Modules 4-6 ATI Pharm Practice Questions
A nurse should identify that dextromethorphan can have which of the following effects when combined with morphine? - Reduced antitussive effect of dextromethorphan - Potentiation of depression of CNS actions. - Increased renal reabsorption of the dextromethorphan - Delayed analgesic effect of the opioid.
Potentiation of depression of CNS actions. Combining dextromethorphan with an opioid, such as morphine, increases the risk for decreased respirations and other depressed CNS responses.
A nurse is teaching a client about the use of antihistamines to treat allergic rhinitis. The nurse should explain that these drugs are effective because they perform which of the following actions? - Decrease viscosity of nasal secretions. - Block H2 receptors. - Prevent histamine from binding to receptors. - Reduce nasal congestion.
Prevent histamine from binding to receptors. Antihistamines treat allergic rhinitis and reduce swelling by blocking histamine from binding to the receptor sites.
A nurse is teaching a client who recently had a myocardial infarction and has a new prescription for docusate sodium. The nurse should inform the client that docusate sodium has which of the following therapeutic effects? - Reduces inflammation - Reduces gastric acid - Prevents diarrhea - Prevents straining
Prevents straining Docusate sodium, a stool softener, prevents straining during defecation and prevents the elevation in blood pressure that can result from straining. It also helps relieve constipation and reduces the painful elimination of hard stools.
A nurse is teaching a client about the use of cromolyn sodium to prevent bronchospasm. The nurse should explain that the drug has which of the following therapeutic effects? - Increase leukocyte activity - Blocks muscarinic receptors - Causes bronchodilation - Reduces inflammation
Reduces inflammation Cromolyn sodium, a mast cell stabilizer, reduces inflammation by inhibiting the inflammatory response.
A nurse is monitoring plasma drug levels in a client who is taking theophylline. Which of the following findings should the nurse expect to see if the client's drug level indicates toxicity? - Seizures - Constipation - Normal sinus rhythm - Somnolence
Seizures Seizures are likely when plasma drug levels of theophylline, a methylxanthine, are higher than 30 mcg/mL, which indicates toxicity.
A nurse is planning teaching for a client who has been prescribed loperamide to treat diarrhea. Which of the following statements should the nurse plan to include? - "Avoid driving or activities requiring alertness." - "If you miss a dose, double the next dose." - "Rinsing the mouth with alcohol-based mouthwash can reduce dryness." - "Having one glass of wine each night can improve medication effectiveness."
"Avoid driving or activities requiring alertness." Loperamide can cause drowsiness and dizziness. The client should avoid driving or activities requiring alertness while taking the drug.
A nurse is teaching a client about the use of fluticasone to treat perennial rhinitis. Which of the following statements by the client indicates an understanding of the teaching? - "I should use the spray every 4 hours while I am awake." - "It can take as long as 3 weeks before the medication takes a maximum effect." - "This medication can also be used to treat motion sickness." - "I can use this medication when my nasal passages are blocked."
"It can take as long as 3 weeks before the medication takes a maximum effect." The client can see some benefits of the medication within a few hours but the maximum benefits can take up to 3 weeks.
A nurse is teaching a client who has a new prescription for beclomethasone. Which of the following instructions should the nurse include? - "Rinse your mouth after each use of this medication." - "Limit fluid intake while taking this medication." - "Increase your intake of vitamin B12 while taking this medication." - "You can take the medication as needed."
"Rinse your mouth after each use of this medication." The client should rinse their mouth after each use to reduce the risk of oral fungal infections.
A nurse is teaching a client who will begin taking aluminum hydroxide. Which of the following information should the nurse include in the teaching? - "If constipation develops, switch to a calcium-based antacid." - "Take this medication two hours before or after other medications." - "This medication increases the risk for pneumonia." - "Have your magnesium level monitored while taking this medication."
"Take this medication two hours before or after other medications." Cimetidine alters the absorption of many medications. The client should ensure no other medications are taken within 1 to 2 hr of taking cimetidine.
A nurse is providing instructions to a client who has a new prescription for albuterol, PO. Which of the following instructions should the nurse include? - "You can take this medication to abort an acute asthma attack." - "Tremors are in the adverse effect of this medication." - "Prolonged use of this medication can cause hyperglycemia." - "This medication can slow skeletal growth rate."
"Tremors are in the adverse effect of this medication." Tremors can occur due to excessive stimulation of beta2 receptors of skeletal muscles.
A nurse is is teaching a client who has a new prescription for sulfasalazine. Which of the following statements should the nurse make? - "Use sunscreen and protective clothing while taking sulfasalazine to prevent sunburn." - "The medication can stain your contact lenses green." - "The medication can color your urine dark brown." - "Take an iron supplement when you take sulfasalazine to prevent anemia."
"Use sunscreen and protective clothing while taking sulfasalazine to prevent sunburn." Photosensitivity is a possible adverse effect of sulfasalazine that makes the skin sensitive to light. The nurse should instruct the client to wear sunscreen and protective clothing when outdoors to prevent burning.
A nurse is caring for a client who has a new prescription for alosetron to treat irritable bowel syndrome. The nurse should instruct the client to report which of the following adverse effects of the drug? - Headache - Drowsiness - Abdominal pain - Sore throat
Abdominal pain Alosetron, a serotonin 5-HT3 receptor antagonist, can cause ischemic colitis. The nurse should tell the client to report abdominal pain, bloody diarrhea, or rectal bleeding, and to stop taking the drug if these manifestations occur.
