Midterm Quiz questions

A client has recently received a diagnosis of depression and has been prescribed citalopram. The nurse is providing health education and the client states, "I'm relieved to have some medication to help with my mood, because it's my daughter's wedding next weekend and I'll be feeling better." What is the nurse's best response? "Antidepressants will help your mood but it usually takes a few weeks to experience the benefits." "This is very good timing for you, but remember that you might have some side effects, especially for the first couple of weeks." "Antidepressants help relieve the lack of energy and concentration during depression but your mood might not be affected." "You'll likely be feeling significantly better by the weekend, but remember to avoid drinking alcohol at the wedding."

"Antidepressants will help your mood but it usually takes a few weeks to experience the benefits"

The nurse is teaching a client about the drug therapy regimen before being discharged. The nurse is emphasizing safety in the home setting. Which statement by the client indicates a need for additional teaching? -"I will make sure to store the medications in the bathroom medicine chest." -"I'll keep a written record of all medicines, prescription or otherwise, that I take." -"I need to take the medicines like the health care provider said, before each meal and at bedtime." -"The drugs that the health care provider prescribed are used to control my blood pressure."

"I will make sure to store the medication in the bathroom medicine chest."

A hospitalized client asks the nurse why the health care provider prescribed an anxiolytic medication. What is the nurse's best response? "An anxiolytic, such as alprazolam, is usually prescribed for long-term anxiety disorders." "This type of medication is typically prescribed to treat excess anxiety that interferes with daily activities." "Anxiolytics are prescribed to treat anxiety and can be purchased without a prescription after discharge." "Anxiolytic drugs are different from antianxiety drugs, because they work without a tranquilizing effect."

"This type of medication is typically prescribed to treat excess anxiety that interferes with daily activities."

A pregnant client asks about the safety of taking thyroid hormone replacement drugs during her pregnancy. What is the nurse's bestresponse? -"Continue thyroid medication only if you have a history of heart disease." -"Thyroid hormones are pregnancy category A drugs and should be taken during pregnancy." -"Take thyroid hormones if you gain more than the recommended amount of weight during pregnancy." -"You don't need thyroid hormones anymore if you took fertility drugs."

"Thyroid hormones are pregnancy category A drugs and should be taken during pregnancy"

A client is prescribed an anxiolytic agent. What would be mostimportant for the nurse to include in the teaching? "Be sure not to stop the drug abruptly." "Take the drug with meals if necessary." "Increase the amount of fiber in your diet." "Try other measures to help you relax, too."

"be sure not to stop the drug abruptly"

The nurse is educating a client who has been prescribed atropine, an anticholinergic drug. Which instructions should the nurse provide to the client? "Do not drive or operate machinery." "If you experience eye pain, contact the health care provider about increasing the dosage." "Increase your fluid intake and activity level." "Take long, hot showers frequently to relieve uncomfortable side effects."

"do not drive or operate machinery"

Which patient statement indicates to the nurse that the patient is experiencing an adverse effect of hyoscyamine? "I feel like my heart is going to jump out of my chest." "I have urinated twice in the last 6 hours." "Things don't look blurry to me." "I moved my bowels this morning."

"i feel like my heart is going to jump out of my chest." Which patient statement indicates to the nurse that the patient is experiencing an adverse effect of hyoscyamine? "I feel like my heart is going to jump out of my chest." "I have urinated twice in the last 6 hours." "Things don't look blurry to me." "I moved my bowels this morning."

A client with depression has been taking citalopram for several months and has presented for a follow-up assessment. The client tells the nurse, "I've been reading a lot online about the benefits of St. John's wort for depression, so I've started taking it once per day." In addition to referring the client to the provider, what is the nurse's best response? "There can be an unsafe reaction between your antidepressant and St. John's wort, which is why taking them both is discouraged." "Herbal remedies often contain unknown doses of the desired ingredient, which can be dangerous." "It's very important that you not take the St. John's wort at the same time of day as your antidepressant." "It's very important that you comply with your prescribed treatment."

"there can be an unsafe reaction between your antidepressant and St. John's wort, which is why taking them both is discouraged"

A client who is receiving morphine reports nausea after every dose of medication. What is the nurse's best response to this client? "I'm sorry. That means you won't be able to have any more pain medication." "This is a common side effect of the medication. I will try to make sure you have something to eat when you take the morphine." "I will mark your chart that you are allergic to morphine." "I will ask the health care provider if I can give you acetaminophen for the pain instead of the morphine."

"this is a common side effect of the medication. I will try to make sure you have something to eat when you take the morphine."

A nurse is instructing a client concerning a newly prescribed drug. What should be included to help improve client compliance and safety? - measures to alleviate any discomfort associated with adverse effects - the cost of the brand-name drug compared with the generic form - statistics related to phase III of testing for the prescribed drug - a list of pharmacies where the drug can be obtained

- measures to alleviate any discomfort associated with adverse effects

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

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

Your client is being treated for streptococcal pharyngitis and is NPO. Her health care provider has ordered Penicillin G to be given IM. She wants to know why she cannot take her medications via an oral route. Your best response is: -Penicillin G is inactivated by gastric acid, therefore it is only given IM or IV. -Penicillin G is inactivated by gastric acid, therefore it is only given IM. -Penicillin G can be given orally but requires higher doses. -Penicillin G is no longer used for this problem.

-Penicillin G is inactivated by gastric acid, therefore it is only given IM or IV.

The nurse administers penicillin to a client and monitors the client for an adverse reaction despite the fact that the client claimed not to be allergic to penicillin. What is the rationale for checking for adverse reactions? {Select all that apply.} -A person can be allergic to any medication at any time. -Medications can react with over-the-counter medications to cause toxicity. -Certain medications react with orange juice to cause toxicity. -If medications are not taken on an empty stomach, adverse reactions may occur. -Medications can react with herbal supplements to cause adverse reactions. -Medications can react with other medications prescribed for the client.

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

A client has been prescribed glucagon for the management of hypoglycemia. Which nursing interventions should the nurse be prepared to provide this client for the management of possible adverse effects? Select all that apply. -Administration of a prescribed suppository for the management of nausea -Implementation of aspiration precautions -Monitor for cardiac arrhythmias -Provide prescribed analgesic for headache -Ready access to supplemental oxygen

-administration of a prescribed suppository for the management of nausea -implementation of aspiration precautions -ready access to supplemental oxygen

The nurse has begun the intravenous infusion of the first dose of a client's prescribed antibiotic. A few minutes later, the client is diaphoretic, gasping for breath and has a heart rate of 145 beats per minute. After calling for help, what is the nurse's priority action? -protecting and maintaining the patency of the client's airway -monitoring the client's vital signs at least every five minutes -administering intravenous antihistamines as prescribed -providing reassurance to the client

-protecting and maintaining the patency of the clients airway

A client who is receiving phenytoin has a serum drug level drawn. Which result would the nurse interpret as within the therapeutic range? 4 mcg/mL 12 mcg/mL 22 mcg/mL 30 mcg/mL

12 mcg/mL The therapeutic serum phenytoin levels range from 10 to 20 mcg/mL. Thus, a level of 12 mcg/mL would fall within this range.

The nurse is monitoring the serum carbamazepine level of a client. Which result would lead the nurse to notify the prescriber that the client most likely needs an increased dosage? 2 mcg/mL 4 mcg/mL 6 mcg/mL 8 mcg/mL

2 mcg/mL 4-12 is therapeutic

Which factor would prohibit the administration of glipizide? a diagnosis of hypertension the ingestion of carbohydrates allergy to sulfonamides increase in alkaline phosphatase

allergy to sulfonamides

Heavy intake of which herb should be avoided by a client who is prescribed an antidiabetic medication? garlic anise basil oregano

garlic known to cause hypoglycemia when taken with antidiabetics

A client diagnosed with erectile dysfunction has been advised to take Viagra. For up to how many hours does the action of the drug persist? 4 hours 8 hours 12 hours 24 hours

4 hours

A client is receiving an SSRI. The nurse would inform the client that the full benefits of the drug may not occur for which time period? 1 week 2 weeks 3 weeks 4 weeks

4 weeks

When a drug is given at a stable dose, how many half-life periods are required to achieve steady-state concentrations and develop equilibrium between tissue and serum concentrations? -2 to 3 -3 to 4 -4 to 5 -5 to 6

4-5

A decrease in dosage of a prescribed benzodiazepine most likely would be necessary if a client was also taking: theophylline. ranitidine. oral contraceptive. alcohol.

oral contraceptive

The client is scheduled to get a breakfast tray at 07:00. At what time should the client receive a prescribed dose of insulin lispro? 06:00 06:20 06:45 07:00

6:45 With short-acting insulins like lispro, aspart, or glulisine, it is important to inject the medication about 15 minutes before eating.

