Meds

A nurse is preparing to administer IV therapy to a client who is compromised. Which of the following are clinical manifestations of left-sided heart failure. (Select all that apply.)

- Dyspnea - Orthopnea - Paroxysmal nocturnal dyspnea

A client in the hospital is prescribed digoxin (Lanoxin) 125 mcg. The computerized medication delivery system on the unit dispenses tablets labeled digoxin 0.25 mg. How many tablets should the nurse dispense to the client?

0.5 tab

A client with a severe infection is prescribed IV vancomycin (Vancocin) 1 g in 250 mL D5W over 2 hr. The nurse should set the IV pump to infuse at how many mL/hr?

125 mL/hr

A client's provider prescribes 3,000 mL of dextrose 5% in 0.45% sodium chloride to infuse IV over 24 hr. The nurse initiates an IV infusion of 1,000 mL of this fluid at 0800. At what time should the nurse prepare to initiate the second 1,000 mL bag? (Document the response in 24-hr [military] time.)

1600

A provider prescribes an IV medication to infuse in 50 mL of 0.9% sodium chloride over 20 min. The drop factor on the manual IV tubing is 20 gtt/mL. The nurse should adjust the IV flow rate to deliver how many gtt/min to the client? (Round to the nearest whole number.)

50 gtts/min

A provider prescribes an IV medication to infuse in 100 mL of dextrose 5% in water over 20 min. The drop factor on the manual IV tubing is 15gtt/mL. The nurse should set the IV flow rate to deliver how many gtt/min to the client? (Round to the nearest whole number.)

75 gtt/min

A client with severe pancreatitis is receiving total parenteral nutrition (TPN). The physician prescribes 1,800 mL to be infused at a continuous rate over 24 hr. At how many mL/hr should the nurse set the IV pump?

75 mL/min

A nurse is preparing to administer an IV injection of phenytoin (Dilantin) to a client. Which of the following nursing actions is appropriate?

Administer a saline solution after injection.

A nurse is caring for a client who is HIV positive and is started on zidovudine (AZT). The nurse should monitor the client for which of the following life-threatening side effects of this medication?

Aplastic anemia

A nurse is preparing to administer digoxin (Lanoxin) to a client who has heart failure. Which of the following actions is appropriate?

Evaluating the client for nausea, vomiting, and anorexia

A client who is taking digoxin (Lanoxin) develops ECG changes and other indications of severe digoxin toxicity. Which of the following medications should the nurse prepare to administer?

Fab antibody fragments (Digibind)

A nurse is caring for a client who is prescribed furosemide (Lasix). For which of the following adverse effects should the nurse monitor?

Hypokalemia

A nurse is caring for a client in liver failure with ascites who is receiving spironolactone (Aldactone). Which of the following outcomes should the nurse expect from this client's medication therapy?

Increased sodium excretion

A client has developed agranulocytosis as a result of taking propylthiouracil (PTU) to treat hyperthyroidism. When preparing to counsel the client, the nurse should base her instructions on the fact that the client is at serious risk for which of the following?

Infection

A nurse is caring for a client who is taking levothyroxine (Synthroid). Which of the following manifestations should suggest to the nurse that the client may have taken an overdose of levothyroxine?

Insomnia

A nurse is caring for a client who has erectile dysfunction and is interested in taking sildenafil (Viagra). The nurse informs the client that sildenafil is contraindicated due to the fact that the client also takes which one of the following medications?

Isosorbide (Isordil)

A nurse is caring for a client who is receiving nifedipine (Procardia). The nurse checks the client's blood pressure before administering medication and reports 98/58. Which of the following actions should the nurse take first?

Recheck the client's blood pressure.

A nurse is talking with a client who is about to start taking nitroglycerin oral, sustained-release capsules (Nitro-Time). Which of the following instructions should the nurse include?

Swallow the capsules whole.

A nurse is caring for a client who is hospitalized and is on day 1 of a 10-day course of IV penicillin G potassium. Ten minutes into the infusion of the third dose, the client reports that the IV site itches. The client also states that he is "feeling dizzy and short of breath." The nurse's priority action is to

stop the infusion

A nurse is caring for a client who is diagnosed with a urinary tract infection (UTI) and is taking ciprofloxacin (Cipro) 500 mg PO every 12 hr. Which of the following instructions should the nurse give to the client?

"Drink at least 1 to 2 quarts of fluid each day while taking Cipro."

A nurse is caring for a client who is newly diagnosed with diabetes mellitus and is prescribed glipizide (Glucotrol). When instructing the client about this medication, the nurse should describe its method of action with which of the following statements?