A nurse is caring for a client who is having difficulty mobilizing thick respiratory secretions. Which of the following drugs should the nurse expect to administer to the client? - Ipratropium - Beclomethasone - Acetylcysteine - Azelastine
Acetylcysteine Acetylcysteine is a mucolytic that loosens thick respiratory secretions.
A client is about to start taking aluminum hydroxide tablets to reduce gastric acid. Which instructions should you include when talking with the client about taking this drug? (Select all that apply). - Take the drug with a large meal - Chew the tablets thoroughly - Drink a glass of water after taking it - Increase fluid and fiber intake - Take it once daily
Chew the tablets thoroughly Drink a glass of water after taking it Increase fluid and fiber intake Instruct clients to take aluminum hydroxide tablets one and three hours after meals, and at bedtime. The client should chew the tablets thoroughly (not swallow them whole) and follow the tablets or the liquid suspension with water to make sure it gets to the stomach promptly. This type of antacid can cause constipation, so make sure clients increase fluid and fiber intake and exercise more. Advise eating six small meals per day, instead of three large meals. Clients can take this drug up to six times a day.
A nurse is teaching a client who has a prescription for zileuton. Which of the following instructions should the nurse include? - Check apical pulse before taking the drug - Take the drug only as needed before exercising - Rinse mouth after using the drug - Have laboratory tests performed at regular intervals
Have laboratory tests performed at regular intervals Zileuton, a leukotriene modifier, can cause liver injury. The nurse should monitor liver function once a month for 3 months, then every 2 to 3 months during the first year of treatment.
A nurse is preparing to administer phenylephrine to a client. The nurse should identify that which of the following manifestations is an adverse effect of this drug? - Headache - Sleepiness - Hypotension - Constipation
Headache Oral sympathomimetics stimulate the adrenergic receptors, causing blood vessel constriction, which can cause nervousness, headache, blurred vision, and tremors.
A nurse is planning to ondansetron to a client. For which of the following adverse effects of ondansetron should the nurse monitor? (Select all that apply). - Headache - Diarrhea - Shortened PR interval - Hyperglycemia - Prolonged QT interval
Headache Diarrhea Prolonged QT interval
What are the side effects of nebulized ipratropium (anticholinergic)?
Headache Dizziness Blurred vision Increased intraocular pressure Dry/sore throat
A nurse is teaching a client who is beginning fluticasone propionate/salmeterol therapy. Which of the following instructions should the nurse include? - Take the drug as needed for acute asthma - Follow a low-sodium diet - Use an alternate-day dosing schedule - Increase weight-bearing activity
Increase weight-bearing activity Weight-bearing activity can help minimize bone loss, which is an adverse effect of fluticasone propionate/salmeterol, an inhaled glucocorticoid an inhaled long-acting beta2 agonist (LABA) combination medication.
You should instruct a client using phenylephrine spray for nasal congestion to do which of the following to avoid rebound congestion? - Limit the drug's use to 3 to 5 days. - Add an intranasal glucocorticoid. - Taper the dose before discontinuation. - Restrict the drug's use to one nostril at a time.
Limit the drug's use to 3 to 5 days. Clients should use phenylephrine, a topical sympathomimetic, short-term to prevent rebound congestion. Using an intranasal glucocorticoid, tapering the dose, and instilling the drug in one nostril may help wean the client off of a topical sympathomimetic after extended use, but these actions will not prevent rebound congestion.
Identify medications to treat acute asthma.
Long-Acting Beta Agonists (LABA) - Formoterol Short-Acting Beta Agonists (SABA) - Albuterol Glucocorticoids - Fluticasone Nebulized ipratropium - Anticholinergic
A nurse is caring for a client who has diabetes and is experiencing nausea due to gastroparesis. The nurse should expect a prescription for which of the following medications? - Lubiprostone - Metoclopramide - Bisacodyl - Loperamide
Metoclopramide Metoclopramide is a dopamine antagonist that is used to treat nausea and also increases gastric motility. It can relieve the bloating and nausea of diabetic gastroparesis.
What do sympathomimetic drugs do?
Mimic the effects of stimulation by the sympathetic nervous system
A nurse is caring for a client who has been taking phenylephrine nasal drops for the past 10 days for sinusitis. The nurse should assess the client for which of the following manifestations as an adverse effect of this medication? - Sedation - Nasal congestion - Productive cough - Constipation
Nasal congestion When used for over 5 days, rebound nasal congestion can occur when taking nasal sympathomimetic medications (phenylephrine).
A nurse is teaching a client about the use of an expectorant to treat a cough. The nurse should include that an expectorant has which of the following therapeutic effects? - Suppresses the cough stimulus - Reduces surface tension - Reduces inflammation - Dries mucous membranes
Reduces surface tension Expectorants act by reducing the surface tension and viscosity of respiratory secretions. This results in thinning thick mucus, making it easier to cough out of the lungs and drain out of the nose and sinuses.
A nurse is caring for a client who is taking codeine. The nurse should identify that which of the following assessments is priority to make? - Blood pressure - Apical heart rate - Respirations - Level of consciousness
Respirations The greater risk to clients who are taking codeine, an opioid agonist, is severe respiratory depression. Therefore, the respiratory rate is the priority assessment.
A nurse is teaching a client about the adverse effects of pseudoephedrine. Which of the following should the nurse include? (Select all that apply). - Restlessness - Bradycardia - Insomnia - Muscle pain - Anxiety
Restlessness Insomnia Anxiety Restlessness is an adverse effect of pseudoephedrine, an oral sympathomimetic. Insomnia and anxiety is an adverse effect of pseudoephedrine.