Teaching a patient and family about buspirone would include which statement? A. "Expect some relief from your anxiety in about 7 to 10 days, but the full effect of this medication may take up to 6 weeks." B. "Be certain that you do not take more than your prescriber has ordered, because this medication can be addicting." C. "Your diazepam will be stopped immediately while the buspirone takes effect." D. "Buspirone will probably make you feel sleepy."

A

A client on cephalosporin therapy is prescribed cefazolin for a sinus infection. After administration of the first dose of the cefazolin, the client reports itching. The nursing assessment reveals a rash over the client's torso. What is the most likely cause of the itching? -A side effect from the cefazolin. -A cross-sensitivity reaction. -A need for a dosage reduction -A tolerance reaction to the cephalosporin

A cross-sensitivity reaction Cefazolin is contraindicated in anyone with a known allergy to cephalosporins. Caution must be used in clients with renal failure and in pregnant or lactating women. Because of the structural similarities between cephalosporins and penicillins, clients who are allergic to one type of drug may experience cross-sensitivity to the other. Cephalosporin hypersensitivity occurs in 5% to 10% of clients with penicillin allergy. Clients with a history of severe allergic reactions to penicillins should not receive cephalosporins because of their increased risk for cross-sensitivity reactions.

A 70-year-old patient has just started taking lorazepam 10 days ago for anxiety issues related the death of her husband. She is staying with her daughter for a couple of weeks. The patient's daughter has noticed that her mother is having difficulty walking and seems to be confused at times and calls the clinic to report this to the nurse. The nurse will inform the daughter that: -a dose adjustment should be made if these symptoms persist. -the drug should be stopped immediately if these effects persist. -the drug should be administered intravenously if these effects persist. -no changes should be made at this time; the adverse effects will resolve with continued use.

A dose adjustment should be made if these symptoms persist

How should the nurse explain the major difference between normal and abnormal anxiety? Abnormal anxiety is generally unresponsive to treatment. Abnormal anxiety is prolonged and impairs normal function. Abnormal anxiety is a brief response to situational stress. Normal anxiety often triggers reports of insomnia.

Abnormal anxiety is prolonged and impairs normal function

Which statements best indicates the client understands recommended vaccines following the 65th birthday? -A tetanus-diphtheria booster every 2 years, annual influenza vaccine, and a yearly administration of pneumococcal vaccine -An influenza vaccine booster every 10 years, annual tetanus-diphtheria vaccine, and a one-time administration of pneumococcal vaccine at 65 years of age -A tetanus-diphtheria booster every 10 years, annual influenza vaccine, and a one-time administration of pneumococcal vaccine at 65 years of age -A tetanus-diphtheria booster every 2 years

A tetanus-diphtheria booster every 10 years, annual influenza vaccine, and a one-time administration of pneumococcal vaccine at 65 years of age

A group of nursing students are reviewing information about nonopioid analgesics. The students demonstrate understanding of the information when they identify which drug as a nonsalicylate analgesic? acetaminophen aspirin diflunisal magnesium salicylate

Acetaminophen Acetaminophen is classified as a nonsalicylate analgesic. Aspirin, diflunisal, and magnesium salicylate are salicylates.

A male client is seeking an over-the-counter medication to ease both the pain and inflammation associated with his osteoarthritis of his knee. The nurse knows that which drug will only reduce pain? Acetaminophen Aspirin Naproxen sodium Ibuprofen

Acetaminophen Acetaminophen is not an anti-inflammatory medication. It is an analgesic and an antipyretic. Aspirin, naproxen sodium, and ibuprofen decrease pain and inflammation.

A parent has sought care from the nurse practitioner to treat a child's fever. The nurse practitioner is most likely to recommend what nonsalicylate drug? Acetaminophen Ibuprofen Naproxen Indomethacin

Acetaminophen Acetaminophen is the most frequently used drug for managing fever and pain in children. Ibuprofen and naproxen are both effective treatments for pain and fever in children but they are not the most commonly used medications. Indomethacin is not indicated for fever control.

A female health care worker has received her annual influenza vaccination and has remained at the clinic after administration so that the nurse may observe for adverse reactions. The worker reports pain at the site of IM injection. What should the nurse recommend? ASA acetaminophen meperidine heat application

Acetaminophen Most vaccines can cause fever and soreness at the site of injection. Acetaminophen can be taken two to three times daily for 24 to 48 hours if needed to decrease fever and discomfort. Aspirin and heat are not explicitly recommended; opioids are not necessary.

A 24-year-old female athlete is using high doses of anabolic steroids to enhance her performance. She may be at risk for which condition? Acne Fluid deficiency Excessive sedation Hypotension

Acne Virilization in a woman is the most common reaction associated with anabolic steroids, especially when higher doses are used. Acne occurs frequently in all age groups and both sexes. Nausea, vomiting, diarrhea, fluid and electrolyte imbalances (the same as for the androgens, discussed previously), testicular atrophy, jaundice, anorexia, and muscle cramps may also be seen. Fluid retention, not deficiency, is a common side effectof anabolic steroid use. Sedation and hypotension are not adverse reactions to this hormone.

A primary health care provider has prescribed levothyroxine to a client with hypothyroidism. Which information would the nurse include in the teaching plan to promote an optimal response to the drug therapy? -Bring your recorded pulse rates to the primary health care provider. -Offer suggestions about the dosage schedule. -Administer the drug early in the morning before breakfast. -Apply soothing creams or lubricants to prevent rashes.

Administer the drug early in the morning before breakfast

A disulfiram-like reaction may occur if which substance is consumed within 72 hours after administration of certain cephalosporins? alcohol cheese meat bananas

Alcohol

Matt, age 16, has been taking testosterone since age 7 for the treatment of hypogonadism. He is in the health care provider's office today for follow-up care. He asks about taking anabolic steroids instead of testosterone because he heard this will increase his growth. What is the primary difference between anabolic steroids and testosterone? Anabolic steroids are synthetic. Anabolic steroids produce both anabolic and androgenic effects. Anabolic steroids are given via the buccal route. Anabolic steroids have a greater anabolic effect.

Anabolic steroids have a greater anabolic effect

What effects are exerted by aspirin? (Select all that apply.) Analgesic Antipyretic Anti-inflammatory Anti-infective Antiviral

Analgesic Antipyretic anti-inflammatory

A nurse is caring for an adult client diagnosed with bacterial sinusitis. The nurse has cautioned the client against taking prescribed oral erythromycin together with antacids. What is the basis of this instruction? Antacids delay metabolism of the drug. Antacids can exacerbate nausea and reflux. Antacids cause a dangerous rise in gastric pH. Antacids decrease the absorption of the drug.

Antacids decrease the absorption of the drug

A client who has been taking valproic acid (sodium valproate) for a seizure disorder is asking the nurse about getting pregnant. Why is pregnancy discouraged in women who are being treated for seizure disorders? Seizure disorders are genetic Seizure disorders are familial Antiepilepsy drugs decrease fertility Antiepilepsy drugs are teratogenic

Anti-epilepsy drugs are teratogenic

The nurse is caring for a 32-year-old client who is taking amitriptyline for depression. What nursing intervention would be appropriate if this client developed orthostatic hypotension? -Instructing the client to double the dosage until the adverse effect goes away -Consulting with the physician to change the medication -Asking the client to sit on the side of the bed for 1 minute before getting up -Informing the client this adverse reaction should be gone in a week

Asking the client to sit on the side of the bed for 1 minute before getting up

In today's health care environment, there is often more contact between the client and the nurse than between the client and the health care provider. What does this put the nurse in the best position to do? -Assess the client's inability to document medication taken. -Assess the client's inability to communicate with caregivers. -Assess the therapeutic success of the drug therapy. -Assess the client's reluctance to purchase the prescribed drug.

Assess the therapeutic success of the drug therapy

Which would be important to perform for a client who has received an anticholinergic agent? (Select all that apply.) Auscultating bowel sounds Monitoring urine output Monitoring heart rate Administering an antidiarrheal agent Assessing deep tendon reflexes

Auscultating bowel sounds Monitoring urine output Monitoring heart rate

A truck driver has been diagnosed with a generalized anxiety disorder (GAD) and lorazepam has been prescribed. The client asked the nurse how this medication will affect his job. The nurse would advise him how? -avoid driving until he is aware of the adverse effects. -change his profession, because the drug has long-term effects after cessation of therapy. -avoid driving at night, because lorazepam affects the wake-sleep cycle and can lead to drowsiness. -drive only 2 hours after consuming the drug and stop when it's time for the subsequent dose.

Avoid driving until he is aware of the adverse effects

A nurse is assigned to administer glargine to a patient at a health care facility. What precaution should the nurse take when administering glargine? Administer glargine via IV route. Avoid mixing glargine with other insulin. Shake the vial vigorously before withdrawing insulin. Administer insulin that has been refrigerated.