"Glucotrol stimulates your pancreas to release adequate insulin."

A nurse is caring for a client who has congestive heart failure (CHF) and was started on digoxin (Lanoxin). Which of the following client statements should alert the nurse that the client may be experiencing a side effect of digoxin?

"I feel nauseated and have no appetite."

A nurse is caring for a client who has several environmental allergies and was admitted in status asthmaticus. The provider prescribes cromolyn sodium (Intal) via metered dose inhaler (MDI) to be added to the client's home management along with an albuterol (Proventil) MDI. When performing discharge teaching, the nurse should identify the need for additional teaching when the client states,

"I will be sure to take the Intal four times a day before using the Proventil."

A nurse is performing discharge teaching for a client who is taking phenytoin (Dilantin). Which of the following comments by the client should alert the nurse that further teaching is needed?

"I'll be glad when I am free of seizures so I can stop taking this medicine."

A nurse is teaching a client who has angina pectoris about starting therapy with nitroglycerin (Nitrostat) sublingual tablets. The nurse verifies the client's understand when the client states which of the following?

"I'll dial 911 if one tablet does not relieve my pain and then take up to two more 5 minutes apart while waiting.

A nurse on a medical unit is caring for a client who has angina pectoris and reports chest pain with a severity of 6 on a 0 to 10 scale. The nurse administers sublingual nitroglycerin (Nitrostat). After 5 min, the client states that his chest pain is now a 2. Which of the following actions should the nurse take?

Administer another nitroglycerin tablet.

A nurse in a clinic is performing a routine examination for a client. The client has a blood pressure of 170/104 mm Hg, and the provider prescribes propranolol (Inderal). The nurse should question the prescription after noting in the client's medical record a history of

asthma

A nurse is teaching a client who has angina pectoris about starting therapy with nitroglycerin (Nitrostat) tablets. The nurse should instruct the client to take the medication

at the first indication of chest pain.

A nurse is talking with a client who is about to start taking captopril (Capoten) to treat hypertension. Which of the following instructions should the nurse include to help the client manage this medication's adverse effects?

Do not use salt substitutes while taking this medication.

A client is prescribed 2 mg morphine sulfate (Duramorph) IV. The medication is dispensed by the pharmacy in vials labeled morphine sulfate, 10 mg/mL. How many mL should the nurse administer per dose?

0.2

A client is prescribed a heparin IV infusion at 1,200 units/hr. Heparin comes premixed from the pharmacy in 25,000 units per 500 mL D5W. At how many mL/hr should the nurse set the IV pump?

24

A nurse is caring for a client who is hospitalized with active pulmonary tuberculosis (TB) and is to be started on intravenous rifampin (Rifadin) therapy. The nurse should instruct the client that this medication might do which of the following?

Turn body secretions to a red-orange color

A provider is discharging a client who has pulmonary tuberculosis with a prescription for rifampin (Rifadin). The nurse should include which of the following information in the client's discharge teaching?

Urine and other secretions will turn orange.

The nurse is completing a medication review of a client who has elevated cholesterol levels and takes an anticoagulant. Which of the following finding should the nurse report to the provider?

Uses garlic as a cholesterol lowering agent

A client has been taking omeprazole (Prilosec) for the past 4 weeks. The nurse determines that the medication is effective when the client reports relief from

acid indigestion.

A nurse is caring for a client who has a prescription for digoxin 0.25 mg PO daily. The amount available is digoxin 0.125 mg tablets. How many tablets should the nurse administer to the client? (Round to the nearest whole number.)

2 tabs

A nurse is caring for a client who is taking lisinopril (Zestril). Which of the following outcomes should the nurse anticipate?

Decreased blood pressure

A nurse is caring for a client with cirrhosis who has a new prescription for cephulac (Lactulose). Following administration, the nurse will monitor the client for which adverse effect of this medication?

Diarrhea

A nurse is preparing to teach a client how to draw up regular insulin and neutral protamine hagedorn (NPH) insulin into the same syringe. Which of the following instructions is appropriate for the nurse to provide?

Discard any regular insulin that appears cloudy.

A nurse is caring for a client who takes levothyroxine (Synthroid) 88 mcg/day PO, furosemide (Lasix) 100 mg/day PO, acyclovir (Zovirax) 200 mg PO BID, and cimetidine (Tagamet) 300 mg PO QID. Which one of the following medications poses the highest risk for life-threatening adverse effects?

Furosemide

A nurse is to administer subcutaneous short-acting insulin combined with long acting insulin to the client before he eats breakfast at 8:00 AM. Which of the following should the nurse do?

Give the insulin at 7:30 AM after checking the blood glucose level results.

