NUR 352 Final
Which pediatric client is at greatest risk for medication toxicity? A. A 10 year old recovering from an appendectomy. B. A 1 year old diagnosed with a heart valve problem. C. A 15 year old diagnosed with exercise-induced asthma. D. A 6 year old being treated for first-degree burns.
A 1 year old diagnosed with a heart valve problem.
A client will begin taking prazosin. What is the appropriate action by the nurse? A. Raise the side rails of the hospital bed prior to sleep. B. Provide the first dose prior to breakfast. C. Offer to take the client to the restroom every 2 hours. D. Administer the medication with food.
Offer to take the client to the restroom every 2 hours.
A nurse is reviewing the past medical history of a client who has been admitted for breast cancer. Which factor in the client's history is associated with breast cancer? A. Oral contraceptive use B. Breast-feeding two children C. Bearing two children to full term before 25 years of age D. Current age of 31 years
Oral contraceptive use
A client with chronic kidney disease and anemia has been prescribed erythropoietin alfa for a current hemoglobin level of 13 mg/dL. What is the priority action of the nurse? A. Question the order. B. Determine the client's allergy history. C. Administer the medication as prescribed. D. Contact the provider for an order for packed red blood cells.
Question the order.
A 64 year old client with a bacterial infection is prescribed a fluoroquinolone. Which information , if mentioned by the client, would require the nurse to withhold the medication? A. The client struggles with medication compliance. B. The client has recently completed an antibiotic for a urinary tract ifection. C. The client is completing training for a marathon this month. D. The client has a severe allergy to penicillin antibiotics.
The client is completing training for a marathon this month.
A client with schizophrenia is starting clozapine therapy. Which information is highest priority to include in client teaching? A. The client should have periodic fasting glucose levels drawn. B. The client should monitor for weight gain and adhere to a healthy diet. C. The client must have regular white blood cell count (WBC) levels drawn. D. The client should report fine hand tremors to the health care provider.
The client must have regular white blood cell count (WBC) levels drawn.
A nurse is preparing to administer chemotherapy to a client with cancer. Which agent is most likely to cause chemotherapy-induced nausea and vomiting? A. docetaxel B. cisplatin C. bleomycin D. methotrexate
cisplatin
A client with a past medical history of opioid use disorder has several episodes of noninfectious diarrhea. The nurse is about to administer the prescribed loperamide when the client states, "I do not want to take that, it will make me high." What is the best response by the nurse? A. "Have you used this medication to make you high before?" B. "I will contact the prescriber and request diphenoxylate instead." C. "Even though it contains an opioid, it will not make you high." D. "I understand your concern, but it is important to decrease your diarrhea."
"Even though it contains an opioid, it will not make you high."
The client is prescribed dexamethasone 0.1% one drop every 8 hours to treat uveitis, an inflammatory condition of the eye. Which statement by the client would the nurse be most concerned about? A. "I am currently being treated for otitis externa as well." B. "I was diagnosed with a systemic fungal infection last week." C. "Will this medication interact with the medication I take for my migraines?" D. "I also suffer from gout periodically. Are these two problems related?"
"I was diagnosed with a systemic fungal infection last week."
Which reported statement by the client is of greatest concern when taking a medication to treat glaucoma? A. "I noticed the color of my eyes is becoming darker brown after starting the latanoprost." B. "After starting brimonidine, I began experiencing dry mouth." C. "I am experiencing sensitivity to light while taking timolol." D. "I was taking dorzolamide and developed conjunctivitis."
"I was taking dorzolamide and developed conjunctivitis."
A client with type II diabetes has been prescribed canagliflozin. Which statement by the client indicates understanding of the teaching provided by the nurse? A. "I will monitor for signs and symptoms of urinary tract infections while taking this medication." B. "Since I will be urinating more, I can stop taking my diuretic medications." C. "I will increase potassium in my diet to counteract side effects of this medication." D. "I do not need to worry about hypoglycemia with this medication, since it is not insulin."
"I will monitor for signs and symptoms of urinary tract infections while taking this medication."
The student nurse is caring for a client who is 7 months postpartum. The client reports insomnia, sadness, and moodiness. The provider has prescribed paroxetine and pyridoxine. Which statement made by the student nurse would require intervention by the nurse? A. "Pyridoxine should be taken daily." B. "Do you feel like harming to yourself or your baby?" C. "If you are lactating, it is best to wean prior to taking these medications." D. "Is there a chance you could be pregnant?
"If you are lactating, it is best to wean prior to taking these medications."
The client asks if there is any other option besides antibiotics to treat acute otitis media. Which is the correct response by the nurse? A. "Pain management is also part of the treatment plan for otitis media." B. "Pain management is only necessary when antibiotics are prescribed." C. "Antibiotics are the only way to cure otitis media." D. "Pain management is reserved for use when the tympanic membrane is burst."
"Pain management is also part of the treatment plan for otitis media."
A nursing student is giving report on a client in the urgent care clinic being seen for allergic conjunctivitis. Which statement made about the cromolyn for allergic conjunctivitis indicates a correct understanding of the medication actions? A. "The benefits of the medication may take several days to develop." B. "Clients can continue using their contact lenses throughout treatment." C. "There are no known side effects to the medication." D. "The medication must be given by mouth."
"The benefits of the medication may take several days to develop."
A nurse is teaching the client about the treatment for trichomoniasis. Which information should the nurse include in the teaching prior to administration? A. "You need to avoid alcohol during treatment and for 14 days after medication is stopped." B. "The medication may cause a metallic taste in your mouth." C. "Your partner(s) will not require treatment." D. "The medication may cause nausea, vomiting, or stomach pain." E. "You cannot take disulfiram-containing products for 2 weeks."
"The medication may cause a metallic taste in your mouth." "The medication may cause nausea, vomiting, or stomach pain." "You cannot take disulfiram-containing products for 2 weeks."
A client taking aspirin for rheumatoid arthritis has recently been prescribed misoprostol. The client asks why they are now taking a second medication. What is the correct response by the nurse? A. "The misoprostol will help protect your stomach from ulceration." B. "The combination of these two medications decreases joint stiffness." C. "Misoprostol will increase the effectiveness of the aspirin." D. "This seems to be an error, let me check with our prescriber."
"The misoprostol will help protect your stomach from ulceration."