Avoid mixing glargine with other insulin

A nurse is working with a client who is taking an MAOI. What would be the most important instruction to the client? -avoid use of soy sauce in the diet. -adhere to combination drug therapy. -discuss the cultural significance of taking an MAOI. -avoid taking the drug on an empty stomach.

Avoid use of soy sauce in the diet The client should be instructed to avoid soy sauce, which contains high levels of tyramine. Potentially fatal pharmacodynamic interactions can occur with MAOIs when they are combined with foods rich in tyramine. The client's willingness to adhere to the combination therapy and the cultural significance of taking an MAOI, although important factors to be assessed, are not as important as this safety-related dietary consideration.

A couple comes to the fertility clinic to get information about treatment for their infertility. What would be included in the information this couple receives regarding adverse effects? Peripheral edema Birth defects Cardiovascular events. Renal failure

Birth defects

The nurse should be prepared to administer an increased dose of atropine to achieve the desired pupil reaction to the client with which characteristic? Select all that apply. -black clients -dark-brown irises -myoptic vision -males over the age of 50 -females over the age of 50

Black clients dark-brown irises

The nurse is caring for a client who is receiving an intravenous barbiturate. What assessment should the nurse prioritize? Blood pressure Oxygen saturation Assessment for bleeding Anaphylaxis

Blood pressure Hypotension is a possible effect when barbiturates are given IV and is more common than hypoxia. Bleeding is not associated with intravenous barbiturate use. Anaphylaxis would be a serious but rare occurrence.

A male client, age 75, is started on flavoxate (Urispas). What adverse effect should the client be made aware of? Skin rash Headache Weight gain Blurred vision

Blurred vision

A client is receiving a barbiturate intravenously. The nurse would monitor the client for: hypertension. bradycardia. tachypnea. bleeding.

Bradycardia

A client is diagnosed with trigeminal neuralgia. What antiepileptic agent may be used to treat this disorder? phenytoin carbamazepine fosphenytoin fosphenytoin ethosuximide

Carbamazepine

The 56-year-old client is diagnosed with osteoarthritis and reports joint pain and stiffness. Which medication would be identified as appropriate for the client to take? Eletriptan Ergotamine Sumatriptan Celecoxib

Celecoxib

A group of students are role-playing scenarios involving biological weapon exposure. Which medication would the students identify as using for a client with cutaneous anthrax? Ribavirin Ciprofloxacin Streptomycin Gentamicin

Ciprofloxacin For cutaneous anthrax, ciprofloxacin or doxycycline would be used. Ribavirin would be used for hemorrhagic fever; streptomycin or gentamicin would be used for tularemia.

The nurse is providing care for a client who has been prescribed trazodone for the treatment of depression. What assessment should the nurse prioritize? Cognition and level of consciousness Urine output and creatinine clearance Oxygen saturation and respiratory rate Skin integrity and peripheral perfusion

Cognition and Level of Consciousness

What changes due to aging in the geriatric client may affect excretion and promote accumulation of drugs in the body? -decreased activity. -decreased gastric motility. -decreased cognition. -decreased glomerular filtration rate.

Decreased glomerular filtration rate

When describing the action of barbiturates and barbiturate-like agents in the control of seizures, what would the nurse include? Promotion of impulse conduction Stimulation of the cerebral cortex Depression of motor nerve output Maintenance of cerebellar function

Depression of motor nerve output The barbiturates and barbiturate-like drugs depress motor nerve output, inhibit impulse conduction in the ascending reticular activating system (RAS), depress the cerebral cortex, and alter cerebellar function. They stabilize nerve membranes throughout the CNS directly by influencing ionic channels in the cell membrane, thereby decreasing excitability and hyperexcitability to stimulation.

What is the prototype for the classification of drugs referred to as benzodiazepines? alprazolam lorazepam diazepam clonazepam

Diazepam

A nurse is caring for a 6-year old child with a severe case of typhoid fever. The client was mistakenly administered tetracycline, which can cause adverse reactions. What could be a permanent effect in the child? Epigastric distress Abdominal pain or cramping Discoloration of the teeth Visual disturbances

Discoloration of the teeth

A client who is being treated for cancer developed a serum sickness reaction. The care team has been notified, and the client is being stabilized. What is the nurse's priority action? -Discontinue the drug immediately as ordered. -Administer prescribed epinephrine subcutaneously. -Encourage the use of a MedicAlert identification. -Administer topical corticosteroids.

Discontinue the drug immediately as ordered

A client has been prescribed ciprofloxacin IV for the treatment of cellulitis. After initiating the infusion of the client's first scheduled dose, the client develops a pronounced rash on the chest and arms. How should the nurse respond initially to this event? -Discontinue the infusion and inform the care provider promptly. -Slow down the rate so that the infusion takes place over 2 hours. -Administer oral diphenhydramine to the client during the infusion. -Administer an STAT dose of acetylcysteine.

Discontinue the infusion and inform the care provider promptly

The nurse receives a call from a male client who takes finasteride (Proscar) for treatment of BPH, and tells the nurse that his wife may be pregnant. What does the nurse expect the health care provider to do? Discontinue the medication. Decrease the dose of medication. Increase the dose of medication. Change the finasteride to dutasteride.

Discontinue the medication A client who takes an androgen hormone inhibitor will need to have the drug discontinued if a sexual partner is (or may become) pregnant, because pregnant women should not handle this medication. The provider would not increase or decrease the dose, nor would the provider change the drug to dutasteride.

Which information should be included in the teaching plan of a client who is taking a sedative for a diagnosis of insomnia? Select all that apply. -Take the medication 2 hours before bedtime. -Avoid tea or coffee with meals and prior to sleep. -Do not drive or operate heavy machinery while taking the medication. -Call the prescriber after 2 weeks if the medication appears to be ineffective. -Do not drink alcoholic beverages 2 hours before or within 8 hours after taking the drug.

Do not drive or operate heavy machinery while taking the medication Do not drink alcoholic beverages 2 hours before or within 8 hours of taking the drug Information included on the teaching plan focuses on how the medication produces a therapeutic response and that the sleep pattern is improved. The medication can impair the mental and physical abilities required for performing potentially dangerous tasks such as driving a vehicle or operating heavy machinery. The client should avoid tea or coffee before bedtime but is allowed to drink them during the day. Avoiding alcoholic beverages 2 hours before or within 8 hours after taking the medication is recommended. Calling the prescriber is appropriate but waiting 2 weeks is too long. The medication should be taken one hour before bedtime.

When teaching a patient on an MAO inhibitor, what would be important to include in the teaching? Take at bedtime. Drink lots of fluid. Do not take OTC drugs. Report double vision right away.

Do not take OTC drugs

A nurse is aware that older adults tend to have a significantly decreased rate of hepatic blood flow compared with younger adults. What effect is this likely to have on pharmacokinetics and pharmacodynamics in an older adult? -Drug clearance is likely to be slower. -Elimination half-time is likely to be faster. -The kidneys will likely compensate for decreased hepatic capacity. -Multiple bioactive substances will be needed for therapeutic effect.

Drug clearance is likely to be slower

The perinatal nurse recognizes that what vaccine can be safely given to a neonate? Hepatitis B Varicella Measles, mumps and rubella (MMR) Hepatitis A

Hep B

A menopausal client prescribed estrogen asks what the implications of taking the medication are. Which response by the nurse bestdemonstrates an understanding of the associated implications? "Estrogen decreases the risk of dementia, myocardial infarctions, strokes, breast cancer, and blood clot." "Estrogen increases the risk of certain cancers, myocardial infarctions, and blood clots." "Estrogen has not been proven to increase the risk of any significant medical conditions." "If estrogen and progesterone are taken together, there are no increased health risks."

Estrogen increased the risk of certain cancers, myocardial infarctions, and blood clots

If treatment fails, retreatment is necessary. Which of the following drugs are used in retreatment of tuberculosis? Select all that apply: Ethionamide (Trecator) Rifampin (Rifadin) Aminosalicylic acid (Paser) Cycloserine (Seromycin) Capreomycin (Capastat)

Ethionamide (Trecator) Aminosalicylic acid (Paser) Cycloserine (Seromycin) Capreomycin (Capastat) Retreatment drug regimens most often consist of the secondary drugs ethionamide (Trecator), aminosalicylic acid (Paser), cycloserine (Seromycin), and capreomycin (Capastat). Ofloxacin (Floxin) and ciprofloxacin (Cipro) may also be used in retreatment.

