours. b. 0600 hours. c. 2200 hours. d. 1100 hours.
C: digoxin levels should be drawn 6-12 hours after dose administered (given at 1000 aka 10 am, levels drawn 8 hours later at 2200 aka 6 pm)
A client is prescribed a beta-adrenergic blocker for the treatment of hypertension. The client also has diabetes. What should the nurse teach the client? a. Increase insulin intake by two to three units daily each morning. b. Eat a diet low in complex carbohydrates. c. Take the morning dose of insulin after eating breakfast. d. Monitor blood glucose levels frequently and report hypoglycemia.
D
A client who is prescribed metoprolol (Lopressor) asks the nurse how the medication works. What is the correct response by the nurse? a. "This drug eliminates excess sodium molecules from the blood and lymph fluid." b. "This drug eliminates excessive fluid from the circulatory volume." c. "This drug inhibits the action of acetylcholine in the blood vessels." d. "This drug decreases cardiac output by lowering heart rate and blood pressure."
D
A client with chronic adrenal insufficiency taking hydrocortisone (Cortef) and fludrocortisone is planning a family vacation. What essential teaching does this client need prior to taking this trip? a. "Take your blood pressure once or twice while you're gone." b. "Avoid crowded indoor areas to avoid infections." c. "Have your vision checked before you leave." d. "Carry an oral and injectable form of both drugs with you on your trip."
D
A nurse is preparing to administer an initial dose of Lisinopril to an African-American client. What manifestation should the nurse monitor after administering the drug? a. Dry irritating cough. b. Increased potassium levels. c. Dizziness when standing up. d. Swelling in the face and upper airway.
D
The client states, "I always put my nitroglycerin patch in the same place so I do not forget to take it off." What information would the nurse provide to the client? a. Clients are more likely to remember to apply the patch if the same site is used daily. b. Repeated use of the same application site will enhance medication absorption. c. Rebound phenomenon is likely to occur when the same site is used more than once. d. Skin irritation due to the nitroglycerin ointment can occur if the same site is used repeatedly.
D
The community health nurse visits a client who has been prescribed lovastatin (Mevacor).Which statement by the client indicates that further teaching is necessary concerning this drug therapy? a. "I should try to maintain my body weight at an optimal level." b. "Most people with lipid disorders don't have any symptoms." c. "The best time for me to take this medication is before I go to bed." d. "I will take my drug with beverages that contain grapefruit juice."
D
The nurse is administering a medication for depression that affects serotonin (5-HT) and function in the limbic system in the brain. The nurse understands this medication can affect what other organs? a. Spinal cord. b. Eyes. c. Adrenal glands. d. Gastrointestinal.
D
The nurse is assessing a client's heart rate. The heart rate is 26 beats per minute. The nurse suspects the heartbeat is originating in which part of the heart? a. SA node. b. AV node. c. Myocardium. d. Purkinje fibers.
D
Which statement made by a client indicates that additional teaching by the nurse concerning digoxin (Lanoxin) is needed? a. "I will probably be taking the drug for the rest of my life." b. "I should count my pulse for 1 full minute before I take this drug." c. "I should stop drinking my ginseng tea while taking this drug." d. "I can expect to have some swelling in my feet and ankles from this drug."
D
A nurse is evaluating teaching for a client newly prescribed Lisinopril (Prinivil). Which statement, if made by the client, indicates that further teaching is necessary? a. "I should notify my health care provider of symptoms of hypotension such as dizziness or fainting." b. "I should avoid the use of salt substitute containing potassium." c. "If a dose is missed, I will take it as soon as possible but not too close to the next dose." d. "Too much calcium in my diet will elevate my blood pressure."
D Doesn't affect serum calcium levels
A nurse is teaching the client newly prescribed oral hydralazine (Apresoline). What would the nurse include in this teaching? a. Slow heart rate is a common adverse effect of this drug. b. Nausea rarely occurs in clients who take this drug. c. Diarrhea is a sign of serious adverse effect and should be reported. d. Avoid the use of nonsteroidal anti-inflammatory drugs while taking hydralazine.
D Nonsteroidal anti-inflammatory drugs can decrease the antihypertensive effects of hydralazine.
A healthcare provider has ordered an alpha1-adrenergic antagonist for each of these clients. A nurse should question the order for the client with which disorder? a. Benign prostatic hyperplasia. b. Pheochromocytoma. c. Raynaud's disease. d. Tachycardia.
D One adverse effect for alpha 1 antagonist is tachycardia
A client is receiving hydralazine (Apresoline) for elevated blood pressure levels. The nurse would monitor for which adverse effect of this drug? a. Atelectasis. b. Crystalluria. c. Photosensitivity. d. Orthostatic hypotension
D Orthostatic hypotension is a common adverse effect of vasodilators such as hydralazine.
A client with severe allergy to bee stings is prescribed intramuscular epinephrine in case of bee stings. The client asks the nurse how this drug will help with an allergic reaction. What is the correct response by the nurse? a. "Epinephrine will stop the systemic release of histamine produced by the mast cells." b. "This drug counteracts the formation of antibodies in response to an invading antigen." c. "Epinephrine increases the number of white blood cells produced to fight the primary invader." d. "This drug increases blood pressure and improves breathing by dilating airways."
D Used during anaphylaxis to prevent hypotension and bronchoconstriction
A client with chest pain is receiving sublingual nitroglycerin. The nurse monitors the client for which adverse effect? a. Photosensitivity. b. Elevated blood pressure. c. Vomiting and diarrhea. d. Headache.
D (most common effect)
A nurse is preparing to administer an ACE inhibitor to a client with heart failure. Which diagnostic test results would the nurse review prior to administering the drug? a. Chloride levels. b. Red blood cell level. c. White blood cell level. d. Blood urea nitrogen (BUN).
D: BUN to ensure sufficient renal function since ACE inhibitor block angiotensin II and can lead to renal impairment
