NURS 3210 Pharmacology Final Exam Quiz Questions

The prescriber has written the following order: Vancomycin 500mg in 250mL IV infused over 90 mins q6h. Calculate the infusion rate for this order. ___ml/hr. (Only enter numerical values. Round to the nearest hundredth.)

166.67

The nurse is preparing to administer a bolus dose of verapamil (Calan) as follows:"Give 5-mg bolus of verapamil, IV push, over 2 minutes. May repeat in 30 minutes if needed." The medication is available in a 2.5-mg/mL strength solution. Identify how many milliliters will the nurse draw into the syringe for this dose. ___ml (Please enter numerical answer only.)

2

The order for a child reads, "Give furosemide (Lasix) 2 mg/kg IV STAT." The child weighs 33 pounds. Identify how many milligrams the child will receive for this dose. _______

30 mg

A preoperative nurse is caring for a client before a scheduled ocular surgery. The health care provider (HCP) has ordered mannitol (Osmitrol), 1.5g/kg IV 1 hour before surgery. The client weighs 110 lbs. How many grams of mannitol (Osmitrol) will this client receive for this dose? _______ g (Numerical value only)

75

A patient in the neurologic intensive care unit is being treated for cerebral edema. Which class of diuretic is used to reduce intracranial pressure? a. Osmotic diuretics b. Thiazide diuretics c. Vasodilators d. Loop diuretics

A. Osmotic diuretics Osmotic diuretics are indicated for the reduction of intracranial pressure and for the treatment of cerebral edema.

A client has a prescription to take guaifenesin. The nurse determines that the client understands the proper administration of this medication if the client states that she or he will perform which action? a. Take the tablet with a full glass of water b. Take an extra dose if fever develops c. Decrease the amount of daily fluid intake d. Take the medication with meals only

A. Take the tablet with a full glass of water Guaifenesin is an expectorant and should be taken with a full glass of water to decrease the viscosity of secretions. Extra doses should not be taken. The client should contact the primary health care provider if the cough lasts longer than one week or is accompanied by fever, rash, sore throat, or persistent headache. Fluids are needed to decrease the viscosity of secretions. The medication does not need to be taken with meals.

A client is receiving instructions regarding the use of caffeine. The nurse shares that caffeine should be used with caution if which of these conditions is present? a. A history of peptic ulcers b. A history of kidney stones c. Migraine headaches d. Asthma

a. A history of peptic ulcers Caffeine should be used with caution by patients who have histories of peptic ulcers or cardiac dysrhythmias or who have recently had myocardial infarctions. The other conditions are not contraindications to the use of caffeine.

A 14-year-old boy is taking tretinoin (Retin-A) for acne. Which statement will the nurse include when. teaching the client about this medication? a. "This drug may cause increased redness of your skin." b. "You should exfoliate your skin every other day when taking this medication." c. "To speed up the healing process get plenty of sunlight." d. "Avoid fast food because it is heavy in salt and saturated fats."

a. "This drug may cause increased redness of your skin." Tretinoin may cause increased redness and drying, and the patient needs to avoid weather extremes, ultraviolet light, and abrasive cleansers. Certain foods (including fast food) do not need to be avoided.

A female client will be starting therapy with oral isotretinoin (Amnesteem) as part of treatment for severe acne, and the nurse is providing teaching. Which teaching point will the nurse include in her teaching plan about isotretinoin? a. "You will have to use two contraceptive methods while on this drug." b. "You will have to avoid pregnancy for 2 weeks after taking this drug." c. "You must avoid sexual activity while on this drug." d. "If you are taking an oral contraceptive, you may take this drug."

a. "You will have to use two contraceptive methods while on this drug." It is now required that at least two contraceptive methods be used by sexually active women during and for 1 month after completion of therapy with isotretinoin. The other statements are incorrect.

Which information should the nurse teach the client who is prescribed fluticasone propionate (Flovent) inhaler? a. Advise the client to gargle after each administration. b. Instruct the client to use the inhaler on a PRN basis. c. Teach the client to check his or her forced expiratory volume daily d. Encourage the client not to use a spacer when using the inhaler.

a. Advise the client to gargle after each administration. Gargling after each administration will help decrease the development of oropharyngeal yeast infections. This medication is intended for preventive therapy, not for aborting an ongoing asthma attack, and they should not be taken on a PRN basis. A spacer, a device that attaches directly to the metered-dose inhaler, should be used because a spacer increases the delivery of the drug to the lungs and decreases deposition of the drug on the oropharyngeal mucosa. Forced expiratory volume is the single most useful test of lung function, but the instrument required is a spirometer, which is expensive, cumbersome, and not suited for home use.