After teaching a female client who is prescribed a scopolamine patch, the nurse determines that the teaching was successful when the client states that she will change the patch in which time frame? Every 3 days Every day Every other day Every 7 days

Every 3 days

What is the most common cause of subclinical hyperthyroidism? -untreated osteoporosis -history of neck radiation -excess thyroid hormone therapy -central nervous system depressant therapy

Excess thyroid hormone therapy

Which would the nurse expect to assess in a client who has been given propantheline? Pupil constriction Diarrhea Bradycardia Excitement

Excitement

An adult client received the annual influenza vaccine yesterday afternoon and has now presented back to the clinic reporting malaise. The client's oral temperature is 37.4°C (99.3°F). What is the nurse's best action? -Explain that vaccines often cause a mild immune response and have the client self-monitor -Ask the client to remain at the clinic to be monitored for signs of anaphylaxis -Explain to the client that the malaise is likely caused by a mild case of influenza -Administer epinephrine as prescribed

Explain that vaccines often cause a mild immune response and have the client self-monitor Vaccines often cause symptoms such as fever, malaise, chills or agitation due to their stimulation of the immune system and the inflammatory process. However, this does not mean the client has an active influenza infection. Anaphylaxis would occur much earlier and with more significant signs and symptoms. Monitoring at the clinic would consequently not be necessary. The client's temperature does not constitute a fever.

More patients experience hyperthyroidism than hypothyroidism.

False Hypothyroidism is the most common thyroid dysfunction

Naloxone (Narcan) will reverse the effects of which drug? -Fentanyl (Duragesic) -Lorazepam (Ativan) -Valproic Acid (Depakote) -Warfarin (Coumadin)

Fentanyl Naloxone (Narcan) is an opioid antagonist, which means it will only reverse the effects of opioids like fentanyl (Duragesic).

Which would a nurse expect to assess in a client experiencing hyperthyroidism? Slow and deep tendon reflexes Bradycardia Flushed, warm skin Intolerance to cold

Flushed, warm skin

An 80-year-old male client presents to the health care provider's office with reports of fatigue and a change in the color of stools. He self-administers ibuprofen 400 mg each night for general discomfort. The provider orders a stool test for guaiac, which yields positive results. The provider discontinues the ibuprofen. The nurse is responsible for a client education plan. The client should be educated regarding what as a risk with chronic use of NSAIDs? GI discomfort GI distress GI bleed GI upset

GI bleed

What statement describes a required characteristic of all generic drugs? -Generic drugs are required to be protected by a current American patent. -Generic drugs are designated and patented exclusively by the manufacturer. -Generic drugs are categorized according to overall usefulness and potential for abuse. -Generic drugs must be therapeutically equivalent and less expensive than trade name drugs.

Generic drugs must be therapeutically equivalent and less expensive than trade name drugs

A newborn is diagnosed with hypothyroidism. What will the client likely develop if the condition is left untreated? -intellectual disability -renal dysfunction -an immune disorder -paralytic ileus

Intellectual disability

A nurse is caring for a patient who has developed a hypoglycemic reaction. Which intervention should the nurse perform if swallowing and gag reflexes are present in the patient? Administer glucagon by the parenteral route. Administer the insulin via insulin pump. Administer oral antidiabetics to the patient. Give oral fluids or candy.

Give oral fluids or candy

Which would a nurse identify as an example of a sulfonylurea? Glyburide Metformin Acarbose Miglitol

Glyburide Metformin- biuanide Acarbose/Miglitol- Alpha-glucosidase inhibitors

Which is the best indicator of overall diabetic control? Fasting blood glucose levels 2-hour postprandial blood glucose levels Absence of acetone in the urine Glycosylated hemoglobin levels

Glycosylated hemoglobin levels

"Evaluation" of the client's response to drug therapy relates most closely to which phase of the nursing process? -Problem -Goal -Plan -Cause

Goal

Which action by the new nurse would alert the charge nurse that more education is needed for the new nurse, after administering an anxiolytic to a client? Having the client walk to the bathroom Raise the side rails Place the call light within reach Dim the lights

Having the client walk to the bathroom Having the client walk to the bathroom would be appropriate before administering the drug to reduce the client's risk for injury. Raising the side rails would be appropriate after administering an anxiolytic. Placing the call light within reach would be appropriate after administering an anxiolytic. Dimming the lights would be appropriate after administering an anxiolytic.

During ongoing assessment of clients receiving insulin detemir (Levemir), the nurse assesses the client for symptoms of hypoglycemia that include which symptoms? (Select all that apply.) Increased thirst Increased urination Headache Confusion Diaphoresis

Headache confusion diaphoresis

What assessment should the nurse perform prior to administration of a scheduled dose of levothyroxine? -level of consciousness and orientation -oxygen saturation level -heart rate -respiratory rate

Heart rate Regular monitoring of blood pressure and pulse is essential in older adults receiving levothyroxine. As a general rule, levothyroxine should not be given if the resting heart rate is more than 100 beats per minute. This medication does not impact any of the other functions and so assessment is not necessary.

A patient is admitted to the emergency department with a suspected overdose of acetaminophen. What adverse effect is mostcommon in acute or chronic overdose of acetaminophen? Nephrotoxicity Hepatotoxicity Pulmonary insufficiency Pancreatitis

Hepatotoxicity In acute or chronic overdose of acetaminophen, the patient can develop hepatotoxicity. Nephrotoxicity is not an adverse effect associated with acetaminophen overdose. Pulmonary insufficiency is not an adverse effect associated with acetaminophen overdose. Pancreatitis is not an adverse effect associated with acetaminophen overdose.

The nurse is obtaining a history from a 23-year-old man. The nurse suspects that the client may be using DHEA if he displays which symptom? Hirsutism Sleepiness Lethargy Placidity

Hirsutism Clients taking DHEA may display symptoms such as hirsutism, insomnia, irritability, and nervousness.

A client is prescribed methylergonovine. The nurse reviews the client's medical record for possible contraindications to the use of this drug. Which, if found, would the nurse identify as being a contraindication to the prescribed drug? hypertension diabetes asthma hypertriglyceridemia

Hypertension

A client presents at the clinic reporting weight loss despite an increased appetite. For which condition should this client be assessed? Chronic thyroiditis Hyperglycemia Hypothyroidism Hyperthyroidism

Hyperthyroidism

Which statements indicate that a client understands the need for a follow-up after the initial injection of medroxyprogesterone? "I know that this injection is good for 1 year." "I know that this injection lasts for 3 months." "I know that I do not need to worry about STDs after getting this injection." "I know that I will need to return in 6 months for another injection."

I know that this injection lasts for 3 months

After teaching a client who is prescribed sildenafil about using the drug, the nurse determines that the teaching was successful when the client states: "I need to take the pill about an hour before any sexual stimulation." "I should take the medication just before I start having sex." "I can take the pill in the morning before I engage in sex later in the day." "I should take the pill after dinner if I'm planning to have sex later that night."

I need to take the pill about an hour before any sexual stimulation

The nurse is educating an adult male client diagnosed with erectile dysfunction about the prescribed sildenafil. Which statement made by the client establishes the need for further clarification? "If I have an erection lasting longer than 4 hours, I need to seek medical attention because it could cause permanent damage to my penis." "If I eat a fatty meal I will need to take two pills instead of one, so the drug will take effect faster." "If I lose vision or hearing after taking the drug, I will seek medical attention and notify my prescriber immediately." "Sildenafil taken with nitrates can lead to extremely low blood pressure, dizziness, passing out, heart attack, or stroke."

If i eat a fatty meal I will need to take two pills instead of one, so the drug will take effect faster

A male clent has been diagnosed with impotence and is started on a regimen of androgens. Which statement by the client indicates that he has understood the teaching? "If I experience increasing baldness, I will contact my health care provider immediately." "If my skin appears yellow or my urine turns dark, I will contact my health care provider." "My blood count will drop, but if I have bruising, I will contact my health care provider." "I know headaches are common, so I won't get alarmed if it is severe."

If my skin appears yellow or my urine turns dar, I will contact my health care provider

A nurse should advise a client beginning therapy with testosterone (Androderm) of which adverse effects? (Select all that apply.) Impotence Fluid retention Male pattern baldness Somnolence Mania

Impotence Fluid retention Male patter baldness

The nurse brings the client's afternoon medications and attempts to teach the client about them. The client states, "Just tell my wife about them, she will take care of me at home." What is the most appropriate nursing diagnosis for this client? -Effective Self Health Management -Ineffective Self Health Management -Noncompliance -Deficient Knowledge

Ineffective self health management Ineffective Self Health Management occurs when the client exhibits difficulty integrating a daily living program for the treatment of his illness; the client is unwilling to participate in his medication treatment process. Regarding the other answers, Deficient Knowledge occurs when the client lacks cognitive ability, and Noncompliance indicates the behavior fails to coincide with the agreed plan.

A group of nursing students are presenting information on the hepatitis B vaccine. What would the students prepare to tell others about the recommended population? -Children under the age of 15 -Infants and people at high risk for contracting the disease -People with diabetes mellitus or renal disease -People over the age of 65

Infants and people at high risk for contracting the disease

What best describes the action of nonsteroidal anti-inflammatory drugs (NSAIDs)? Blocks hypothalamus activity Act directly on thermoregulatory cells Inhibit phagocytosis Inhibit prostaglandin synthesis

Inhibit prostaglandin synthesis Nonsteroidal anti-inflammatory drugs (NSAIDs) inhibit prostaglandin synthesis. Salicylates block prostaglandin activity. Acetaminophen acts directly on thermoregulatory cells in the hypothalamus. Gold salts inhibit phagocytosis.