A nurse is teaching a client who has a new prescription for dextromethorphan to suppress a cough. The nurse should instruct the client to monitor for which of the following manifestations as an adverse effect of this medication? - Diarrhea - Anxiety - Sedation - Palpitations
Sedation Dextromethorphan can cause sedation. Advise the client to avoid activities that require alertness.
Explain how to use an albuterol inhaler.
Shake medication Breathe in 3-5 seconds Hold med for 10 seconds Rinse mouth PRN 4 hr glucose check
A nurse is providing teaching to a client who has a new prescription for omeprazole to treat a duodenal ulcer. Which of the following instructions should the nurse include? - Take the medication with food - Swallow the capsules whole - Dissolve the tablets in water - Take the medication at bedtime
Swallow the capsules whole Omeprazole, a proton pump inhibitor, is unstable in stomach acid. The nurse should instruct the client swallow the capsules or tablets whole and not to crush or chew the capsules or tablets.
A nurse is providing teaching to a client who has a new prescription for dimenhydrinate to prevent motion sickness. Which of the following instructions should the nurse include? (Select all that apply). - Sit upright for 30 min after taking the drug - Avoid antacids. - Take the drug 30 to 60 min before activities that trigger nausea. - Avoid activities that require alertness. - Increase fluid and fiber intake
Take the drug 30 to 60 min before activities that trigger nausea Avoid activities that require alertness Increase fluid and fiber intake The nurse should instruct the client to take dimenhydrinate 30 to 60 min before activities that trigger nausea, and again before meals and at bedtime. Dimenhydrinate can cause sedation. The nurse should instruct the client to avoid activities that require alertness. Dimenhydrinate can cause anticholinergic effects, such as dry mouth and constipation. The nurse should instruct the client to increase activity level, and fluid and fiber intake.
A nurse is teaching a client about ipratropium. The nurse should include that this drug has which of the following adverse effects? (Select all that apply). - Muscle tremors - Urinary retention - Dry mouth - Insomnia - Tachycardia
Urinary retention Dry mouth Urinary retention can occur with ipratropium, an inhaled anticholinergic. Ipratropium can dry oral secretions.
You are obtaining a health history from a client who is to start using a new ipratropium inhaler. Which of the following information from the client's history alerts you to take further action? (Select all that apply). - Seizure disorder - Urinary retention - Depression treated with a monoamine oxidase inhibitor (MAOI) - Hypothyroidism treated with synthetic thyroid hormone. - Glaucoma
Urinary retention Glaucoma Clients who have urinary retention should use caution when taking ipratropium, an anticholinergic drug, that may worsen the condition. This drug requires caution with clients who have glaucoma because of the risk for increased intraocular pressure. Clients who have a seizure disorder or take MAOIs or thyroid hormones can take ipratropium. The drug is inappropriate for clients who have prostatic hypertrophy.
A nurse is teaching a client who is taking prednisone for an acute asthma exacerbation. Which of the following instructions should the nurse include? - "Avoid taking nonsteroidal anti-inflammatory drugs." - "Rinse your mouth after taking the medication to prevent a yeast infection." - "Stop taking the medication if you become nauseous." - "Change position slowly when standing up."
"Avoid taking nonsteroidal anti-inflammatory drugs." Gastric protective measures are essential for clients who are taking oral glucocorticoids. Anti-inflammatory drugs can cause GI bleeding, so clients should not take them concurrently with prednisone.
A nurse is teaching the family of a child who has cystic fibrosis and a new prescription for acetylcysteine. Which of the following information should the nurse include in the instructions? - "Expect this medication to suppress your child's cough." - "Expect this medication to smell like rotten eggs." - "Expect this medication to cause euphoria." - "Expect this medication to turn your child's urine orange."
"Expect this medication to smell like rotten eggs." Acetylcysteine has a sulfur content that causes a rotten-egg odor.
You are instructing a client about using cromolyn via inhalation to treat exercise-induced bronchospasm. You advise the client to take the drug: - 15 minutes before exercising - if needed to stop bronchospasm - after strenuous activity - once in the evening at bedtime
15 minutes before exercising Cromolyn may prevent exercise-induced asthma if used 15 minutes before exercising. Cromolyn is not effective at stopping bronchospasm. Clients may use cromolyn via nebulizer up to 4x per day to prevent bronchospasm. Using the inhaler at bedtime will not prevent exercise-induced asthma.
A nurse is caring for four clients who have peptic ulcer disease. The nurse should identify misoprostol is contraindicated for which of the following clients? - A client who is pregnant - A client who has osteoarthritis - A client who has a kidney stone - A client who has a urinary tract infection
A client who is pregnant Misoprostol can induce labor and is contraindicated in pregnancy.
A nurse should recognize that misoprostol is contraindicated for a client who has which of the following conditions? - A seizure disorder - Rheumatoid arthritis - A positive pregnancy test - Heart failure
A positive pregnancy test Misoprostol, a prostaglandin E1 analog, is a teratogenic drug. It can cause uterine contractions and induce spontaneous abortion; therefore, providers must confirm that clients are not pregnant before prescribing the drug; and clients who take misoprostol must use contraception.