A nurse is teaching a young woman about a new medication, topiramate. Which statement is included in the instructions? A. "If you are allergic to sulfa drugs, you should not take this medication." B. "This medication should not be taken if you plan to get pregnant." C. "Take this medication in the morning with a full glass of water." D. " Prior to taking this medication, take your blood pressure."
"This medication should not be taken if you plan to get pregnant."
A client was recently diagnosed with vulvar atrophy and dyspareunia an recently had a benign breast lump. She is currently taking ethinyl estradiol and norethindrone. She reports a red, swollen, tender area in the back of her calf. Which recommendation by the nurse is appropriate? A. "You must stop the medication immediately and come into the office." B. "You may try using an NSAID to help relieve your calf pain." C. "You can continue the medication and follow up with your provider." D. "You should stop the mmedication and see if the swelling resolves."
"You must stop the medication immediately and come into the office."
The nurse is counseling a 17 year old client with secondary amenorrhea. The client's last normal menses was 4 months ago, and she wishes to begin a contraceptive. Which recommendation by the provider does the nurse anticipate? A. "You will need a laparoscopy to determine the cause of your amenorrhea." B. "You should continue to wait for your period and once you get it, you may start your contraceptive." C. "You will need to have some laboratory testing done and then begin medroxyprogeterone to induce a withdrawal bleed." D. "You can begin the contraceptive any time."
"You will need to have some laboratory testing done and then begin medroxyprogeterone to induce a withdrawal bleed."
A nurse is caring for a client with a nasogastric (NG) tube. The client's order is written for NG tube irrigation every 8 hours to maintain homeostasis. Which solution should the nurse use to irrigate the NG tube? A. sterile water B. 0.9% normal saline C. 0.45% normal saline D. tap water
0.9% normal saline
Based upon current recommendations for the influenza vaccine, which clients should receive the immunization? A. 32 year old client with asthma B. 45 year old client on prednisone for rheumatoid arthritis C. 58 year old woman who cares for her husband with cancer D. 28 year old pregnant woman E. 19 year old college student
A. 32 year old client with asthma B. 45 year old client on prednisone for rheumatoid arthritis C. 58 year old woman who cares for her husband with cancer D. 28 year old pregnant woman
Which client would be recommended to start a proton pump inhibitor (PPI) along with the prescription for a nonsteroidal anti-inflammatory drug (NSAID)? A. A client currently taking glucocorticoids. B. A client currently taking metformin for diabetes mellitus. C. A client with a history of myocardial infarction. D. A client with a history of rheumatoid arthritis.
A client currently taking glucocorticoids.
The client is receiving quetiapine for sleep and for agitation. Which assessment finding would require immediate intervention by the nurse? A. Urinary output 30 mL over the past 2 hours B. Systolic blood pressure 98 mmHg C. A red, blistering rash D. Heart rate 115 beats per minute
A red, blistering rash
A client begins taking a beta-adrenergic antagonist medication after experiencing a myocardial infarction. Which assessment finding(s) would alert the nurse that the client is experiencing an adverse effect of the medication? A. Bradycardia B. Hyperglycemia C. Swelling of extremities D. Shortness of breath E. Bronchodilation
A. Bradycardia C. Swelling of extremities D. Shortness of breath
A male client presents to the primary care provider with fever and chills. The client reports having had bilateral flank pain and difficulty urinating for the past 24 hours. The nurse collects a urine specimen. Which medication(s) does the nurse anticipate the provider to prescribe? A. Ciprofloxacin B. Ibuprofen C. Morphine D. Lisinopril E. Sildenafil
A. Ciprofloxacin B. Ibuprofen
Naloxone reverses which effects when given to a client experiencing an opioid overdose? A. Abdominal cramping B. Euphoria C. Pain relief D. Sedation E. Respiratory depression
A. Abdominal cramping B. Euphoria C. Pain relief D. Sedation E. Respiratory depression
A nurse is preparing to administer a Rho (D) immune globulin injection to the client. Which information in the client's chart would cause the nurse to question the order? A. Blood pressure 140/90 mmHg B. 2+ proteinuria C. B- blood type D. A+ blood type
A+ blood type
A client with severe, chronic obstructive pulmonary disease (COPD) is taking a phosphodiesterase 4 (PED-4) type inhibitor. Which assessment findings would alert the nurse that the client is experiencing a side effect of the medication? A. Hypertension B. Diarrhea C. Weight loss D. Insomnia E. Cough
B. Diarrhea C. Weight loss D. Insomnia
A client arrives to the emergency department reporting more than six episodes of diarrhea per day for the last 5 days. The nurse assesses the client for what signs/symptoms associated with frequent diarrhea? A. Urine output 60 mL/hr B. Flattened T waves on electrocardiogram C. Muscle cramps D. Serum osmolality 260 mOsm/L E. Bicarbonate 30 mEq/dL
B. Flattened T waves on electrocardiogram C. Muscle cramps D. Serum osmolality 260 mOsm/L
A client diagnosed with major depressive disorder has been prescribed fluoxetine. Which information would the nurse include while providing teaching to the client? A. The medication should be taken as needed during periods of severe depression. B. The medication's full therapeutic effect may take 6 to 8 weeks. C. The medication can cause worsening depression and suicidal thoughts. D. Taper medication with provider supervision when discontinuing medication. E. The medication can cause sedation, seizures, and tachycardia
B. The medication's full therapeutic effect may take 6 to 8 weeks. C. The medication can cause worsening depression and suicidal thoughts. D. Taper medication with provider supervision when discontinuing medication.
The nurse is preparing to administer etanercept to a client with rheumatoid arthritis. Which assessment finding(s) would alert the nurse to potential contraindications to this medication? A. Bilateral crackles in the lung bases B. 2+ pitting edema of the right lower extremity C. Platelet count of 135,000 x 103/mcgL D. A tuberculin skin test with induration measuring 10 mm E. Hyperactive bowel sounds in all four abdominal quadrants
Bilateral crackles in the lung bases A tuberculin skin test with induration measuring 10 mm
A client with severe constipation has developed abdominal pain, distention, nausea, and inability to pass stool. Which medication will the nurse request to provide the best relief for the client? A. Ondansetron B. Ranitidine C. Bisacodyl suppository D. Docusate sodium
Bisacodyl suppository
A client with cancer the interdisciplinary team discussion about cell cycle-specific and nonspecific chemotherapy agents. The client asks the nurse for a further explanation of the difference. Which statement is true about cell cycle-specific and cell cycle nonspecific chemotherapy agents? A. Cell cycle nonspecific agents exert effect during specific phases of the cell cycle. B. Cell cycle-specific agents act independently of the cell cycle phases. C. Both cell cycle-specific agents and nonspecific agents are used in cancer treatment. D. Chemotherapy agents are used when surgical intervention is not possible or unavailable.