A 79-year-old woman who takes several medications for a variety of chronic health problems has been prescribed an oral antiplatelet aggregator that is to be taken once daily. The nurse has encouraged the woman to take the pill at the same time of day that she takes some of her other medications. What is the most likely rationale for the nurse's advice? -Integrating the new drug into the client's existing schedule promotes adherence. -Combining a new drug with one or more existing drugs mitigates the risk of adverse effects. -Taking several drugs at one time maximizes recovery time for the liver and kidneys. -Rapid drug clearance fostered when a client is able to minimize the number of drug administration times.

Integrating the new drug into the client's existing schedule promotes adherence

After teaching a group of students about thyroid drugs, the instructor determines that the teaching was successful when the students identify what as an example of a thyroid hormone? Iotrix Methimazole Propylthiouracil Sodium iodide I131

Iotirx

A patient with muscle ache would like to use an over-the-counter nonsteroidal anti-inflammatory drug (NSAID). The patient informs a nurse that he is taking antihypertensive drugs for blood pressure control. Why should the nurse caution the patient against the use of an NSAID while on antihypertensive drug therapy? It causes increased metabolism of the antihypertensive drug. It causes increased absorption of the antihypertensive drug. It causes decreased effectiveness of the antihypertensive drug. It causes decreased metabolism of NSAIDs.

It causes decreased effectiveness of the antihypertensive drug

A client with a history of benign prostatic hypertrophy (BPH) is seeking androgenic medication treatment for penile erectile dysfunction. What information should the nurse provide the client regarding this therapy? It will likely require an extensive period of therapy It could trigger adult onset asthma It has been associated with type 2 diabestes It increases the risk for prostate cancer

It increases the risk of prostate cancer

A young mother asks the clinic nurse about the "chickenpox" vaccine. The mother states that she and her husband have both had chickenpox, but that she wants to protect her child if she can. What should the nurse tell the mother about the recommendation for the chickenpox vaccine? -It is recommended for all children who have not been exposed to the varicella virus. -It is not recommended for children under the age of 6. -It is not recommended for children who have not been exposed to the varicella virus. -It is recommended only for adults who have not had chickenpox.

It is recommended for all children who have not been exposed to the varicella virus

A client has been taking citalopram for 2 weeks and has expressed a desire to discontinue it, stating, "I don't feel any better than I did before I started these pills." What should the nurse teach the client? -It may take up to two more weeks before the client feels better -Improvements are likely evident to others even if not to the client -The drug requires six to eight weeks before it reaches peak levels -The client's pessimism is likely a symptom of the underlying depression

It may take up to two or more weeks before the client feels batter

What is the expected action of sitagliptin on type 2 diabetes? -It blocks the S phase of the cell cycle. -It slows the rate of inactivation of the incretin hormones. -It is a synthetically prepared monosodium salt. -It inhibits hydrogen, potassium, and ATPase.

It slows the rate of inactivation of the incretin hormones

A male clent who uses a transdermal testosterone gel for treatment of his oligospermia applies the medication first thing in the morning and washes it off before bed. What client education is necessary? -Use additional doses of the gel. -Use the same amount of doses, just increase the amount of gel used. -Leave the gel on until the next application is due. -Only use the gel at times of procreation.

Leave the gel on until the next application is due

A client has been administered an opioid. What effect should the client be regularly assessed for? -oliguria -level of consciousness (LOC) -edema -tachycardia

Level of consciousness Opioids will produce decreased LOC. Oliguria is not a result of the administration of an opioid. Edema is not a result of the administration of an opioid. Tachycardia is not a result of the administration of an opioid.

Which of the following are examples of fluoroquinolones? Select all that apply. Levofloxacin (Levaquin) Amoxicillin (Amoxil) Cephalexin (Keflex) Spectinomycin (Trobicin) Ciprofloxacin (Cipro)

Levofloxacin Ciprofloxacin Amoxicillin- beta lactam Cephalexin- cephalosporin Spectinomycin- unclear

A nurse is teaching a client about a prescribed thyroid supplement and describes a drug that is relatively inexpensive, requires once-a-day dosing, and has a more uniform potency than do other thyroid hormone replacement drugs. Which drug is the nurse describing? -levothyroxine -propylthiouracil -methimazole -liotrix

Levothyroxine

Which would be most important to assess in a client receiving testosterone for a prolonged period of time? Liver function studies Complete blood count Serum electrolyte levels Platelet count

Liver function studies

What should the nurse include as a possible adverse effect when teaching a client about phenytoin? Liver toxicity Diarrhea Increased white blood cell count Physical dependence

Liver toxicity

A client comes to the emergency department experiencing status epilepticus. Which medication would the nurse expect to administer? Lorazepam Levetiracetam Trimethadione Methsuximide

Lorazepam Lorazepam is the drug of choice in the treatment of status epilepticus, an emergency characterized by continual seizure activity with no interruptions. Levetiracetam in an anticonvulsant is used as adjunctive therapy to treat partial onset seizures as well as tonic-clonic seizures. Trimethadione is used to treat epilepsy. Methsuximide is used for focal seizures.

A nurse is preparing to administer a scheduled dose of levothyroxine to an elderly client who is being treated in the hospital for a respiratory infection. Prior to administering the drug, the nurse should perform what assessment? measurement of blood pressure assessment of pupillary response chest auscultation for rales temperature measurement

Measurement of blood pressure

After teaching a class about the various drugs used to control blood glucose, the instructor determines that the teaching was successful when the class identifies what as a biguanide? Metformin Miglitol Tolbutamide Glipizide

Metformin

A client prescribed metformin is scheduled to undergo diagnostic testing with the administration of parenteral radiographic contrast media containing iodine. What fact should direct the nurse's plan of care for this client? -The client will be prescribed an extra dose of metformin due to address the contrast material's effect on the body. -Metformin should be discontinued at least 48 hours before and after diagnostic tests that use contrast medias. -The client needs to be encouraged to drink 1 to 2 L of water to flush the contrast media out the kidneys. -The metformin will be temporarily substituted for with insulin, to address the risk of potential kidney failure.

Metformin should be discontinued at least 48 hours before and after diagnostic tests that use contrast medias Metformin should be discontinued at least 48 hours before diagnostic tests are performed with these materials and should not be resumed for at least 48 hours after the tests are done and tests indicate renal function is normal. By altering the metformin therapy, none of the other options are required.

A 40-year-old male client with arthritis of the knee joint has been prescribed an analgesic to relieve the pain. Which medication is a narcotic analgesic? Aspirin Ibuprofen Celecoxib Morphine

Morphine

A 21-year-old woman is prescribed an oral contraceptive pill to prevent pregnancy. The nurse should inform the client of which adverse effects of this medication? Cessation of bleeding and/or spotting Nausea Weight loss Reduction of breast tissue

Nausea

A client has been prescribed vardenafil. Which medication in the client's history would the nurse be <b>most</b> concerned about? insulin tamoxifen amoxicillin nitroglycerin

Nitroglycerin

The nurse is transcribing physician orders for a client with pneumonia who has been admitted to the hospital. Why should the physician order the medications using the generic name instead of a brand name? -It does not make a difference if the brand names are used, and it is a preference of the physician. -The pharmacy department is not aware of the brand names, so -generic names should be written. -Numerous brand names may exist for the same drug, so the generic drug should be ordered. -More nurses are familiar with the generic names than with the brand names.

Numerous brand names may exist for the same drug, so the generic should be ordered

What is the nursing diagnosis the framework for? -medical interventions -nursing interventions -evaluation summations -outcome statements

Nursing interventions

The nurse is caring for a client who is seeking care for a chronic condition. The nurse is aware that the FDA has issued a black box warning regarding the use of thyroid hormones for the treatment of what condition? Obesity Hypotension Diabetes mellitus type 1 GERD

Obesity

A nurse is caring for a patient with diabetes mellitus who is receiving an oral antidiabetic drug. Which of following ongoing assessments should the nurse perform when caring for this patient? Assess the skin for ulcers, cuts, and sores. Observe the patient for hypoglycemic episodes. Monitor the patient for lipodystrophy. Document family medical history.

Observe the patient for hypoglycemic episodes

A client has been prescribed oral tetracycline. The nurse will instruct the client to take the drug how? -on an empty stomach. -take with a meal. -with milk or fruit juice. -at bedtime only.