You should instruct a client who is taking zileuton to report which of the following possible indications of a serious adverse effect of this drug? - Abdominal pain - Dysphagia - Blurred vision - Bradycardia
Abdominal pain Zileuton may cause liver damage and hepatitis. Clients should report any signs of hepatic toxicity, such as abdominal pain or jaundice. Dysphagia is not likely to result from taking zileuton, although this drug can cause neck pain and rigidity. Zileuton is unlikely to cause blurred vision, although it can cause conjunctivitis. Bradycardia is unlikely to result from taking zileuton, although this drug can cause chest pain.
Identify the disadvantages of opioids as antitussives.
Addiction, dizziness, drowsiness, decreased respiration, constipation, nausea, vomiting
A nurse is providing instructions to a client who has a new prescription for albuterol and beclomethasone inhalers for the control of asthma. Which of the following instructions should the nurse include in the teaching? - Take the albuterol at the same time each day. - Administer the albuterol inhaler prior to using the beclomethasone inhaler. - Use beclomethasone if experiencing an acute episode. - Avoid shaking the beclomethasone before use.
Administer the albuterol inhaler prior to using the beclomethasone inhaler. When a client is prescribed an inhaled beta2-agonist (albuterol) an an inhaled glucocorticoid (beclomethasone), the client should take the beta2-agonist first. The beta2-agonist promotes bronchodilation and enhances absorption of the glucocorticoid.
You are instructing a client who has a new prescription for cetirizine. Which of the following information should you be sure to include? - Restrict fluids to minimize the drug's adverse effects. - Take the drug in the morning to reduce adverse effects. - Take the drug on an empty stomach to increase absorption. - Administer the drug prophylactically during allergy seasons.
Administer the drug prophylactically during allergy seasons. Cetirizine is a second-generation antihistamine used primarily to relieve symptoms associated with seasonal allergic rhinitis. Increasing fluids if possible may help reduce dry mouth and constipation. Taking cetirizine in the morning will not minimize its adverse effects. Taking antihistamines with food may help reduce gastric distress.
What are the long term effects of steroid use?
Adrenal suppression Osteoporosis Infection PUD (Peptic ulcer disease) Myopathy Electrolyte imbalance Weight gain
A nurse is teaching a client who has a prescription for albuterol via inhaler and fluticasone via inhaler for asthma management. For which of the following reasons should the nurse instruct the client to use the albuterol inhaler before using the fluticasone inhaler? - Albuterol will increase the absorption of fluticasone - Albuterol will decrease inflammation. - Albuterol will reduce nasal secretions. - Fluticasone will reduce the adverse effects of albuterol.
Albuterol will increase the absorption of fluticasone Albuterol, an inhaled, short-acting beta2 agonist, causes bronchodilation, which will increase the absorption of fluticasone, an inhaled glucocorticoid.
A nurse is caring for a client who is taking allopurinol to treat gout and has a new prescription for azathioprine to treat ulcerative colitis. For which of the following reasons should the nurse clarify these prescriptions with the provider? - Allopurinol delays the conversion of azathioprine and can lead to toxicity. - Azathioprine increases the effectiveness of allopurinol. - Allopurinol increases the metabolism of azathioprine and can require an increased dosage. - Azathioprine decreases the effectiveness of allopurinol
Allopurinol delays the conversion of azathioprine and can lead to toxicity. Allopurinol delays the conversion of azathioprine to an inactive form and can lead to toxicity. If used concurrently, the dose of azathioprine must be reduced.
A nurse is teaching a client who takes phenytoin and has a new prescription for sucralfate tablets. Which of the following instructions should the nurse include? - Take an antacid with the sucralfate. - Take sucralfate with a glass of milk - Allow a 2-hr interval between these medications - Chew the sucralfate thoroughly before swallowing
Allow a 2-hr interval between these medications Sucralfate can interfere with the absorption of phenytoin, so the client should allow a 2-hr interval between the sucralfate and phenytoin.
A nurse is teaching a client about using intranasal glucocorticoids. Which of the following instructions should the nurse give? - Start at a low dose and gradually increase it. - Take the drug as needed for nasal congestion. - Allow at least 2 weeks for the full therapeutic effect. - Use the drug prior to exercise.
Allow at least 2 weeks for the full therapeutic effect. It can take 2 or 3 weeks to see the full therapeutic effect of intranasal glucocorticoids.
Which of the following drugs has protocols that require clients to meet specific risk-management criteria and sign a treatment agreement before the nurse can administer the drug? - Lubiprostone - Azathioprine - Sulfasalazine - Alosetron
Alosetron Clients who take alosetron, a serotonin 5-HT3 receptor antagonist, can develop severe constipation that can lead to impaction, bowel obstruction, perforation, and potentially fatal ischemic colitis. Because of these risks, nurses must inform clients of the benefits and risks of the drug therapy, and clients must sign a treatment agreement.
A nurse is caring for a client who has peptic ulcer disease. The nurse should monitor the client's phosphorus levels when administering which of the following drugs? - Omeprazole - Aluminum hydroxide - Sucralfate - Famotidine
Aluminum hydroxide Antacids that contain aluminum, such as aluminum hydroxide, can cause hypophosphatemia because of the aluminum's ability to bind with phosphate and decrease its absorption. The nurse should monitor the client's phosphorus levels while administering this drug.
A nurse is caring for a client who has a new prescription for famotidine to treat GERD. The nurse should instruct the client to wait at least 1 hr between taking famotidine and which of the following over-the-counter drugs? - Gingko biloba - Antidiarrheals - St. John's wort - Antacids
Antacids Antacids can decrease the absorption of famotidine, a histamine2-receptor antagonist. The nurse should instruct the client to wait at least 1 hr between taking famotidine and taking an antacid.