Both cell cycle-specific agents and nonspecific agents are used in cancer treatment.
The client is prescribed an albuterol inhaler to be used four times a day to treat asthma. Which condition in the client's history is most likely to be contraindication to taking this medication? A. Chickenpox B. Bradycardia C. Osteoporosis D. Gout
Bradycardia
A hospice client has not had a normal bowel movement for the last 4 days, beyond a small amount of liquid stool. The nurse assesses the client's abdomen and finds bowel sounds present in all four quadrants, slight distension, and no pain. What is the nurse's priority action? A. Administer ordered sennosides and docusate sodium. B. Encourage the client to increase fiber and fluid intake. C. Administer an enema. D. Check for impaction with a digital rectal exam.
Check for impaction with a digital rectal exam.
Timolol drops have been ordered to treat glaucoma. What essential instructions should the client receive? A. Monitor respiratory rate and for signs and symptoms of upper respiratory infection. B. Monitor blood glucose and alert the prescriber to any significant changes. C. Monitor urine output and daily weight. Promptly report any edema. D. Hold slight pressure on the inner tear duct of the eye for 1 minute after instilling the drop.
Hold slight pressure on the inner tear duct of the eye for 1 minute after instilling the drop.
A client with a history of electrolyte imbalance reports right-sided flank pain and hematuria. The nurse suspects the client may be experiencing which electrolyte imbalance? A. Hyponatremia B. Hyperphosphatemia C. Hypokalemia D. Hypercalcemia
Hypercalcemia
A client newly diagnosed with diabetes insipidus (DI) has been prescribed indomethacin. The nurse verifies that he medication has been effective based upon which assessment finding(s)? A. Decreased joint swelling B. Increased urine specific gravity C. Decreased blood pressure D. Decreased serum osmolality E. Increased serum sodium
Increased urine specific gravity Decreased serum osmolality
A client has been taking levothyroxine for the past 3 months. The nurse would be concerned about toxicity of the medication if which signs or symptoms were discovered? A. Constipation B. Insomnia C. Tachydysrhythmias D. Hypotension E. Increased appetite
Insomnia Tachydysrhythmias Increased appetite
A client is taking fluoxetine for major depressive disorder. The client's spouse calls the clinic and reports the client is confused, restless, and has a temperature of 101.2oF. What is the nurse's priority action? A. Instruct the client to stop taking the fluoxetine. B. Explain that these are expected side effects of floxetine. C. Recommend the client take the medication at night. D. Determine if the client has other flu-like symptoms.
Instruct the client to stop taking the fluoxetine.
A client with an acute gout flare reports severe nausea when taking colchicine. Which medications would be an acceptable alternative for the client's treatment? A. Naproxen B. Prednisone C. Allopurinol D. Indomethacin E. Acetaminophen
Naproxen Prednisone Indomethacin
A client with peptic ulcer disease has been taking omeprazole for the past 10 years and is concerned about long term effects of the medication. Which are potential long term effects the nurse should discuss with the client? A. Osteopenia B. Renal insufficiency C. Hypomagnesemia D. Stomach cancer E. Hyperkalemia
Osteopenia Hypomagnesemia
Which antiepileptic medications are used for generalized and partial seizures and work on the sodium channels? A. Oxcarbazepine B. Phenobarbital C. Lacosamide D. Carbamazepine E. Valproic acid
Oxcarbazepine Carbamazepine
A client with peptic ulcer disease taking pantoprazoledevelops a fever and white blood cell count of 13,500/µL. What is the priority nursing action? A. Check a complete set of vital signs. B. Obtain a urine specimen for culture and sensitivity. C. Palpate for tactile fremitus. D. Palpate the abdomen for distention or masses.
Palpate for tactile fremitus.
A nurse is caring for a client diagnosed with seizure disorder. Which laboratory value would the nurse assess prior to administration of phenytoin? A. White blood cell count B. Potassium level C. Sodium level D. Hemoglobin and hematocrit
Sodium level
The client with Addison disease has been prescribed prednisone daily during a period of increased psychological stress. The nurse includes which educational information with regard to the prescribed prednisone therapy? A. Increase dietary protein to prevent weight loss while taking prednisone. B. Ingest more salt to counteract the hypotension caused by prednisone. C. Taper the medication slowly over 7 to 10 days when discontinued. D. Monitor for signs/symptoms of hypoglycemia while taking this medication.
Taper the medication slowly over 7 to 10 days when discontinued.
A client is diagnosed with otitis externa. Comorbidities include diabetes mellitus, hypertension, and advanced multiple sclerosis. Which type of education regarding medication administration would the nurse provide? A. The oral administration of a prescription for fluoroquinolone. B. The oral administration of a prescription for hydrocortisone/neomycin/polymyxin B solution. C. The administration of topical medications, for a prescription of alcohol plus acetic acid solution. D. The administration of topical combination medications, for a prescription of fluoroquinolone/glucocorticoid solution.
The oral administration of a prescription for fluoroquinolone.
The nurse is preparing to administer neutral protamine Hagedorn (NPH) insulin 16 units and regular insulin 14 units in the same syringe. Which order of actions represents the correct steps in combining these medications? A. Verify the medication order, inject air into the regular insulin vial, inject air into the NPH vial, draw up 16 units NPH insulin into the syringe, and draw up 14 units regular insulin into the syringe. B. Verify medication order, inject air into the NPH vial, inject air into the regular insulin vial, draw up 14 units regular insulin into syringe, and draw up 16 units NPH insulin into syringe. C. Verify the medication order, inject air into the regular insulin vial, inject air into the NPH vial, draw up 14 units regular insulin into syringe, and draw up 16 units NPH insulin into syringe. D. Inject air into the NPH vial, inject air into the regular insulin vial, draw up 14 units regular insulin into syringe, draw up 16 units NPH insulin into syringe, and verify medication order.
Verify medication order, inject air into the NPH vial, inject air into the regular insulin vial, draw up 14 units regular insulin into syringe, and draw up 16 units NPH insulin into syringe.