On an empty stomach

What route of administration is most commonly used for the administration of ciprofloxacin when prescribed to an older adult client? oral (PO) intravenous (IV) subcutaneous (SQ) intramuscular (IM)

Oral

When preparing to administer a fluoroquinolone, the nurse understands that the majority of drugs belonging to this class are administered by which route? Oral Subcutaneous Intramuscular Topical

Oral

What would the nurse expect to assess in a client receiving a narcotic for pain relief? Dilation of the pupils Diarrhea Orthostatic hypotension Tachypnea

Orthostatic hypotension Narcotics are associated with orthostatic hypotension, pupil constriction, constipation, and respiratory depression with apnea.

The nurse is discussing the use of corticosteroids with a group of nursing students and tells that students that both men and women who take corticosteroids are at risk for what side effect? Infertility Osteoporosis Hypertension Paget's disease

Osteoporosis

One week ago, a 74-year-old was started on a benzodiazapine for the treatment of an anxiety disorder. The client comes into the clinic for a follow-up visit and states feeling nervous, is having trouble sleeping, and feels hyperactive. What does the nurse understand may be occurring as a result of this medication? -allergic reaction to the benzodiazepine -paradoxical excitement -taking too much of the medication (nonadherence) -not taking the medication as ordered (noncompliance)

Paradoxical excitement When beginning drug therapy with a sedative or benzodiazepine to treat anxiety, the older client may experience an effect that is the opposite of intended. This effect is known as paradoxical excitement, whereby the client is wide awake and hyperactive rather than calm and relaxed.

A nurse is caring for a patient with insomnia. For which type of patient should the nurse exercise caution when administering sedatives and hypnotics? Patients who are lactating Patients with heart trouble Patients with hypertension Patients with gastrointestinal upset

Patients who are lactating

Michael, 25 years old, has had mitral valve regurgitation since age four, after having rheumatic fever. Michael is planning to go to his dentist to have his teeth cleaned. Because of Michael's history he will need to take antibiotics in conjunction with this procedure to prevent bacteremia. Which class of antibiotics will Michael most likely receive if he has no allergies? Vancomycin Penicillin Cephalosporin Tetracycline

Penicillin Penicillin G may also be used as prophylaxis in special patient populations to prevent bacterial endocarditis prior to procedures likely to produce temporary bacteremia, such as dental procedures. These patients include those with prosthetic heart valves, mitral valve prolapse, most congenital heart diseases, and acquired valvular heart disease. It may also be used as prophylaxis in patients with recurrent rheumatic fever or rheumatic heart disease.

A client is scheduled to receive an immunization. In which client may the administration of a live vaccine be contraindicated? client with renal impairment client with hepatic failure client taking steroid therapy client over the age of 65

client taking steroid therapy

A male client is prescribed an anticholinergic drug by his health care provider. He likes to hike with his grandchildren. The home care nurse instructs the client that anticholinergic medications have which effect? -Increased sweating and the risk for heat stroke and dehydration -Postural hypotension and increased risk for falls and from exposure to the elements -Bradycardia in older adults, which increases the risk for falls and from exposure to the elements -Prevents sweating and heat loss and increasing the risk of heat stroke

Prevents sweating and heat loss and increasing the risk of heat stroke

Which medical diagnosis is a contraindication for testosterone therapy? Select all that apply. pPregnancy prostate cancer breast cancer liver dysfunction cardiovascular disease

Prostate cancer breast cancer pregnancy

A student asks the nursing instructor what insulin has the quickest therapeutic effect once administered. What would be the bestresponse? PZI (Humulin U) NPH (Humulin N) Regular (Humulin R) Ultralente (Humulin U Ultralente)

Regular (Humulin R) Regular insulin has the quickest onset of 30-60 minutes. PZI and ultralente have an onset of 4-8 hours. NPH has an onset of 60-90 minutes.

What type of insulin will most likely be administered intravenously to a client with a blood glucose level over 600 mg/dL (33.33 mmol/L)? NPH insulin lente insulin ultralente insulin regular insulin

Regular insulin Regular insulin has rapid onset of action and can be given via IV. It is the drug of choice for acute situations, such as diabetic ketoacidosis. Isophane insulin (NPH) is used for long-term insulin therapy. Lente insulin is an intermediate-acting insulin. Ultralente insulin is a long-acting insulin.

The client has had a myocardial infarction. The nurse is administering morphine sulfate for the pain. What vital sign would the nurse monitor that directly relates to the use of this narcotic? Heart rate Respiratory rate Temperature Pulse

Respiratory rate The first sign of narcotic overdose is often respiratory depression. Therefore, monitoring the client's vital signs, particularly respirations, is extremely important when administering narcotics.

Which nursing diagnosis would be most important for a nurse to include in the plan of care for a client who is receiving an antiseizure agent and experiencing common adverse effects? Risk for injury Risk for imbalanced fluid volume Impaired skin integrity Ineffective coping

Risk for injury

A client has begun taking an antidepressant that causes the client to be drowsy. What nursing diagnosis should the nurse prioritize related to drug therapy? -Risk for injury -Risk for imbalanced fluid volume -Impaired memory -Impaired physical mobility

Risk for injury Drowsiness and fatigue can interfere with the client's ability to function, placing the client at risk for injury. Ability to function may be affected by the drowsiness and fatigue but safety would be the priority. Mobility may be affected by the client's issues, but safety would be the priority. Drowsiness is unlikely to affect the client's memory.

After teaching a group of nursing students about antidepressants, the instructor determines that the teaching was successful when the students identify which as inhibiting the reuptake of serotonin? Selective serotonin reuptake inhibitors Tricyclic antidepressants Monoamine oxidase inhibitors Atypical antidepressants

SSRI

Which would the nurse anticipate to be used for the prevention of nausea from motion sickness? Scopolamine (Transderm Scop) Dronabinol (Marinol) Benzodiazepines Phosphorated carbohydrate solution (Emetrol)

Scopolamine (Transderm Scop)

A nurse is instructing a patient in the administration of regular insulin by the subcutaneous route. Which strategy would the nurse suggest if the goal is to promote absorption of the regular insulin? -Rotate injection sites by using the arm one day, the stomach the next day, and the thigh the day after and then repeating the cycle. -Select one injection site for regular insulin injections and use it exclusively. -Administer the medication 30 to 60 minutes after a meal. -Select one anatomic area for regular insulin injections and then use serial locations within that area.

Select one anatomic area for regular insulin injections and then use serial locations within that area.

A woman is diagnosed with pulmonary hypertension. The nurse explains the drug prescribed and the patient states, "That's a drug that used to treat erectile dysfunction." Which drug would this mostlikely be? Sildenafil Vardenafil Tadalafil Alprostadil

Sildenafil

The nurse is caring for a 26-year-old client with partial seizures and has been prescribed oxcarbazepine as monotherapy. It will be critical for the nurse to inform the client of which needed action? -the client should allow for periods of rest during the day. -since she is taking oral contraceptives, she will need to use an additional form of birth control. -she must have an eye exam at least every other month during oxcarbazepine therapy. -GI problems are to be expected.

Since she is taking oral contraceptives, she will need to use an additional form of birth control

Because of the black box warning for clients taking lamotrigine, the nurse should instruct a client to discontinue this medication immediately if he or she develops what unexpected reaction? periods of insomnia skin rashes anorexia fever

Skin rashes

A nurse is caring for a patient administered ethotoin. What are signs of toxicity for which the nurse should monitor the patient? Constipation Slurred speech Diarrhea Urinary frequency

Slurred speech

A black box warning alerts health care providers to risks in young adults 18 to 24 years of age when taking antidepressant medications. Which symptoms of concern should be included? -paranoia, rapid speech, and difficulty with concentration -statements or resignation and futility and a desire to die -alternating periods of hypomania and depression -reports of headaches, sleepiness, and apathy

Statements or resignation and futility and a desire to die

The nurse is teaching a client who has been started on antiseizure medications. The nurse should inform the client that abrupt withdrawal from the medications can cause which problem? Hypertensive crisis Cardiac dysrhythmia Respiratory arrest Status epilepticus

Status epilepticus

A nurse is preparing to teach a client about the adverse effects of prescribed nonsteroidal anti-inflammatory drug (NSAID) therapy. The nurse plans to focus on the most common adverse reactions caused by this group of drugs. Which effects would the nurse include as being involved? stomach lungs liver peripheral nerves

Stomach

A client is receiving a thyroid hormone to treat hypothyroidism. Which would indicate to the nurse that the client needs a reduced dosage of the drug? Tachycardia Slowed reflexes Pale dry skin Intolerance to cold

Tachycardia Tachycardia suggests hyperthyroidism due to excessive thyroid hormone; this would require a reduction in dosage. The other responses suggest hypothyroidism and drug ineffectiveness.

A nurse is working with a newly diagnosed diabetic client on understanding hypoglycemia and insulin reactions. Which action would be most important for the client to understand when planning the response to an insulin reaction? -Inject a prescribed dose of insulin as soon as you suspect the reaction is occurring. -Stay calm and still until the reaction subsides. -Notify your health care provider immediately. -Take an oral dose of some form of glucose as soon as possible.