The nurse is reviewing the use of central nervous system stimulants. Which of these are indications for this class of drugs? (Select all that apply.) a. Appetite suppression b. ADHD c. Neonatal apnea d. Narcolepsy e. Panic attacks f. Depression

a. Appetite suppression b. ADHD c. Neonatal apnea d. Narcolepsy Central nervous system stimulants can be used for narcolepsy, neonatal apnea, ADHD, and appetite suppression in the treatment of obesity. They are not used for depression and panic attacks.

While teaching the client about taking a new prescription of oral metronidazole (Flagyl), the nurse should include which of the following most significant elements? a. Avoid intake of alcoholic beverages b. Headache may accompany ingesting the drug c. Drug may cause constipation d. Drug may cause vaginal dryness

a. Avoid intake of alcoholic beverages Ingesting alcoholic beverages with Flagyl can result in exaggerated sympathomimetic signs/symptoms including GI distress.

When developing a written nursing care plan for a client receiving chemotherapy for treatment of cancer, the nurse writes, "Assess each voiding for hematuria." The administration of which type of chemotherapeutic agent would prompt the nurse to add this assessment? a. Cyclophosphamide b. Chlorambucil c. Bleomycin sulfate d. Vincristine

a. Cyclophosphamide Hemorrhagic cystitis is the characteristic adverse reaction of cyclophosphamide.

The health care provider prescribes the H2 antagonist famotidine, 20 mg PO in the morning and at bedtime. Which statement regarding the action of H2 antagonists offers the correct rationale for administering the medication at bedtime? a. Hydrochloric acid secreted during the night is blocked. b. The drug relaxes stomach muscles at night to reduce acid. c. Gastric acid secreted at night is buffered, preventing pepsin formation. d. Ingestion of the medication at night offers a sedative effect, promoting sleep.

a. Hydrochloric acid secreted during the night is blocked. It's a H2 blocker/H2 antagonists act on the parietal cells to inhibit gastric secretion. Some gastric secretion occurs all the time, even when the stomach is empty, unless medications are taken to inhibit this action. It does not relax stomach muscles and it does not offer a sedative effect; these are not actions of famotidine. Buffering gastric acid is the action of antacids. Antacids do not affect healing or prevent the recurrence of ulcers; they merely provide symptomatic relief. Knowing the difference between H2 antagonists and antacids is important when teaching clients.

When a patient is receiving diuretic therapy, which of these assessment measures would best reflect the patient's fluid volume status? a. Intake, output, and daily weight b. Measurements of abdominal girth and calf circumference c. BP and pulse d. Serum potassium and sodium levels

a. Intake, output, and daily weight Intake, output, and daily weights are the best assessment measures to monitor a patient's fluid volume.

A client begins taking an atypical antipsychotic medication. The nurse must provide informed consent and education about common medication side effects. Which client education will be most important? a. Maintain a balanced diet and adequate exercise. b. Report any unusual facial movements. c. Monitor for any changes in sleep pattern. d. Be sure that the diet is adequate in salt intake.

a. Maintain a balanced diet and adequate exercise. Several atypical antipsychotic medications can cause significant weight gain, so the client should be advised to maintain a balanced diet and adequate exercise. Salt intake is important with lithium, a mood stabilizer. The other options are less common than weight gain.

The nurse is assessing a stuporous client in the emergency department who is suspected of overdosing with opioids. Which agent should the nurse prepare to administer if the client becomes comatose? a. Naloxone b. Atropine sulfate c. Flumazenil d. Vitamin K

a. Naloxone Naloxone is an opioid antidote used in opioid overdose to reverse CNS and respiratory depression. Atropine is used for bradycardia, intestinal hypertonicity and hypermotility, muscarinic agonist poisoning, peptic ulcer disease, and biliary colic. Vitamin K is used to manage warfarin overdose and vitamin K deficiency in newborns. Flumazenil reduces the sedative effects of benzodiazepines following general anesthesia or overdose.