A client asks why they should not give their 10 month old child ibuprofen after receiving vaccinations. Which response by the nurse is correct? A. "Ibuprofen is not recommended for use related to the risk of Reye syndrome." B. "Ibuprofen must be given intramuscularly to treat vaccination related side effects, which adds more pain for the child." C. "Ibuprofen and other NSAIDs blunt the effect of the vaccination by decreasing the production of antibodies necessary to mount the immune response desired by the vaccination." D. "Ibuprofen is not effective in a 10 month old due to their immature liver and inability to metabolize the drug. Acetaminophen is more effective choice to give."
"Ibuprofen and other NSAIDs blunt the effect of the vaccination by decreasing the production of antibodies necessary to mount the immune response desired by the vaccination."
A client with diabetes and peptic ulcer disease has been prescribed clarithrmycin for the treatment of Helicobacter pylori. Which statement made by the client indicates teaching by the nurse was effective? A. "If I develop hearing loss while taking this medication, it is reversible." B. "A change in the taste of food may indicate a serious reaction to the medication." C. "If I develop a rash I should limit my sun exposure." D. "I will stop this medication immediately if I have an episode of diarrhea."
"If I develop hearing loss while taking this medication, it is reversible."
A nurse is caring for a client with a history of multiple sclerosis (MS). The client asks the nurse why so many medications are prescribed. Which statement(s) explain why many medications are used in the treatment of MS? A. "The medications manage acute exacerbations." B. "The medications modify the disease." C. "The medications aid in diagnosis of the disease." D. "The medications are used to slow the progression of the disease process." E. "The medications are used to assist with symptom management."
A. "The medications manage acute exacerbations." B. "The medications modify the disease." E. "The medications are used to assist with symptom management."
A client has been diagnosed with central nervous system bacterial infection. Which antibiotics does the nurse recognize as options for the treatment of CNS infections? A. Cefepime, IV B. Metronidazole, IV C. Vancomycin, PO D. Penicillin G, PO E. Ciprofloxacin, IV
A. Cefepime, IV B. Metronidazole, IV
A client who has been in the hospital for an extended stay to receive chemotherapy is planning for discharge. For which signs and symptoms does the nurse teach the client to seek medical evaluation? A. White spots on the tongue B. Difficulty swallowing C. Unexplained weight loss D. A persistent cough E. Dry patches on the skin of the feet
A. White spots on the tongue B. Difficulty swallowing C. Unexplained weight loss D. A persistent cough
A client arrives to the emergency department with the following signs/symptoms: BP 186/102, HR 144 beats/minute, temperature 102.8oF (39.3oC), oxygen saturation 99%. The client, who has a history of hypertension and hyperthyroidism, reports flu-like symptoms for the past week. Which prescribed order is the priority nursing action based on these findings? A. Obtain an electrocardiogram. B. Apply oxygen via nasal cannula as needed. C. Administer propranolol 100 mg PO. D. Administer propylthiouracil (PTU) 200 mg PO.
Administer propylthiouracil (PTU) 200 mg PO.
The nurse is caring for a client who is experiencing increasingly worse indigestion. Which medication prescribed to the client would be of greatest concern to the nurse? A. Alendronate B. Allopurinol C. Aspirin D. Prednisone
Alendronate
A palliative care client comes to the emergency department with nausea and vomiting on New Year's Eve. During the assessment, the nurse learns that the client lives alone and frequently comes to the emergency department on holidays with episodes of nausea and vomiting. Which medication does the nurse anticipate administering? A. Metoclopramide B. Benzodiazepine C. Ondansetron D. Haloperidol
Benzodiazepine
A client with osteoporosis and a urinary tract infection is prescribed calcium supplements and ciprofloxacin to be administered at 0800. What is the priority action by the nurse? A. Contact the pharmacist to discuss an alternative antibiotic. B. Hold the ciprofloxacin and administer the calcium supplement. C. Contact the prescriber to change the dosing schedule for the calcium. D. Administer the medications as prescribed at 0800.
Contact the prescriber to change the dosing schedule for the calcium.
A nurse is caring for a client with challenges in memory recall. The client is being treated with a N-methyl-D-aspartate (NMDA) receptor antagonist medication. Which disease is part of the client's history? A. Seizure disorder B. Parkinson disease C. Multiple sclerosis D. Alzheimer disease
D. Alzheimer disease
The nurse is caring for a client with an acute exacerbation of heart failure (HF). The client is prescribed spironolactone, losartan, and digoxin. The client reports little improvement of symptoms despite taking all medications as prescribed. Which additional intervention should the nurse recommend? A. Advise client to take additional dose of spironolactone for the next 2 days. B. Increase the client's fluid intake to 2.5 L/day. C. Decrease sodium intake to <2 g/day. D. Increase dietary potassium to improve cardiac function.
Decrease sodium intake to <2 g/day.
A client with severe chronic obstructive pulmonary disease has been taking prednisone for several years. Which assessment findings noted by the nurse would indicate an insufficient dose of prednisone? A. Hypotension B. Hyponatremia C. Hyperglycemia D. 2+ pitting edema E. Tachycardia
Hypotension Hyponatremia Tachycardia
A nurse is caring for a client who has just begun taking diazepam to treat anxiety. The nurse should monitor the client for which side/adverse effect(s) of this medication? A. Light-headedness B. Hearing los C. Anterograde amnesia D. Bradypnea E. Hypertension
Light-headedness Anterograde amnesia Bradypnea
A nurse is caring for a client who is prescribed lisinopril. The client tells the nurse that they are experiencing a cough. Which medication does the nurse anticipate the prescriber to prescribe as an alternative to lisinopril? A. Losartan B. Verapamil C. Furosemide D. Hydralazine
Losartan
A client with atrial flutter is taking verapamil. Which new finding on the ECG would require the nurse to hold the medication and notify the prescriber? A. Occasional premature ventricular contractions (PVCs) B. Atrial-to-ventricular ratio of 4:1 C. PR interval 0.3 milliseconds D. Ventricular rate 125 beats per minute
PR interval 0.3 milliseconds
A client with major depressive disorder is prescribed phenelzine by a provider. Which client teaching is the highest priority? A. Phenelzine interacts with many foods and medications. B. Continue taking phenelzine even after mood improves. C. Phenelzine's full therapeutic effect may take 6 to 8 weeks. D. Phenelzine may cause insomnia and some sexual side effects
Phenelzine interacts with many foods and medications.