A nurse should recognize that sulfasalazine is contraindicated for clients who have which of the following conditions? - Pancreatitis - Aspirin sensitivity - Bronchitis - GERD
Aspirin sensitivity Any sensitivity to salicylates, sulfonamides, or trimethoprim is a contraindication for the use of sulfasalazine, a 5-aminosalicylate. This is because intestinal bacterial metabolize the drug into 5-aminosalicylic acid, a salicylate. Aspirin is also a salicylate.
A nurse is providing teaching to a client who has a new prescription for loperamide. Which of the following instructions should the nurse include? - Dissolve the power thoroughly in 8 oz (237 mL) of water. - Take with diphenhydramine to prevent extrapyramidal effects. - Avoid activities that require alertness. - Take 30 min before activities that trigger nausea.
Avoid activities that require alertness. Loperamide, an opioid agonist, can cause sedation and dizziness. The nurse should instruct the client to avoid taking it before activities that require alertness.
What are the side effects of albuterol (SABA)?
BRONCHOSPASM Chest pain Palpitations Nervousness Restlessness Tremor
What are the side effect of formoterol (LABA)?
BRONCHOSPASM Hypersensitivity
What are the side effects of fluticasone (glucocorticoids)?
Bad long term effects including: Hypertension Acne, poor wound healing ADRENAL SUPPRESSION PEPTIC ULCERATION THROMBOEMBOLISM MUSCLE WASTING Depression
Describe the mechanism of action for proton pump inhibitors.
Block basal and stimulated acid production and reduce gastric acid secretion by irreversibly inhibiting the enzyme that produces gastric acid.
A client is about to start taking alosetron to treat diarrhea. You should instruct the client to watch for and report which of the following adverse drug reactions of this drug? - Constipation - Difficulty swallowing - Blurred vision - Confusion
Constipation Alosetron, a serotonin 5-HT3 receptor antagonist, can cause constipation that can lead to impaction and perforation. The client should monitor bowel patterns and stop the drug for constipation.
A nurse should recognize that using pseudoephedrine to treat allergic rhinitis requires cautious use with clients who have which of the following conditions? - Peptic ulcer disease - A seizure disorder - Anemia - Coronary artery disease
Coronary artery disease Because pseudoephedrine, an oral sympathomimetic, can cause systemic vasoconstriction, it requires cautious use with clients who have severe hypertension or coronary artery disease.
What are the dangers of over the counter cold medications for hypertensive patients?
Decongestants in OTC cold medications relieve nasal stuffiness by narrowing blood vessels and reducing swelling in the nose. This narrowing can affect other blood vessels are well and stimulate Alpha 1, causing vasoconstriction and further increasing hypertension.
A nurse is teaching a client about the use of beclomethasone to treat asthma. The nurse should explain that the drug has which of the following therapeutic effects? - Thins mucus - Relaxes bronchial smooth muscle - Decreases inflammation - Increases the cough threshold
Decreases inflammation Beclomethasone, an intranasal glucocorticoid, treats asthma by reducing inflammation.
A nurse is caring for a client who received prochlorperazine 4 hr ago. The client reports spasm of the face. The nurse should expect a prescription for which of the following medications? - Fomepizole - Naloxone - Phytonadione - Diphenhydramine
Diphenhydramine An adverse effect of prochlorperazine (same class as metoclopramide) is acute dystonia, which is evidenced by spasms of the muscles in the face, neck, and tongue. Diphenhydramine is used to suppress extrapyramidal effects of prochlorperazine.
A nurse is assessing a client who was administered ondansetron IV 1 hr ago. Which of the following findings should the nurse recognize as an adverse effect of this drug? - Dizziness - Bradycardia - Tardive dyskinesia - Dyspepsia
Dizziness Dizziness and lightheadedness are the most common adverse effect of ondanserton.
You are about to administer ondansetron to a client to prevent anesthesia-induced nausea and vomiting. You prepare to monitor the client for which adverse effects of this drug? - Bronchospasm - Dizziness - Hypertension - Anxiety
Dizziness Ondansetron, a serotonin antagonist, can cause dizziness, lightheadedness, and sedation. It is unlikely to cause bronchospasm, hypertension, or anxiety. However, it can cause a headache, so recommend an over-the-counter analgesic for headache pain. This drug can also cause ECG changes in clients and should be used cautiously with clients who have abnormal heart rhythm or electrolyte imbalance.
Explain the proper way to discontinue glucocorticoids.
Do not stop abruptly because glucocorticoids suppress adrenal function. Dose must be gradually tapered off to prevent adrenal crisis.
A nurse is teaching an adult client about diphenhydramine. The nurse should inform the client to expect which of the following adverse effects while taking this drug? - Muscle tremors - Drowsiness - Excitation - Insomnia
Drowsiness The most common adverse effect of diphenhydramine, a first-generation antihistamine, is drowsiness.
Legal restrictions apply to the purchase of pseudoephedrine because of which of the following risks? - Respiratory depression - Drug abuse - Drug tolerance - Rebound congestion
Drug abuse Because it is possible to alter pseudoephedrine and epinephrine into methamphetamine, a commonly abused drug, the law restricts the drugs' purchase.