Take an oral dose of some form of glucose as soon as possible

A nurse is caring for a patient undergoing thyroid hormone replacement therapy. What should the nurse inform this patient regarding administration of the drug? Take the drug before bedtime. Take the drug just before dinner. Take the drug after lunch. Take the drug before breakfast.

Take the drug before breakfast

A patient with partial seizures has been prescribed succinimides at a health care facility. The patient experiences GI upset after succinimides administration. What should the nurse instruct the patient to do? Take the drug once only at bedtime. Take the drugs before meals. Take the drug with food or milk.

Take the drug with food or milk

A 72-year-old client has been diagnosed with benign prostatic hypertrophy (BPH) and will begin treatment with tamsulosin. The client admits that he is skeptical about the drug's ability to relieve his distressing symptoms. The nurse should respond in what way? "Tamsulosin can increase the amount of urine your kidneys produce, resulting in better urine flow." "Tamsulosin can relax your prostate and your bladder neck, making it easier to pass urine." "Tamsulosin makes your urine less alkaline, reducing the irritation that makes your prostate enlarge." "Tamsulosin increases the strength of your bladder muscle and results in a stronger flow of urine."

Tamulosin can relax your prostate and your bladder neck, making it easier to pass urine

A parent states that they generally give their children "half an aspirin" in the event that any of them has a fever. What is the nurse's best response to the client's statement? -Teach the client about the risk for hepatic damage that accompanies aspirin. -Assess the client's understanding of safe doses and frequency. -Teach the client about the benefits of acetaminophen. -Teach the client to avoid giving aspirin due to the risk of Reye syndrome.

Teach the client to avoid giving aspiring due to the risk of Reye syndrome

A client is using a transdermal system for androgen administration. Which drug would the client most likely be using? Fluoxymesterone Danazol Testosterone Methyltestosterone

Testosterone

What is the primary purpose associated with the use of the nursing process related to the implementation of medication therapy? -That the drug is given at the right time -That holistic, evidence-informed care is given -That the right dose is given to the patient -That the drug is given to the right patient

That holistic, evidence-informed care is given

Which information presented in the client's history should prompt the nurse to discourage a client from self-medicating with an over-the-counter (OTC) acetaminophen, aspirin, and caffeine combination drug? The client has not adhered to previous treatment regimens. The client has a chronic venous ulcer on the lower leg. The client has a diagnosis of liver cirrhosis. The client is a smoker.

The client has a diagnosis of liver cirrhosis

A client is prescribed topiramate. The nurse cautions the client to avoid the intake of alcohol for which reason? -The client is at risk for increased CNS depression. -A disulfiram-like reaction can occur. -The client's risk for dependence is increased. -The combination may lead to a hypertensive crisis.

The client is at risk for increase CNS depression

To best assure client safety, what information should the nurse provide to a client whose fluoxetine therapy has been discontinued? -The dosage of the medication will be gradually reduced over a period of 6 to 8 weeks. -Electroconvulsive therapy (ECT) will be prescribed 2 to 3 weeks before stopping the fluoxetine. -A monoamine oxidase (MAO) inhibitor will be prescribed concurrently with the fluoxetine for 2 to 3 weeks. -It will be important that the client avoid stressful situations until another selective serotonin reuptake inhibitor (SSRI) can be prescribed.

The dosage of the medication will be gradually reduced over a period of 6 to 8 weeks

The nurse received an order for furosemide (Lasix). Why should the nurse write the generic name on the order sent to the pharmacy? -The generic name is easier to say and remember. -There is less chance of the wrong drug being given, because trade names can be similar. -The generic name is the preferred way to order the drug. -The hospital policy specifies that only generic names can be used in the medical record.

There is less chance of the wrong drug being given, because trade names can be similar

An older adult woman has been experiencing significant joint pain and has informed her primary care provider that she has begun taking aspirin two to three times each day. What aspect of this patient's medical history may contraindicate the use of aspirin? The patient has a diagnosis of type 2 diabetes. The patient has a history of peptic ulcer disease. The patient had a total abdominal hysterectomy 2 years ago. The patient takes an SSRI for depression.

The patient has a history of peptic ulcer disease

A male patient is being discharged home from the hospital after having pneumonia. At home, the patient will be taking the same drugs he was taking before he was hospitalized. These drugs include an anti-anxiety medication and a medication for insomnia. During the home care nurse's initial visit, what should the nurse review with the patient? The risk of injuries if reaction times are slowed by drugs The risk of injuries if the mental processes are slowed by drugs The risk of injuries if let insomnia go untreated by drugs The risks of injuries if mental and physical responses are slowed by drugs

The risk of injuries if mental and physical responses are slowed by drugs

A student asks the pharmacology instructor to explain the action of anticholinergic agents. What would be the instructor's best response? -They block nicotinic receptors. -They compete with serotonin for muscarinic acetylcholine receptor sites. -They act to block the effects of the parasympathetic nervous system. -They increase norepinephrine at the neuromuscular junction.

They act to block the effects of the parasympathetic nervous system

A 30-year-old woman who is in the first trimester of pregnancy has presented to her primary care provider with a 4-day history of a reddened, itchy left eye that is crusted with purulent exudate. The clinician suspects a bacterial, rather than viral, etiology. How will the client's pregnancy affect the potential use of ciprofloxacin to treat her conjunctivitis? -Ciprofloxacin is safe to use in pregnancy and the client may use to same dose and route as a nonpregnant client. -The use of ciprofloxacin is contraindicated in pregnancy. -It is safe for the client to use topical ciprofloxacin but the oral route is potential teratogenic. -The client will require a lower dose and longer course of ciprofloxacin than a nonpregnant, adult client.

The use of Ciprofloxacin is contraindicated in pregnancy

The nurse is caring for a 23-year-old female client who uses oral contraceptives and has been prescribed ampicillin for treatment of a respiratory infection. What information is most important for the nurse to share with this client? -Use a type of barrier birth control while you are taking this antibiotic. -Do not take your oral contraceptives while you are taking this medication. -Your menstrual cycle will have a heavier flow while on this medication. -Taking this antibiotic with your oral contraceptives will cause an increased chance of bleeding.

Use a type of barrier birth control while you are taking this antibiotic

A patient is receiving an antidepressant that helps to decrease addictive behavior. Which drug most likely would be prescribed? Venlafaxine Buproprion Mirtazapine Selegiline

Venlafaxine

The nurse is checking the orders for pain management for a client that had coronary surgery 24 hours ago. The nurse identifies that the client has been receiving Celebrex and a narcotic postoperatively for pain management. What is the most appropriate response of the nurse? -Administer the Celebrex and narcotic because it is his pain management regimen. -Administer the Celebrex. -Discontinue the Celebrex. -Withhold the Celebrex and notify the health care provider.

Withhold the Celebrex and notify the health care provider Celebrex should not be used for pain management after coronary surgery due to the risk of cardiovascular thrombosis, myocardial infarction, and stroke. The nurse should not administer the medication and should notify the provider. The nurse cannot discontinue the Celebrex without prescriptive authority.

A male client is taking aspirin 81 mg by mouth each day for prevention of recurrent myocardial infarction. He makes a dentist appointment for a tooth extraction. He calls the health care provider's office and asks the nurse if he is at risk for bleeding. Which response is correct? -"Yes, low doses of aspirin may increase your risk of bleeding; I will call you with your new prescriber's orders." -"No, the dose of aspirin is too low to increase your risk of bleeding." -"Yes, you need to stop the aspirin immediately." -"Your dentist must extract the tooth in a hospital setting to reduce the risk of hemorrhage."

Yes, low doses of aspirin may increase your risk of bleeding; I will call you with your new prescribers orders If a client has a history of taking aspirin, including the low doses prescribed for antithrombotic effects, there is a risk of bleeding from common therapeutic procedures (e.g., intramuscular injections, venipuncture, insertion of urinary catheters or GI tubes) or diagnostic procedures (e.g., drawing blood, angiography).

A 70-year-old client is seen in the family practice clinic. Which vaccine should be administered to prevent herpes zoster? zoster vaccine Haemophilus influenzae type B vaccine human papillomavirus (HPV) pneumococcal polyvalent

Zoster vaccine

A child has symptoms of influenza, including a fever. Which medication should not be administered to the child because of the risk of Reye's syndrome? acetaminophen acetylsalicylic acid ibuprofen ascorbic acid

acetylsalicylic acid

The client reports to the nurse that the client is having ringing in the ears. The nurse questions the client on use of what medication? Aspirin Acetaminophen Steroids Antibiotics

aspirin

A 34-year-old woman has presented to the clinic for the first time, and the nurse learns that she has been taking medroxyprogesterone for the past 13 years. This aspect of the woman's medical history should prompt what assessment? cardiac stress testing renal ultrasound bone density testing evaluation of triglyceride levels

bone density testing There is a black box warning regarding the use of medroxyprogesterone that relates to its being associated with the loss of stored calcium from bones, which increases the risk of broken bones and osteoporosis, especially after menopause. There is a greater risk of bone loss with long-term use. Consequently, bone density testing may be warranted. There is no particular indication for this client to undergo stress testing, renal ultrasound, or triglyceride testing.