A nurse is caring for a client with Parkinson disease (PD). The client is prescribed levodopa. Which are expected assessments of a client with PD? A. Altered level of consciousness B. Motor weakness C. Confusion of person, place, and time D. Postural rigidity E. Sexual dysfunction F. Tremors to hands at rest
Postural rigidity Tremors to hands at rest
A client given lidocaine as local anesthetic for a surgical procedure reports tinnitus and a metallic taste in the mouth. What is the appropriate action of the nurse? A. Reassure the client that these are expected side effects that will diminish quickly. B. Recognize the symptoms of systemic toxicity, notify hte prescriber, and prepare to provide airway support if needed. C. Recognize the symptoms of an allergic reaction, notify the prescriber, and prepare to administer epinephrine. D. Reassure the client that because they received a topical dose of the medication, they are not at risk for systemic toxicity or allergic reaction.
Recognize the symptoms of systemic toxicity, notify hte prescriber, and prepare to provide airway support if needed.
A client is diagnosed with complex partial seizures and is prescribe phenobarbital. After 1 hour, the nurse assesses the client. Which assessment finding requires immediate action? A. Blood pressure of 130/78 mmHg B. Pain rating of 2 on a 1 to 10 scale, 10 as highest rating C. Respiratory rate of 8 breaths/minute D. Heart rate of 69 beats/minute
Respiratory rate of 8 breaths/minute
Which client exhibiting signs of opioid tolerance? A. A client who has stopped experiencing constipation while continuing to take opioids for chronic pain. B. "A client who requires increased doses of an opioid to provide the same level of pain relief over time. C. A client who has been taking 30mg of morphine daily with continued therapeutic effects over the last month. D. A client taking oxycodone and experiences significant sedation when drinking alcohol.
"A client who requires increased doses of an opioid to provide the same level of pain relief over time.
Which statement is accurate regarding the nurse's understanding of alpha blockade? A. "Alpha antagonist medications lower blood pressure by the dilation of he arterioles, directly reducing arterial pressure." B. "Alpha anagonist medications can help to treat nasal congestion by constriction of the blood vessels in the nasal cavity." C. "Alpha blockade may result in bradycardia by triggering the baroreceptor reflex." D. "Alpha blockade results in contraction of the smooth muscle, helping to treat conditions such as benign prostatic hyperplasia."
"Alpha antagonist medications lower blood pressure by the dilation of he arterioles, directly reducing arterial pressure."
To reduce the risk of adverse effects caused by tetracycline, which instruction will the nurse provide to the adult client? A. "Increase your intake of calcium while on this medicine." B. "Avoid alcohol while taking tetracycline." C. "Limit direct sunlight exposure to 2 hours per day." D. "Brush your teeth three times a day."
"Avoid alcohol while taking tetracycline."
The client asks the nurse why COX-2 inhibitors should be used in the lowest dose possible for the shortest amout of time. Which response by the nurse provides an accurate explanation? A. "COX-2 inhibitors increase the risk of myocardial infarction, stroke, and other cardiovascular events." B. "Elevated liver enzymes and resulting liver damage can be seen with the long-term use of COX-2 inhibitors." C. "COX-2 inhibitors are converted into toxic metabolites that may accumulate if the medication is taken over a long period." D. "Long-term use of COX-2 inhibitors is associated with increased risk of bleeding."
"COX-2 inhibitors increase the risk of myocardial infarction, stroke, and other cardiovascular events."
A client with an extensive cardiac history is prescribed omeprazole. The nurse reviews the medication history and the client is also prescribed clopidogrel, metoprolol, and furosemide. Which instructions should the nurse provide to the client regarding the medications. A. "Furosemide is taken in the morning, and the metoprolol is taken at night." B. "Clopidogrel should be taken 12 hours apart from the omeprazole." C. "Clopidogrel, metoprolol, and furosemide can be taken together, but the omeprazole needs to be taken 4 hours after the other medications." D. "Take all the medications with food in the morning."
"Clopidogrel should be taken 12 hours apart from the omeprazole."
Metformin has been prescribed for a client newly diagnosed with type 2 diabetes mellitus. Which client statement about this medication validates to the nurse that the client understood the teaching? A. "Stimulates glucose production in the liver." B. "Decreases sensitivity of peripheral tissue to insulin." C. "Decreases production of glucose by the liver." D. "Treats unstable type 2 diabetes."
"Decreases production of glucose by the liver."
A client who was prescribed nitrofurantoin for a urinary tract infection 1 week ago calls to report the symptoms have returned. What is the most appropriate response by the nurse? A. "You need to restart the antibiotic since your symptoms are back." B. "Did you complete the full course of antibiotic as directed?" C. "It is common for symptoms to return after completing the antibiotic." D. "It is likely that you have another infection. Do you have a fever?"
"Did you complete the full course of antibiotic as directed?"
A new nurse graduate is discussing the use of epinephrine with the nurse manager. Which statement by the new nurse demonstrates an understanding of this medication? A. "Epinephrine given intravenously requires continuous cardiac monitoring related to an increased risk of arrhythmias and hypertension." B. "Epinephrine should be used cautiously in clients with diabetes due to the risk of hypoglycemia." C. "When epinephrine is taken orally it should be separated from other medications and food by at least 1 hour." D. "Epinephrine given subcutaneously will absorb faster than if given intramuscularly."
"Epinephrine given intravenously requires continuous cardiac monitoring related to an increased risk of arrhythmias and hypertension."
A client with a diagnosis of hypertension and a past medical history of asthma is prescribed a beta1-selective adrenergic antagonist. Which statement is accurate regarding the client's understanding of the medication selection? A. "By taking a beta1-selective adrenergic antagonist medication, it ensures that I will never experience bronchoconstriction as an adverse effect." B. "I need to be aware of the increased risk of developing diabetes mellitus while taking beta1-selective adrenergic antagonists." C. "I am prescribed a beta1-selective adrenergic antagonist medication because a nonselective beta-adrenergic blocker may affect my asthma." D. "Since I am taking a beta1-selective adrenergic antagonist instead of a nonselective beta-adrenergic antagonist, I can expect that a lower dose of medication will be used."
"I am prescribed a beta1-selective adrenergic antagonist medication because a nonselective beta-adrenergic blocker may affect my asthma."