A client with metastatic cancer who has been receiving fentanyl for several weeks reports to the nurse that the medication is not effectively controlling the pain. Which action should the nurse initiate? a. Notify the health care provider of the need to increase the dose. b. Administer naloxone per PRN protocol for reversal. c. Monitor the client for symptoms of opioid withdrawal. d. Instruct the client about the indications of opioid dependence.

a. Notify the health care provider of the need to increase the dose. Clients can develop a tolerance to the analgesic effect of opioids and may require an increased dose for effective long-term pain relief. The client is not exhibiting indications of dependence, withdrawal, or toxicity.

The nurse assesses for which most common side effect in a client with tuberculosis taking isoniazid (INH)? a. Paresthesia in limbs b. Non-adherence c. GI disturbances d. Ototoxicity

a. Paresthesia in limbs The most common adverse effect of associated with isoniazid is peripheral neuritis manifested as paresthesia of the extremities.

A woman has been receiving both radiation and chemotherapy for her cancer. Lately, she has developed anorexia caused by the treatments, so she needs short-term nutrition supplementation. The nurse anticipates that the physician will initiate which therapy? a. Peripheral parenteral nutrition b. Oral nutritional supplements with meals c. Central total parenteral nutrition d. Nasogastric enteral supplementation

a. Peripheral parenteral nutrition Patients receiving radiation and chemotherapy often experience anorexia secondary to nausea/vomiting and lack of appetite. Because of this condition the patient needs supplemental nutrition that bypasses the enteral system, so peripheral parenteral nutrition is the optimal intervention.

After being diagnoses with open-cratered gastric ulcer, a 19-year-old female client starts crying and refuses to take the prescribed medication. The nurse should complete which of the following activities at this time. Select all that apply. a. Sit with client to allow her to express her feelings b. Ask client to ingest one dose of misoprostol (Cytotec) c. Teach client about misoprostol (Cytotec) d. Teach client about ranitidine (Zantac) e. Explain risks associated with not treating an open-crater gastric ulcer

a. Sit with client to allow her to express her feelings e. Explain risks associated with not treating an open-crater gastric ulcer Discussion of feelings with another person helps the client manage emotional reactions. The nurse does not know why the client is crying. Although the client is emotionally upset, the nurse is obligated to inform the client of the risks associated with current behavior. Therefore options 2 & 4 are correct, the other options are not.

A patient will be taking oral iron supplements at home. The nurse will include which statements in the teaching plan for this patient? (Select all that apply.) a. Take the iron tablets with meals to reduce GI upset. b. Take the iron tablets on an empty stomach 1 hour before meals. c. Stools may become black and tarry. d. Drink 8 ounces of milk with each iron dose. e. Taking iron supplements with orange juice enhances iron absorption.

a. Take the iron tablets with meals to reduce GI upset. c. Stools may become black and tarry. e. Taking iron supplements with orange juice enhances iron absorption. Iron tablets need to be taken with meals to reduce gastrointestinal distress, but antacids and milk interfere with absorption. Orange juice enhances the absorption of iron. Stools may become black and tarry in patients who are on iron supplements. Tablets need to be taken whole, not crushed, and the patient needs to be encouraged to eat foods high in iron. Iron tablets need to be taken with meals to reduce gastrointestinal distress, but antacids and milk interfere with absorption. Orange juice enhances the absorption of iron. Stools may become black and tarry in patients who are on iron supplements. Tablets need to be taken whole, not crushed, and the patient needs to be encouraged to eat foods high in iron.

The nurse is administering eardrops that contain a combination of an antibiotic and a corticosteroid. What is the rationale for combining these two drugs in eardrops? a. The corticosteroid reduces the inflammation and itching associated with ear infections. b. The combination works to help soften and eliminate cerumen. c. The drops help to eliminate fungal infections. d. The corticosteroid reduces pain associated with ear infections.

a. The corticosteroid reduces the inflammation and itching associated with ear infections. Corticosteroids, such as hydrocortisone, are commonly used in combination with otic antibiotics to reduce the inflammation and itching associated with ear infections. Antibiotics do not eliminate fungal infections. The other options are incorrect.

A patient has been taking lithium for 1 year, and the most recent lithium level is 0.9 mEq/L. Which statement about the laboratory result is correct? a. The lithium level is therapeutic. b. The lithium level is too high. c. Lithium is not usually monitored with blood levels. d. The lithium level is too low.

a. The lithium level is therapeutic. Desirable long-term maintenance lithium levels range between 0.6 and 1.2 mEq/L. The other responses are incorrect.