A nurse is caring for a client who is to begin therapy (furosemide) Lasix. The nurse notes that the client has not been receiving supplemental electrolytes. Which laboratory value is a priority for the nurse to check before administering furosemide?

Potassium

A nurse is caring for a client who receives furosemide (Lasix) to treat heart failure. Which of the following laboratory values should the nurse be sure to monitor specifically for this client?

Potassium

A nurse is talking with a client who has type 2 diabetes mellitus that has responded well to oral hypoglycemic medication. The client reports morning fasting blood glucose levels above 180 mg/dL for the past week. In reviewing the client's medication history, the nurse should identify which of the following medications as a possible contributing factor to the recent change in glycemic control?

Prednisone. (Deltasone)

A client is prescribed 300 mg clindamycin (Cleocin) IV to infuse over 30 min. The medication comes premixed in a 50 mL bag. At how many mL/hr should the nurse set the IV pump?

100 mL/hr

After administering morning medications, a nurse realizes that the nifedipine (Procardia) prescribed for one client was inadvertently administered to the client's roommate. The nurse's priority action should be to

Check the client's vital signs.

A nurse is providing discharge teaching for a client who has pulmonary edema and is about to start taking furosemide (Lasix). Which of the following instructions should the nurse include?

Eat foods that contain plenty of potassium.

A nurse is assessing an older adult client who is receiving digoxin (Lanoxin). To evaluate the client for digoxin toxicity, the nurse should check for which of the following manifestations?

Anorexia

A client who has a gastric ulcer is about to start taking sucralfate (Carafate). The nurse determines that teaching was effective when the client states that he will take this medication

1 hr before meals and at bedtime.

A nurse is caring for a client who is to receive liquid medications via gastrostomy tube. The client is prescribed phenytoin (Dilantin) 250 mg. The nurse has available unit dose vials of phenytoin that are labeled 125 mg/5 mL. How many mL should the nurse administer per dose?

10 mL

A provider prescribes lactated Ringer's solution IV to infuse at 120 mL/hr for a client who has a respiratory disorder. The drop factor on the manual IV tubing is 60 gtt/mL. The nurse should set the IV flow rate to deliver how many gtt/min? (Round to the nearest whole number.)

120 gtt/min

A nurse is caring for a client who has an IV fluid prescription for 1,000 mL lactated Ringer's, followed by 1,000 mL dextrose 5% in 0.9% sodium chloride, then followed by 1000 mL dextrose 5% in water. The three solutions are to infuse over 24 hr. The drop factor on the manual IV tubing is 10 gtt/mL. The nurse should adjust the IV flow rate to deliver how many gtt/min? (Round to the nearest whole number.)

21 gtt/min

A client is prescribed an IV infusion of D5¼ NS at 150 mL/hr. There are no IV pumps available, so the nurse must hang the solution on gravity flow tubing. The tubing has a drop factor of 10 gtt/mL. The nurse should adjust the IV to run at how many gtt/min?

25 gtts/min

A nurse is preparing to administer furosemide (Lasix) 40 mg IV. Available is furosemide 10 mg/1 mL. How many mL should the nurse administer to the client? (Round to the nearest whole number.)

4 mL

A nurse is caring for a client with diabetes mellitus who receives 25 units of NPH insulin every morning if her blood glucose level is above 200 mg/dL. The nurse monitors this client for hypoglycemia because NPH insulin peaks how long after administration?

4 to 12 hr

A postoperative client is prescribed an IV infusion of D5 Ringer's Lactate at 120 mL/hr. The tubing has a drop factor of 20 gtt/mL. The nurse should set the IV flow rate to how many gtt/min?

40 gtts/min

A client who has type 1 diabetes mellitus is to have IV fluid that contains 48 units of Regular insulin (Humulin R) in 1,000 mL to infuse at 2 units/hr. The nurse should set the IV pump to deliver how many mL/hr? (Round to the nearest whole number.)

42 mL/hr

A home health nurse is reviewing the medication list of an older adult client who reports falling a couple of times over the past week. Which of the following medications should the nurse suspect is contributing to the client's falls?

Alprazolam (Xanax)

A client has a new prescription for transdermal nitroglycerin (Nitro-Dur) to treat angina pectoris. When talking with the patient about using this drug, the nurse should include which of the following instructions? (Select all that apply.)

Apply the patch to a hairless area and rotate sites. Apply a new patch each morning. Remove the patch for 10 to 12 hr daily.

A nurse is talking with a client who is about to start using transdermal nitroglycerin (Nitro-Dur) to treat angina pectoris. Which of the following is an appropriate instruction for this medication therapy?