A client with osteoporosis has been prescribed raloxifene. Which statement by the client requires immediate intervention by the nurse? A. "My breast cancer has been in remission for several years now." B. "I have been bruising much more easily over the past several months." C. "When I sit for prolonged periods of time, my feet begin to tingle and hurt." D. "I have developed a cough that seems to have some blood in it."
"I have developed a cough that seems to have some blood in it."
A female client with genital herpes simplex becomes pregnant. What statement by the client concerning her prescribed acyclovir would indicate that teaching by the nurse has been effective? A. "I need to switch to the topical formulation of this medication now that I am pregnant." B. "I should only take this medication during an active outbreak of my herpes." C. "I may continue the acyclovir throughout the course of my pregnancy." D. "It is best to discontinue the use of this medication until I deliver the baby."
"I may continue the acyclovir throughout the course of my pregnancy."
A nurse from another area is shadowing on the bone marrow transplant and chemotherapy nursing units. Which statement by the shadow nurse is appropriate regarding the clients and medications used in this area? A. "PPE is used during routine morning care to the clients." B. "Many of the clients have supportive and engaged families." C. "I noticed that there are special procedures for administering the drugs here." D. "I need to make sure that all the clients here are well cared for."
"I noticed that there are special procedures for administering the drugs here."
Which statement made by the client suggests the need for further education regarding a newly prescribed medication? A. ""There seems to be several brand names for this medication; it's confusing." B. "I'm glad I don't have to use the medication's chemical name when refilling the prescription." C. "I prefer a trade named version of the medication since they are generally more effective." D. "I'm paying for this prescription, so I'd like it written for the generic form."
"I prefer a trade named version of the medication since they are generally more effective."
Which statement by the client receiving digoxin should warrant additional instruction? A. "I will hold this medication if my blood pressure is > 100 mmHg." B. "If I experience any nausea, I should call my provider." C. "I will check my heart rate before I take this medication." D. "This medication will slow down my heart rate."
"I will hold this medication if my blood pressure is > 100 mmHg."
The nurse is caring for a 46 year old client who reports continuous vaginal bleeding for the past 14 days. The client does not take any medications and has been menopausal for 2 years. Which statement by the client would indicate that teaching was effective? A. "I will schedule an appointment for an ultrasound and biopsy." B. "I will start my progesterone therapy." C. "I will restart my oral contraceptive pills." D. "I will call you if it happens next month."
"I will schedule an appointment for an ultrasound and biopsy."
A nurse is caring for a client with Parkinson disease (PD). The client asks how the disease causes motor dysfunction. Which is the nurse's correct response? A. "The medications affects the cholinergic receptors." B. "It is caused by a destruction of dopamine neurotransmitter." C. "The cause is related to autoimmune destruction of myelin." D. "Serotonin, a neurotransmitter, is overproduced by the brain."
"It is caused by a destruction of dopamine neurotransmitter."
When providing discharge teaching regarding beta agonists for a client newly diagnosed with asthma, which information is the most important to give to clients? A. "Quick relief of asthma symptoms can be achieved via inhaled or oral doses of a short-acting beta2 agonist." B. "It is essential that you contact your health care provider should you find yourself needing to use a short-acting beta2 agonist rescue inhaler more than twice weekly." C. "You may be prescribed a long-acting inhaled beta2 agonist to be taken on an as needed basis." D. "Oral beta2 agonists can be sued for short-term relief of an ongoing asthma attack as well as long-term control."
"It is essential that you contact your health care provider should you find yourself needing to use a short-acting beta2 agonist rescue inhaler more than twice weekly."
A nurse is caring for a client who has been prescribed ondansetron prior to administration of etoposide. What statement should the nurse include prior to administration of ondansetron? A. "It will assist in preventing nausea and vomiting." B. "This will increase your neutrophil count." C. "This medication will improve your appetite." D. "The medication is known to improve the sodium level."
"It will assist in preventing nausea and vomiting."
A nurse is teaching a client about the toxicities of chemotherapy. Which statement by the nurse is included in the teaching plan? A. "Applying lotion daily to your dry skin after baths and showers will nourish your skin." B. "If you start to get headaches, make sure you call your primary care physician for treatment." C. "Monitoring your food and fluid intake is important." D. "At times, you may experience palpitations and dizziness."
"Monitoring your food and fluid intake is important."
A nurse is caring for a client who is prescribed lovastatin. Which instruction is correct regarding the medication? A. "Check your BP prior to taking the medication." B. "Take this medication at night." C. "The medication may make you feel tired." D. "Weigh yourself daily and record it."
"Take this medication at night."
A client with chronic pain is taking morphine to help manage symptoms. Which client education is appropriate for the nurse to review with the client at a routine, follow-up visit? A. "The long-term use of opioids can result in a non-productive cough. You may take an over-the -counter cough suppressant to minimize this adverse effect." B. "The concurrent use of central nervous system depressants, including alcohol, can result in profound sedation and respiratory depression. Use of alcohol while taking an opiate should be avoided." C. "The use of morphine is acceptable for use until the third trimester of pregnancy. If you plan to become pregnant, you do not need to discontinue this medication." D. "The combination of opioids with antihistamines may result in severe diarrhea. If you plan to take the two medications together, please consult with your provider prior to starting."
"The concurrent use of central nervous system depressants, including alcohol, can result in profound sedation and respiratory depression. Use of alcohol while taking an opiate should be avoided."
A client is receiving testosterone for replacement therapy. Which statement by the client indicates the client needs additional instruction? A. "I will make sure that I take this medication each day." B. "The medication will not require self-monitoring of my blood pressure." C. "I will need to use protection to prevent sexually transmitted infections." D. "The medication does not need laboratory testing."
"The medication does not need laboratory testing."
The nurse educates a palliative care client about starting an appetite stimulant. Which statement indicates that the client has correctly understood the education? A. "If the medication does not work in a few weeks, I should keep taking it." B. "The medication will help me gain all the weight back that I lost." C. "Appetite stimulants should be avoided, as they can be addicting." D. "The medication is a short-term measure to help me increase my appetite."
"The medication is a short-term measure to help me increase my appetite."
A client presents with chronic renal failure with dialysis. The client's blood pressure (BP) is 180/110 mmHg. The prescriber orders an intravenous line to be placed and administration of sodium nitroprusside. Which statement is included in the instructions to the client the medication? A. "You should feel less pain with this medication." B. "The medication will assist to bring down your blood pressure." C. "Be prepared to feel more relaxed and have a sense of relief." D. "The medication will decrease your oxygen demand and decrease coronary spasm."