The nurse is discharging a client diagnosed with chronic obstructive pulmonary disease (COPD). Which discharge instructions should the nurse provide regarding the client's prescription for prednisone? a. The medication should never be abruptly discontinued b. Stop taking the prednisone if a noticeable weight gain occurs c. Take the prednisone on an empty stomach with a full glass of water d. If you miss a dose of the medication, take two tablets the next time

a. The medication should never be abruptly discontinued Prednisone, is not abruptly discontinued because cortisol (a glucocorticoid) is necessary to sustain life and the adrenal glands stop producing cortisol while the client is taking it. The medication must be tapered off to prevent life-threatening complications.

When the nurse teaches a client about the side effects of anticholinergic medication, what signs or symptoms should be included? a. Urinary retention, constipation, or dilated pupils b. Pupillary constriction, bronchoconstriction, or bradycardia c. Inability to obtain an erection, irregular heart rhythm d. Increased salivation, dysphagia, confusion, restlessness

a. Urinary retention, constipation, or dilated pupils Anticholinergic effects include drying of mucous membranes, dilated pupils, and decreased motility of the GI tract.

A nurse is about to administer albuterol (Ventolin HFA) 2 puff and budesonide (Pulmicort) 2 puff by metered dose inhaler. The nurse plans to administer this medication in which of the following ways? a. albuterol first then budesonide b. budesonide inhaler first then inhaler c. alternating with a single puff each, starting with albuterol d. alternating with a single puff each, starting with budesonide

a. albuterol first then budesonide The nurse should administer albuterol first, wait 2-5 minutes (unless otherwise instructed by the health care provider), then administer the budesonide.

The nurse will be giving ophthalmic drugs to a client with glaucoma. The nurse expects the health care provider to order which med intravenously to reduce intraocular pressure when other medications are not successful? a. Mannitol b. Tobramycin c. Bacitracin d. Ketorolac

a. mannitol (Osmitrol) Drugs used to reduce intraocular pressure include osmotic diuretics such as mannitol, which is given intravenously. Tobramycin and bacitracin are antibiotics; ketorolac has anti-inflammatory actions.

Which patient-teaching instructions are appropriate for a patient taking an antidysrhythmic drug? (Select all that apply.) a. "The presence of a capsule in the stool should be reported to the physician immediately." b. "Do not chew or crush extended-release forms of medication." c. "Take the medications with an antacid if gastrointestinal distress occurs." d. "Limit or avoid the use of caffeine." e. "Take the medication with food if gastrointestinal distress occurs."

b. "Do not chew or crush extended-release forms of medication." d. "Limit or avoid the use of caffeine." e. "Take the medication with food if gastrointestinal distress occurs." Appropriate teaching instructions for a patient taking an antidysrhythmic drug include: do not chew or crush extended-release forms; if gastrointestinal distress occurs, take the drug with food; and limit or avoid the use of caffeine. Do not double medication doses or take medications with an antacid. The presence of a portion of a capsule or tablet in the stool is actually the wax matrix that carried the medication, which has been absorbed. The physician does not need to be notified.

Which statement indicates that client teaching regarding the administration of the chemotherapeutic agent daunorubicin has been effective? a. "I should use sunscreen when I spend time outdoors." b. "I expect my urine to be red for the next few days." c. "I will eat high-fiber foods and drink lots of water." d. "I should use an astringent mouthwash after every meal."

b. "I expect my urine to be red for the next few days." Daunorubicin causes the urine to turn red in color. Using astringent mouthwash after every meal is not recommended. Eating high-fiber foods and drinking a lot of water and using sunscreen when outside are interventions that promote general good health but are not specific to treatment with daunorubicin.

A client with gastroesophageal reflux disease (GERD) is taking metoclopramide (Reglan) as prescribed. What client statement tells the nurse that the medication teaching session was effective? a. "This drug will prevent or stop diarrhea from occurring." b. "The purpose of this drug is to increase GI motility." c. "This drug decreases the tone of the lower esophageal sphincter." d. "This drugs kills H. pylori organism that causes peptic ulcer disease."

b. "The purpose of this drug is to increase GI motility." Metoclopramide is a GI stimulant, increasing motility of the GI tract, shortening gastric emptying time, and thus reducing the risk of the esophagus being exposed to gastric contents.

After liquid tetracycline is ordered for a 2-year-old child, the charge nurse provides which most important instruction to the new graduate nurse who is administering the medication? a. "Have the client drink the dose through a straw." b. "Withhold the drug until I telephone the prescriber." c. "Monitor the client for diarrhea." d. "Administer with 8 ounces of milk."

b. "Withhold the drug until I telephone the prescriber." Because of the staining of teeth and potential for irreversible delayed growth, tetracylcine should not be administered to children younger than 8 years. Discoloration of the teeth is not caused by direct contact with the drug but by systemic absorption.