Apply the transdermal patch in the morning.

A nurse is caring for a client who has supraventricular tachycardia. In addition to an electrocardiogram, which of the following assessment parameters should the nurse monitor closely during IV administration of verapamil (Calan)?

BP

A nurse is providing dietary teaching for a client who has a new prescription for a monoamine oxidase inhibitor (MAOI). When the client develops a sample lunch menu, which of the following items requires intervention?

Bologna sandwich

A nurse is caring for a client who has angina pectoris and is prescribed propranolol hydrochloride (Inderal) 40 mg twice daily. While reviewing the client's health history, which of the following findings would cause the nurse to question the prescription?

Bronchial asthma.

A nurse is caring for a client who was admitted to the hospital with congestive heart failure (CHF) and is taking digoxin (Lanoxin) 0.25 mg daily. The client refused breakfast and is complaining of nausea and generalized weakness. Which of the following actions should the nurse perform first?

Check the client's vital signs.

A nurse has received a prescription to a Garamycin (gentamycin) peak (4-8 mcg/ml) and trough (less than 2 mcg/ml) blood level. In reviewing the client's laboratory report the nurse notes the client's peak result is10 mcg/ml and a trough result is 3.3 mcg/ml. Which of the following clinical manifestations are indicative with these findings? (Select all that apply.)

Complaints of ringing in the ears Complaints of dizziness

A nurse is reinforcing teaching to a client who is to start therapy with Regular insulin (Humuin R) and NPH insulin (Humulin N). Which of the following should the nurse include in the teaching?

Keep the open vial of insulin at room temperature.

A nurse is caring for a client that is experiencing Cushing's Triad following a subdural hematoma. The client exhibits a widening pulse pressure (increased systolic and decreased diastolic blood pressure), a decrease in pulse rate, and altered respiratory pattern. Which of the following should the nurse administer?

Mannitol 25%

A nurse is caring for a client who receives digoxin (Lanoxin). Before administering this medication, which of the following actions should the nurse take?

Measure the client's apical pulse.

A nurse is caring for a client who is being given an aminoglycoside for a bacterial infection. The nurse can aid in minimizing the risk of aminoglycoside toxicity by performing which of the following actions?

Monitoring the serum drug levels.

A nurse is reinforcing teaching to a client about chemotherapy side effects, which of the following information should be included?

Side effects are expected.

A nurse is giving a presentation about caring for clients who are receiving diuretic therapy to treat heart failure. The nurse should explain that which of the following medications puts clients at risk for both hyperkalemia and hyponatremia?

Spironolactone (Aldactone)

A nurse is providing discharge teaching a client who was prescribed verapamil (Calan) for angina. Which of the following information should the nurse include?

Sprinkle capsule contents on food.

A nurse is caring for a client who is taking clarithromycin (Biaxin). The nurse includes a diagnosis of "risk for altered sensory perception" in the client's plan of care. This is appropriate because many clients on clarithromycin have an altered sense of which of the following?

Taste

A nurse is providing teaching to a client who has diabetes mellitus and has a new prescription for chlorpropamide (Diabinese). The nurse should teach the client to avoid consumption of which of the following while taking this medication?

alcohol

A nurse is attempting to administer a dose of lactulose (Cephulac) to a client who has cirrhosis when the client states, "I don't need this medication. I am not constipated." The nurse should explain that lactulose is also used to decrease serum

ammonia.

A nurse is teaching a client who takes furosemide (Lasix) and has a serum potassium level of 3.2 mEq/L. Which of the following instructions should the nurse include?

bananas

A nurse is caring for a client admitted for acute inflammation of the ankle. The provider diagnoses an acute attack of gout and orders colchicine (Colsalide) 2 mg IV now, then 0.5 mg IV every 6 hr. The nurse should know that the purpose of colchicine is to

decrease joint inflammation.

A nurse is caring for a client who has a severe infection and is being treated with IV gentamycin sulfate (Garamycin). A serum medication level should be obtained with the next dose. The nurse should know that to ensure the most accurate results, the blood samples for the peak and trough levels should be drawn

immediately prior to and 30 min after the next dose.

A client who has angina pectoris is experiencing chest pain and has taken three nitroglycerin tablets sublingually. The client reports relief from the chest pain but now reports a headache. The nurse should explain to the client that this symptom

is an expected side effect of the medication.

A nurse is talking with a client who is about to start taking the bile acid sequestrant colestipol (Colestid) to lower his low-density lipoprotein (LDL) level. It comes in powder form or tablets. The nurse should inform the client that if he chooses tablet form, he

will have to take up to 30 tablets per day.