You should monitor a client taking dextromethorphan because of the potential for which of the following? - Tachycardia - Fluid retention - Blurred vision - Drug abuse
Drug abuse Dextromethorphan can cause euphoria and hallucinations at high doses. Monitor clients taking it for the potential for abuse. Dextromethorphan is unlikely to cause tachycardia, fluid retention, or blurred vision, although it can cause dizziness, dyspepsia, and constipation.
A nurse is teaching a client who has a new prescription for diphenhydramine for allergic rhinitis. The nurse should instruct the client to monitor for which of the following manifestations as an adverse effect of this medication? (Select all that apply). - Dry mouth - Nonproductive cough - Skin rash - Drowsiness - Urinary hesitation
Dry mouth Drowsiness Urinary retention Dry mouth is an anticholinergic manifestation that can occur when a client takes diphenhydramine. Drowsiness is an adverse reaction of this medication. Diphenhydramine is administered to treat insomnia. Urinary retention is an anticholinergic manifestation that can occur when a client take diphenhydramine.
You should recognize that which of the following is a contraindication for taking codeine? - Emphysema - Cataracts - Hyperthyroidism - Nonproductive cough
Emphysema Codeine is unsafe for clients who have decreased respiratory reserve, such as with emphysema or asthma. Cataracts are not a contraindication for codeine use, although the drug can exacerbate some types of glaucoma due to a possible increase in intracranial pressure. Codeine may cause constipation, hypotension, and reduced respiration. Cautious use is essential for clients with hypothyroidism because the drug can worsen bradycardia. Codeine can help suppress a nonproductive cough.
A nurse is teaching a client about cimetidine. Which of the following are adverse effects of cimetidine? (Select all that apply). - Increased libido - Insomnia - Enlargement of breast tissue - Confusion - Decreased sperm count
Enlargement of breast tissue Confusion Decreased sperm count
Describe the class of expectorants and their actions and side effects.
Expectorants increase cough production by thinning mucous secretions. The side effects are headache, dizziness, drowsiness, nausea, diarrhea, GI upset, and rash.
A client is about to start taking omeprazole to treat a duodenal ulcer. Which of the following instructions should you include when talking with the client about taking this drug? - Take it with food - Avoid using aluminum-based antacids - Consume adequate amounts of fluids - Do not drink grapefruit juice
Food can reduce the absorption of omeprazole, so instruct clients to take this drug 1 hr before a meal and with plenty of fluids. Antacids are unlikely to interfere with absorption of omeprazole and might help reduce gastric distress. Grapefruit just interacts with many different drugs but it is unlikely to affect the metabolism of omeprazole.
What class of medications end with -sone?
Glucocorticoids
A nurse is teaching a client who has a new prescription for methotrexate. The nurse should instruct the client to monitor for manifestations of which of the following conditions? - Gout - Constipation - Insomnia - Hirsutism
Gout An adverse effect of methotrexate is hyperuricemia, which causes gout. The nurse should instruct the client to drink plenty of fluids to minimize this effect, and to report edema or pain in the joints.
Describe the patient teaching required for inhaler use.
Hand breath coordination Use spacer when taking inhaled glucocorticoids (allows more drug into lungs) Rinse mouth (prevents oral candidiasis) Hold breath for 10 seconds after administration
What are the side effects of anticholinergic medications?
Increased heart rate Dry mouth Blurred vision Urinary retention Constipation Sedation Hallucinations
A nurse should recognize that diphenoxylate/atropine should be used with caution for a client who has which of the following conditions? - Inflammatory bowel disease - Thrombophlebitis - Agranulocytosis - Immunization with a live virus vaccine within the last 6 weeks
Inflammatory bowel disease Diphenoxylate is an opioid, which can cause the severe complication of toxic megacolon in clients who have inflammatory bowel disease. The nurse should have the client monitor the consistency and frequency of stools throughout therapy.
A nurse is planning care for a client who is receiving chemotherapy and has a new prescription for ondansetron. Which of the following actions should the nurse plan to take? (Select all that apply). - Infuse the drug 30 min prior to chemotherapy. - Administer the drug when the client reports nausea. - Infuse the drug slowly over 15 min. - Administer the drug immediately following chemotherapy. - Repeat the dose 4 hr after chemotherapy.
Infuse the drug 30 min prior to chemotherapy Infuse the drug slowly over 15 min Repeat the dose 4 hr after chemotherapy is correct The nurse should administer IV ondansetron, a serotonin antagonist, 30 min prior to chemotherapy to prevent chemotherapy-induced nausea and vomiting. When treating radiation-induced nausea and vomiting, the nurse should give the drug orally 1 to 2 hr prior to radiation therapy and again every 8 hr. The nurse should infuse ondansetron slowly over 15 min to prevent chemotherapy-induced nausea. For maximum effectiveness, the nurse should administer ondansetron 4 hr after chemotherapy, and again 8 hr after chemotherapy. When treating anesthesia-induced nausea and vomiting, the nurse can give the drug 1 hr before anesthesia induction.
A nurse is reviewing the medical record of a client who has a new prescription for famotidine. The nurse should recognize that which of the following drugs interacts with famotidine? - Phenobarbital sodium - Ketoconazole - Lisinopril - Hydrochlorothiazide
Ketoconazole Famotidine reduces the absorption of ketoconazole
When administering both a LABA/SABA and a glucocorticoid, which medication should always be administered first?