"The medication will assist to bring down your blood pressure."
The nurse sees that a hospice client, who is taking haloperidol, is grimacing an lip smacking. The client's family asks the nurse why this is happening. What is the correct response by the nurse? A. "This is a sign of worsening pain, I will request additional pain medication." B. "This is called tardive dyskinesia. It is a side effect of haloperdol." C. "The dose of haloperidol needs to be increased to treat this," D. "I will contact the health care provider to discuss this finding with you."
"This is called tardive dyskinesia. It is a side effect of haloperdol."
A nurse is caring for a client who has a new prescription for haloperidol. The nurse knows that client teaching has been successful when the client makes which statement? A. "This medication will help improve my desire to be around people." B. "This medication will help me when I have trouble finding words." C. "This medication will help reduce the voices I hear in my head." D. "This medication will help motivate me to get back to work."
"This medication will help reduce the voices I hear in my head."
A nurse is reviewing a client's most recent hemoglobin A1c level of 8.7%. What instruction will the nurse provide to the client based upon this finding? A. "The lab value can be altered significantly since you were not fasting. We should repeat the test in 2 weeks." B. "This result indicates that your diabetes is not well controlled. Your provider may adjust your medication regimen." C. "This test is not a diagnostic measurement of diabetes, rather it is a guide for medication dosing." D. "Your hemoglobin A1c lab value is normal, and no further action needs to be taken."
"This result indicates that your diabetes is not well controlled. Your provider may adjust your medication regimen."
Which client would be an appropriate candidate for treatment using a muscarinic agonist? A. A client with postoperative urinary retention and a past medical history of asthma. B. A client with urinary retention following a total knee replacement. C. A client with urinary retention due to atonic bladder currently being treated for hyperthyroidism. D. A client with urinary retention related to a mass in the urinary tract.
A client with urinary retention following a total knee replacement.
The client is prescribed morphine to be taken postoperatively. Which condition in the client's past medical history might be a contraindication to taking this medication? A. Renal disease B. Emphysema C. Hypertension D. Gout
Emphysema
The nurse is preparing to administer morning medications to four clients. Which client has the greatest risk of medication toxicity? A. A 74 year old client prescribed four medications for hypertension. B. A 52 year old client with renal failure on hemodialysis. C. A 67 year old client receiving three medications that are highly protein bound. D. A 38 year old client with a serum albumin level of 6.2 g/dL.
A 67 year old client receiving three medications that are highly protein bound.
The nurse is making medication rounds. Which client should the nurse prioritize? A. A client who is anxious about a new terminal diagnosis with a respiratory rate of 28. B. A client with a history of emphysema and a respiratory rate of 24. C. A client with bilateral crackles in the lung bases, lower extremity edema, and a respiratory rate of 22. D. A client with diffuse inspiratory and expiratory wheezing, accessory muscle use, and a respiratory rate of 28.
A client with diffuse inspiratory and expiratory wheezing, accessory muscle use, and a respiratory rate of 28.
A nurse is preparing to administer interferon beta-1b to the client with multiple sclerosis. Which nursing intervention is performed prior to the administration of the medicaiton? A. Administer acetaminophen or ibuprofen as prescribed. B. Complete a full set of vital signs. C. Perform a depression survey. D. Assess laboratory values such as complete blood count and liver function tests.
Administer acetaminophen or ibuprofen as prescribed.
A client presents to the emergency department with chest pain. The ECG reveals ST-segment elevation. Vital signs are: BP 142/78 mmHg, pulse 98 beats/minute, respirations 18 breaths/minute, temperature 100.6oF, and oxygen saturation 98%. The nurse should prepare to perform which actions? A. Administer aspirin 325 mg PO B. Prepare to infuse diltiazem IV. C. Administer 2 L oxygen via nasal cannula. D. Obtain blood for laboratory testing. E. Provide the client with 3 tablets of sublingual nitroglycerin immediately.
Administer aspirin 325 mg PO Obtain blood for laboratory testing.
A client with moderate persistent asthma has been taking an oral glucocorticoid for several years. Because of a new diagnosis of renal impairment, the prescriber writes a prescription to discontinue the oral glucocorticoid and start taking inhaled glucocorticoids instead. What is the priority action of the nurse? A. Ensure the client is aware the risk of adrenal suppression will last for 2-3 weeks after stopping the oral glucocorticoid. B. Ask the prescriber to place an order to taper the oral glucocorticoids. C. Monitor the client for signs and symptoms of hypertension, a sign of glucocorticoid withdrawal syndrome. D. Assess the client for hyperglycemia, a sign of glucocorticoid withdrawal syndrome.
Ask the prescriber to place an order to taper the oral glucocorticoids.
The nurse notices that an actively dying client is suddenly agitated, restless, and hallucinating. What is the nurse's priority in this situation? A. Administer pain medications, as pain often causes delirium. B. Assess for reversible causes of delirium. C. Assess for dementia and possible causes. D. Administer ordered neuroleptics immediately to treat delirium.
Assess for reversible causes of delirium.
A client is receiving a medication with a narrow therapeutic index. What is the priority action by the nurse? A. Discuss decreasing the dose of the medication with the prescriber. B. Request an order for a serum medication level immediately. C. Review the client's most recent renal and liver function tests. D. Assess the client for signs and symptoms of medication toxicity.
Assess the client for signs and symptoms of medication toxicity.
Which reported statement by the client is of greatest concern when taking a medication to treat glaucoma? A. "After starting brimonidine, I began experiencing dry mouth." B. "I noticed the color of my eyes is becoming darker brown after starting the latanoprost." C. "I was taking dorzolamide and developed conjunctivitis." D. "I am experiencing sensitivity to light while taking timolol."
C. "I was taking dorzolamide and developed conjunctivitis."
A nurse assesses a client with end-stage chronic obstructive pulmonary disease (COPD) who is having severe dyspnea. Which action(s) should the nurse take? A. Administer high flow oxygen. B. Place client in reverse Trendelenburg position. C. Administer ordered opioids. D. Administer ordered anxiolytics. E. Place the client in high Fowler position.