A young male patient, age 14, has been prescribed testosterone for delayed onset of puberty. Follow-up care includes a visit to the clinic at least every 6 months for ongoing assessment. It will be mostimportant for the nurse to monitor: Sodium and potassium levels Bone growth Fluid intake and output Hemoglobin levels

bone growth

Liothyronine is a thyroid hormone used in replacement therapy for hypothyroidism. The drug must be used with extreme caution in patients with: cardiac problems. mental depression. glaucoma. benign prostatic hyperplasia.

cardias problems

What would danazol (Danocrine) be administered to women for? Reverse folic acid deficiencies Increase hair growth Decrease symptoms of endometriosis Prevent toxic shock syndrome

decrease symptoms of endometriosis

A 72-year-old man with pain issues is being given a drug by the intramuscular route. His serum blood level concentrations have been erratic. The nurse suspects that this may be due to -altered gastric pH levels. -increased levels of plasma albumin. -decreased blood flow to tissues and muscles. -decreased gastrointestinal motility.

decreased blood flow to tissues and muscles

A client is prescribed olanzapine for the treatment of schizophrenia. The client is voiding three times each night and is always thirsty. Based on the adverse effects of olanzapine, what should the nurse suspect is triggering the client's reported polyuria and polydipsia? urinary tract infection diabetes mellitus renal calculi hyperthyroidism

diabetes mellitus

Anticholinergic drugs are used in ophthalmology to sedate the patient. dilate the pupils. constrict the pupils. decrease lacrimal secretions.

dilate the pupils

A client with an upper respiratory infection has been prescribed macrolides. Which changes during an ongoing assessment would lead the nurse to notify the health care provider? Select all that apply. drop in blood pressure increase in respiratory rate sudden increase in temperature regular urine output pulse rate within usual parameters

drop in blood pressure increase in respiratory rate sudden increase in temperature

A client who is going on a cruise is concerned about motion sickness and sees the health care provider, who prescribes scopolamine. The nurse informs the client that using scopolamine may cause the client to experience: pupil constriction. drowsiness. diarrhea. urinary incontinence.

drowsiness

A nurse is administering a mumps vaccine to an adolescent. Which medication should be available when administering an immunization? diphenhydramine hydroxyzine physostigmine epinephrine

epinephrine

Which type of seizures involves a loss of consciousness? Generalized seizures Partial seizures Somatosensory seizures Motor seizures

generalized

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

grapefruit

A 9-year-old boy is taking testosterone injections for treatment of hypogonadism. What should be measured every 6 months on this child? LFT Cholesterol level Vision Hand and wrist epiphyseal growth plates

hand and wrist epiphyseal growth plates

In older adult men, anabolic steroids may be prescribed for a deficiency condition. If hypertensive, what might be the cause for an increase in blood pressure? -Increased RBD production -Increased fluid and sodium retention -Potassium retention -Increased bioavailability of androgens

increased fluid and sodium retention

The nurse is aware that aspirin not only lowers the client's fever but can also reduce the pain the client is experiencing by: promoting the production of prostaglandins. inhibiting the production of prostaglandins. prolonging the bleeding time. inhibiting the aggregation of platelets.

inhibiting the production of prostaglandins Salicylates inhibit production of prostaglandins, making pain receptors less likely to send the pain message to the brain. This reduction also is thought to account for the anti-inflammatory effect. Aspirin does also prolong the bleeding time by inhibiting the aggregation of platelets. This, however, does not have anything to do with decreasing pain in the client.

What best reflects the action of barbiturates when used to control seizures? Inhibition of impulse conduction Stimulation of the cerebral cortex Enhancement of cerebellar functioning Stimulation of motor nerve output

inhibition of impulse conduction

After reviewing information about different insulin preparations, a nursing student demonstrates understanding of the information when the student identifies which medication as an example of a long-acting insulin? insulin glargine insulin lispro insulin aspart isophane insulin suspension

insulin glargine Insulin glargine is an example of a long-acting insulin. Insulin lispro and insulin aspart are rapid-acting insulin. Isophane insulin suspension is an intermediate-acting insulin.

With buccal medications, what factor affects absorption? -fat content of the muscle -integrity of the mucous membranes -acidity of the stomach -lesions in the rectum

integrity of the mucous membranes

When providing client teaching to parents regarding measles, mumps, and rubella vaccine administration, which is mostimportant regarding the schedule for administration? It is administered at 1 to 2 months. It is administered at 3 to 4 months. It is administered at 5 to 6 months. It is administered at 12 to 15 months.

it is administered at 12 to 15 months

Rosiglitazone is being considered for the treatment of diabetes in an adult male client. Before the initiation of rosiglitazone therapy, the nurse should review what laboratory work recently drawn? liver enzymes platelet count D-dimer creatinine

liver enzymes Rosiglitazone has been associated with hepatotoxicity and requires monitoring of liver enzymes. Liver function tests (e.g., serum aminotransferase enzymes) should be checked before starting therapy and every 2 months for 1 year, then periodically. Platelets, D-dimer, and tests of renal function are less significant to the safety and efficacy of treatment.

A client is receiving conjugated estrogens. The nurse would anticipate administering this drug by which route? Oral Subcutaneous Intravaginal Intravenous

oral

The nurse monitoring a client receiving insulin glulisine (Apidra) notices the client has become confused, diaphoretic, and nauseated. The nurse checks the client's blood glucose and it is 60 mg/dL (3.33 mmol/L). Which can a nurse give to treat a client with a hypoglycemic episode? (Select all that apply.) Orange or other fruit juice Glucose tablets Insulin glargine (Lantus) Hard candy Insulin detemir (Levemir)

orange or other fruit juice glucose tablets hard candy

For what group of adults is pre-exposure immunization against hepatitis B recommended? People over the age of 70 People who receive hemodialysis People with chronic illnesses People in their 20s

people who receive hemodialysis Pre-exposure immunization against hepatitis B is recommended for high-risk groups. These may include health care workers; clients with cancer, organ transplants, hemodialysis, immunosuppression drug therapy, or multiple infusions of blood products; male homosexuals; IV drug users; household contacts of HBV carriers; and residents and staff of institutions for mentally challenged people.

A client comes to the clinic for a follow-up visit. The nurse notes a sunburn-like appearance to the client's skin. The client's history reveals the use of ciprofloxacin. The nurse interprets which adverse effect regarding this finding? photosensitivity superinfection pseudomembranous colitis anaphylactic reaction

photosensitivity A superinfection refers to the overgrowth of bacterial or fungal microorganisms not affected by the antibiotic administered. Pseudomembranous colitis is a severe, life-threatening form of diarrhea that occurs when normal flora of the bowel is eliminated and replaced with Clostridium difficile (C. diff) bacteria. Anaphylactic reaction is a severe exaggerated allergic reaction.

Which factor accounts for the increased risk for drug reactions among clients aged 65 years and older? -drugs more readily crossing the blood-brain barrier in older people -physiologic changes affecting all pharmacokinetic processes -increased drug-metabolizing enzymes in older people -diminished immune response

physiological changes affecting all pharmacokinetic processes

A nurse is caring for an 81-year-old client in a long-term care facility who takes nine different medications each day. The client has a recent diagnosis of seizure disorder and has begun treatment with phenytoin (Dilantin), a highly protein-bound drug. After 1 month of Dilantin therapy, the client is still extremely drowsy and sluggish. The nurse determines that the prolonged adverse effect is likely due to: -an increase in creatinine to be filtered. -polypharmacy decreasing the number of available protein-binding sites. -increased efficiency of the blood-brain barrier. -the normally low protein-binding properties of Dilantin.

polypharmacy decreasing the number of available protein-binding sites

The nurse knows that when caring for the older adult, there are several normal aging processes that put the client at risk for toxicity. What factor puts such clients at increased risk for drug toxicity? -reduced efficiency of renal function -reduced efficiency of blood-brain barrier -reduced plasma protein levels -reduced gastric acidity

reduced efficiency of renal function

A patient develops fever and arthralgia 4 days after the administration of tetanus toxoid. What reaction to the vaccine is this? Infectious process Anaphylaxis Serum sickness Distress syndrome

serum sickness Serum sickness presents several days after the administration of a vaccine with symptoms of urticaria, fever, arthralgia, and enlarged lymph nodes. The presence of fever and arthralgia after the administration of an immunization is not noted as an infectious process, serum sickness, or distress syndrome.

A patient is receiving estrogen therapy. What would the nurse instruct the patient to report immediately? Abdominal bloating Weight gain Dizziness Shortness of breath

shortness of breath