LABA/SABA
A nurse is caring for an older adult client who has kidney disease and a new prescription for cimetidine. The nurse should instruct the client to report which of the following manifestations? - Lethargy - Cellulitis - Dry mouth - Myalgia
Lethargy Cimetidine is a H2 receptor antagonist, which can potentially cross the blood-brain barrier. Older adult clients who have kidney impairments are at risk for central nervous system (CNS) effects such as lethargy, depression, confusion, and seizures. The nurse should instruct the client to report these manifestations to their provider.
A female client of childbearing potential is starting therapy with misoprostol to prevent a gastric ulcer. Which of the following instructions should you include when teaching this client? (Select all that apply). - Mid-cycle spotting can occur - Take a pregnancy test prior to therapy. - Report excessive menstrual pain - Use effective contraception - Avoid taking the drug at bedtime
Mid-cycle spotting can occur. Take a pregnancy test prior to therapy. Report excessive menstrual pain. Use effective contraception. Misoprostol, a prostaglandin E analog, is a drug with teratogenic effects. It can induce uterine contractions and abort a pregnancy. Instruct females of childbearing age to confirm that they are not pregnant before taking this drug and to use effective contraception throughout drug therapy. Provide oral and written information about the risks of taking misoprostol during pregnancy. This drug can cause dysmenorrhea, so be sure to monitor for excessive menstrual pain or bleeding. Clients take this drug four times a day, with meals and again at bedtime.
A nurse is caring for a client who is taking lubiprostone. The nurse should tell the client that lubiprostone can cause which of the following adverse drug reactions? - Nausea - Constipation - Urinary retention - Sore throat
Nausea Lubiprostone, a chloride channel activator, can cause nausea. Clients who develop this effect do not need to discontinue the drug but should take it with food and water to minimize GI upset.
A nurse is caring for a client who has a prescription for alosetron. The nurse should recognize that alosetron therapy is effective when the client reports which of the following? - One formed stool per day - Urination without burning - Cessation of nausea or vomiting - Reduced GI reflux effects
One formed stool per day Alosetron, a serotonin 5-HT3 antagonist, treats the diarrhea and pain of severe irritable bowel syndrome. One formed stool per day indicates effective therapy.
For which of the following reasons should a nurse instruct a client to avoid taking guaifenesin with combination over-the-counter cold products? - Over-the-counter cold products can also contain guaifenesin - Blood glucose levels are increased. - Rebound congestion is likely - Drug tolerance is likely.
Over-the-counter cold products can also contain guaifenesin Many combination over-the-counter cold products contain guaifenesin. A client taking both might be taking excessive amounts of the drug. Combination products also contain multiple drugs to treat different manifestations, some of which the client might not have. All drugs have potential adverse effects, so the client should use only those drugs required to treat existing symptoms and only in the recommended amounts.
A nurse is teaching a client about albuterol. The nurse should instruct the client to monitor for and report which of the following as an adverse effect of this drug? - Fever - Bruising - Polyuria - Palpitations
Palpitations Although not common at therapeutic doses, beta2 agonists can cause cardiac stimulation, resulting in chest pain, palpitations, hypertension, and arrhythmias.
A nurse is administering sulfasalazine to a client. Which of the following data should the nurse collect to help identify an adverse drug reaction? (Select all that apply). - Level of consciousness - Skin integrity - Temperature - Urine output - CBC
Skin integrity Temperature CBC Sulfasalazine can cause a skin rash, so the nurse should check the client's skin for rashes. The drug can also cause nausea. If the client reports nausea, the nurse should suggest taking the drug with food or water. Sulfasalazine can cause a fever, so the nurse should check the client's temperature and treat fever with an antipyretic. Sulfasalazine can cause hematologic disorders, such as agranulocytosis and hemolytic and macrocytic anemia. The nurse should check the client's CBC periodically during therapy and tell the client to report sore throat or fatigue.
A nurse is providing instructions about the use of laxatives to a client who has heart failure. The nurse should tell the client to avoid which of the following laxatives? - Sodium phosphate - Psyllium - Bisacodyl - Polyethylene glycol
Sodium phosphate Absorption of sodium from sodium phosphate causes fluid retention which can exacerbate heart failure.
A client is about to start taking sulfasalazine to treat inflammatory bowel disease. You should instruct the client to watch for and report which of the following adverse drug reactions of this drug? (Select all that apply) - Sore throat - Fever - Joint pain - Constipation - Dry mouth
Sore throat Fever Sulfasalazine, an anti-inflammatory drug, can cause blood dyscrasias, such as agranulocytosis and hemolytic and marcocytic anemia. Instruct clients to avoid crowds and people who have communicable infections and to report sore throat, fever, or other indications of infection.
A nurse is caring for a client who is taking phenytoin for a seizure disorder and has a new prescription for sucralfate to treat a duodenal ulcer. The nurse should instruct the client to take the drugs at least 2 hr apart for which of the following reasons? - Phenytoin increases the metabolism of sucralfate. - Phenytoin reduces the effectiveness of sucralfate. - Sucralfate increases the risk of phenytoin toxicity. - Sucralfate interferes with the absorption of phenytoin.
Sucralfate interferes with the absorption of phenytoin. Sucralfate decreases the absorption of phenytoin. The nurse should instruct the client to allow at least 2 hr between taking the two drugs and should monitor the client's phenytoin levels.
Identify the advantages of opioids as antitussives.
Suppresses cough through CNS, increased cough threshold
A nurse is teaching a client about Montelukast. Which of the following instructions should the nurse include? - Use a spacer to improve inhalation. - Take the drug at the onset of bronchospasm. - Rinse mouth to prevent an oral fungal infection. - Take the drug once a day in the evening.