C. Administer ordered opioids. D. Administer ordered anxiolytics. E. Place the client in high Fowler position.
A nurse is caring for a client that has been admitted for myelosuppression secondary to breast cancer treatment. Which diagnostic indicator does the nurse expect to observe in the client's electronic health record? A. Elevated white blood cell count (WBC) B. Decreased neutrophils C. Low potassium level D. Increased hemoglobin
Decreased neutrophils
A client with a brain tumor must be monitored for problems related to what aspect of medication pharmacokinetics? A. Metabolism B. Distribution C. Excretion D. Absorption
Distribution
A nurse is reviewing a client's electroencephalogram (EEG) report. Which chronic neurologic disorder is the client's history has a diagnostic test of EEGs? A. Epilepsy B. Parkinson disease (PD) C. Alzheimer disease (AD) D. Multiple sclerosis (MS)
Epilepsy
The nurse has administered the prescribed dose of an analgesic medication to a client. When considering the nursing process, what is the nurse's next responsibility to the client? A. Evaluating effectiveness of therapy B. Updating the plan of care as needed C. Assessing vital signs D. Planning non-medication interventions
Evaluating effectiveness of therapy
Which medication(s) would the nurse anticipate administering to a client with hyperkalemia? A. Furosemide B. Magnesium sulfate C. Sodium polystyrene sulfonate D. Regular insulin E. Spironolactone
Furosemide Sodium polystyrene sulfonate Regular insulin
Which laboratory value for a client who has recently been prescribed misoprostol for peptic ulcer disease would require immediate action by the nurse? A. Hemoglobin 10.2 mg/dL B. Serum sodium 133 mEq/dL C. Arterial pH 7.46 D. Hma chorionic gonadotropin 30 mlU/mL
Hma chorionic gonadotropin 30 mlU/mL
A client is admitted to the medical unit and is prescribed allopurinol and ciprofloxacin. Following administration of the medications, the client's temperature is 101.2oF (38.4oC). What is the priority nursing action? A. Document the findings and reassess the client in 30 minutes. B. Hold the allopurinol and notify the provider. C. Request an order for complete blood count (CBC). D. Administer a dose of acetaminophen as ordered
Hold the allopurinol and notify the provider.
A client is prescribed potassium chloride 10 mEq/100mL 0.9% normal saline to be infused over 1 hour. Prior to administration, the nurse notes the client's urine output has been 15 mL/hr for the past 3 hours. What is the priority action by the nurse? A. Administer the medication over 30 minutes. B. Increase oral intake of fluids for the next 2 hours. C. Administer the medication via the oral route. D. Hold the dose and notify the provider.
Hold the dose and notify the provider.
A client has been prescribed diphenhydramine 500 mg for the treatment of a mild allergic reaction. After reviewing a drug reference manual, hte nurse identifies that the dose is incorrect. What is the priority action by the nurse at this time? A. Assess the client for signs of anaphylaxis. B. Hold the medication and notify the prescriber. C. Contact the pharmacist to double-check the dose parameters. D. Administer the recommended dose as listed in the drug reference manual.
Hold the medication and notify the prescriber.
Which instructions does the nurse provide to a client taking an antibiotic for suspected streptococcal pharyngitis to reduce the risk of drug resistance? A. Use an oral probiotic while taking the antibiotic. B. Stop the antibiotic once your symptoms have completely resolved. C. Use the lowest dose antibiotic for the shortest duration possible. D. If your culture results are negative, discontinue the antibiotic.
If your culture results are negative, discontinue the antibiotic.
A client with a history of urinary retention presents to the emergency department with symptoms of excessive salivation, blurred vision, diarrhea, and abdominal cramping. Upon examination, the client's blood pressure is 92/54 mmHg. The nurse recognizes that these symptoms are consistent with which situation? A. Anticholinergic poisoning B. Muscarinic poisoning C. Anaphylactic shock D. First-dose effect
Muscarinic poisoning
After administration of gentamicin, the client reports a headache rated as 3/10, on a 1-10 scale. What is the priority action by the nurse? A. Review the client's trough level. B. Administer the prescribed acetaminophen. C. Administer calcium gluconate "stat". D. Notify the prescriber.
Review the client's trough level.
For which clinical indications would benzodiazepines be prescribed appropriately? A. Long-term management of obsessive-compulsive disorder, seizure disorder, and alcohol use disorder. B. Short -term management of post-traumatic stress disorder, muscle spasms, and tachycardia. C. Long-term management of bipolar mania, psoriasis,and insomnia. D. Short-term management of panic disorder, alcohol withdrawal, and preoperative sedation.
Short-term management of panic disorder, alcohol withdrawal, and preoperative sedation.
A nurse is caring for a client who is receiving cisplatin. Which laboratory value is most concerning to the nurse? A. Potassium level of 4.9 mEq/L B. Magnesium level of 2 mEq/L C. Calcium level of 9.2 mg/dL D. Sodium level of 160 mEq/L
Sodium level of 160 mEq/L
A client prescribed losartan calls the nurse to report muscle weakness and palpitations. What is the priority action by the nurse? A. Instruct the client to hold the medication of the next 48 hours. B. Ask the client to check their blood pressure immediately. C. Suggest that the client replace sodium with salt substitutes. D. Tell the client to report to the emergency department for evaluation.
Tell the client to report to the emergency department for evaluation.
The client is given a new prescription of prazosin and asks about the medication. Which information should the nurse provide the client? A. Clients should be monitored closely for risk of bradycardia. B. Take this medication 1 hour before eating or 2 hours after. C. The first dose of this medication should be small and given before going to bed. D. Prazosin may result in sexual dysfunction.
The first dose of this medication should be small and given before going to bed.
The nurse documents that a client with schizophrenia is experiencing anticholinergic side effects from long-term use of risperidone. Which symptoms has the nurse assessed? A. Urinary retention, infrequent bowel movements, blurred vision B. Hyperglycemia, hypercholesterolemia C. Tachycardia, muscle rigidity, hyperreflexia D. Parkinsonism, dytonia, poverty of speech
Urinary retention, infrequent bowel movements, blurred vision
A 30 year old woman has been diagnosed with rheumatoid arthritis and prescribed methotrexate. Which diagnostic studies does the nurse anticipate obtaining prior to starting the medication? A. Serum uric acid B. Urine pregnancy test C. Serum electrolyte levels D. Creatinine E. Aspartate aminotransferase (AST)
Urine pregnancy test Creatinine Aspartate aminotransferase (AST)