Take the drug once a day in the evening. Montelukast, a leukotriene modifier, is most effective when taken once per day in the evening.
A nurse is providing teaching to a client who is about to start taking psyllium to treat constipation. Which of the following instructions should the nurse include? (Select all that apply). - Expect results in 6 to 12 hr. - Urinate every 4 hr. - Take the drug with at least 8 oz (237 mL) of fluid. - Avoid activities that require alertness. - Increase fluid and fiber intake.
Take the drug with at least 8 oz (237 mL) of fluid. Increase fluid and fiber intake. To prevent esophageal obstruction, clients should take psyllium with at least 8 oz of fluid; and after mixing the powdered form, clients should drink it immediately. The nurse should tell the client to increase activity, fluid intake, and fiber intake, and to keep track of bowel function.
Which of the following information indicates that a client who is taking theophylline needs further instruction? - The client drives a school bus every day. - The client drinks 8 oz. of wine with dinner. - The client exercises 1 hour each day. - The client drinks two cups of coffee each morning.
The client drinks two cups of coffee each morning. Caffeine may increase CNS stimulation, causing nervousness, insomnia, and tremors. It may also increase cardiac stimulation and cause tachycardia. Instruct clients taking methylxanthines to avoid caffeine intake. Alcohol use is not a contraindication for theophylline use. Exercise is appropriate for clients who have asthma. Theophylline should not impair the client's ability to operate a motor vehicle. Primary care providers should not prescribe theophylline for clients who have severe liver or renal impairment.
A nurse is caring for a male client who asks the nurse about taking alosetron for irritable bowel syndrome with diarrhea (IBS-D) lasting 3 months. Which of the following information should the nurse provide the client about alosetron? - The drug is prescribed to female clients who have IBS-D lasting more than 6 months. - The drug is prescribed to clients who have chronic diarrhea lasting more than 12 months. - The drug is most beneficial for male clients who have inflammatory bowel disease. - The drug is most beneficial in treating clients who have constipation-predominant IBS (IBS-C).
The drug is prescribed to female clients who have IBS-D lasting more than 6 months. Alosetron is approved only to be prescribed to females who have IBS-D lasting 6 months or longer that has not been controlled by conventional treatment.
A nurse is teaching a client about the use of a mucolytic to treat a cough. The nurse should include that a mucolytic has which of the following therapeutic effects? - Suppresses the cough stimulus - Reduces inflammation - Thins and loosens mucus - Dries secretions
Thins and loosens mucus Mucolytics make mucus less viscous to increase a cough's productivity.
A nurse is teaching a client who has a new prescription form omeprazole. Which of the following information should the nurse include in the teaching? - Take this medication at bedtime - This medication decreases the production of gastric acid - Take this medication 2 hr after eating - This medication can cause hyperkalemia
This medication decreases the production of gastric acid Omeprazole reduces gastric acid secretion by inhibiting the enzyme that produces gastric acid.
For which of the following reasons should a client attach a spacer to a metered-dose inhaler? - To increase the amount of drug delivered to the lungs. - To increase the amount of drug delivered to the oropharynx. - To increase the amount of drug delivered on exhalation. - To increase the speed of drug delivery into the mouth.
To increase the amount of drug delivered to the lungs. A spacer increases the amount of drug that reaches the lungs.
Which of the following information should you include when teaching a client about the use of an albuterol inhaler for asthma management? - Use it every 12 hrs - Use it periodically to prevent exercise-induced asthma. - Store the drug canister in the refrigerator. - Watch for an oral yeast infection.
Use it periodically to prevent exercise-induced asthma. Albuterol is a short-acting beta2 agonist that clients should use only as needed to stop an acute asthma exacerbation or 30 min before exercising to prevent exercise-induced bronchospasm. Salmeterol is an example of a drug that clients take every 12 hrs for long-term asthma management. They should keep albuterol canisters away from heat and direct sunlight, but they should not refrigerate them. Inhaled glucocorticoids, such as beclomethasone, may cause oral yeast infections. They are not an adverse effect of albuterol.
A nurse is teaching a client about ipratropium. Which of the following instructions should the nurse include? - Do not drink anything for 30 min after using the drug. - Wait 5 min between using the drug and another inhaled drug. - This drug is used to thin respiratory secretions. - Check pulse rate after inhaling the drug.
Wait 5 min between using the drug and another inhaled drug. Ipratropium, an inhaled anticholinergic, requires a 5-min wait between its administration and that of another inhaled drug to allow for bronchodilation to take effect.
A nurse is teaching a client who has a prescription for long-term use of oral prednisone for treatment of chronic asthma. The nurse should instruct the client to monitor for which of the following manifestations as an adverse effect of this medication? - Weight gain - Nervousness - Bradycardia - Constipation
Weight gain Weight gain and fluid retention are adverse effects of oral prednisone due to the effect of sodium and water retention.
You should advise a client who is using a beclomethasone oral inhaler to watch for which of the following possible indications of an adverse effect of this drug? - White coating in the mouth - Abdominal pain - Muscle twitching - Palpitations
White coating in the mouth Beclomethasone, an inhaled glucocorticoid, may cause oropharyngeal candidiasis. Clients should gargle after each use, use a spacer to reduce the amount of drug in the mouth and throat, and report any white patches inside the mouth or on the tongue. Leukotriene modifiers are more likely to cause liver injury and abdominal pain. Muscle twitching and palpitations may indicate methylxanthine toxicity.