The nurse is preparing to transfuse a patient with a unit of packed red blood cells (PRBCs). Which intravenous solution is correct for use with the PRBC transfusion? a. 5% dextrose in lactated Ringer's solution (D5LR) b. 0.9% sodium chloride (NS) c. 5% dextrose in water (D5W) d. 5% dextrose in 0.45% sodium chloride

b. 0.9% sodium chloride (NS) 0.9% sodium chloride (NS) is the only solution to use when transfusion PRBCs.

The emergency department nurse is concerned a client may develop signs of alcohol withdrawal. What assessments will the nurse include when providing care to this client? (Select all that apply.) a. difficult to arouse b. Anxiety c. Irritability d. Tachycardia e. Tremors f. Hypotension

b. Anxiety c. Irritability d. Tachycardia e. Tremors The client will demonstrate hypertension and hyperalertness. The remaining symptoms are associated with alcohol withdrawal. Additional symptoms include anorexia, anxiety, easily startled, insomnia, jerky movements, and possibility of seizures 7 to 48 hours after consumption of the last drink.

A patient with a history of mild congestive heart failure (CHF) is receiving diltiazem (Cardizem) for hypertension. The nurse should give priority to which assessments? a. Weight loss and euphoria b. Bradycardia & peripheral edema c. Inc ability to perform ADLs d. Tachycardia & rebound HTN

b. Bradycardia & peripheral edema Bradycardia & peripheral edema are both adverse effects of calcium channel blocker treatment.

Which instruction should the nurse include in the teaching plan for a client who is receiving phenytoin for seizure control? a. Return for monthly urinalysis. b. Brush and floss teeth daily. c. Use sunscreen when outdoors. d. Maintain consistent sodium intake.

b. Brush and floss teeth daily. Brushing and flossing the teeth daily prevent gingival hyperplasia (gum disease) that is common with long-term phenytoin therapy.

A client begins therapy with theophylline. The nurse plans to teach the client to limit the intake of which items while taking this medication? a. oysters, lobster, and shrimp b. coffee, cola, and chocolate c. cottage cheese, cream cheese, and dairy creamers d. melons, oranges, and pineapple

b. Coffee, cola, and chocolate Theophylline is a methylxanthine bronchodilator. The nurse teaches the client to limit the intake of xanthine containing foods while taking this medication. These foods include coffee, cola, and chocolate.

The nurse assess a 75-year-old client for side effects of verapamil. Which of the following side effects would be of most concern for this patient? a. Angina b. Constipation c. Skin rash d. HTN

b. Constipation Verapamil is a calcium channel blocker used to treat angina. Constipation is a frequent complaint of patients taking verapamil. Older patients are at higher risk of complications related to constipation.

The nurse is preparing to administer the disease-modifying antirheumatic drug (DMARD) methotrexate to a client diagnosed with rheumatoid arthritis. Which action is most important prior to administering this medication? a. Assess the client's oral mucosa. b. Have another nurse check the prescription. c. Assess the client's liver function test results. d. Monitor the client's intake and output.

b. Have another nurse check the prescription. Double-checking the prescription is an important intervention because death can occur from an overdose. This medication is administered weekly and in low doses for rheumatoid arthritis and should not be confused with administration of the drug as a chemotherapeutic agent. Assessing the client's liver function and monitoring the client's I's & O's are appropriate interventions for those who are receiving this drug, but they are not the most important interventions. Stomatitis is an expected side effect of this medication.

A patient is being treated for ethanol alcohol abuse in a rehabilitation center. The nurse will include which information when teaching him about disulfiram (Antabuse) therapy? a. This drug will cause the same effects as the alcohol did, without the euphoric effects. b. He needs to know about the common over-the-counter substances that contain alcohol. c. He should not smoke cigarettes while on this drug. d. Mouthwashes and cough medicines that contain alcohol are safe because they are used in small amounts.

b. He needs to know about the common over-the-counter substances that contain alcohol. The use of disulfiram (Antabuse) with alcohol-containing over-the-counter products will elicit severe adverse reactions. As little as 7 mL of alcohol may cause symptoms in a sensitive person. Cigarette smoking does not cause problems when taking disulfiram. Disulfiram does not have the same effects as alcohol.

A 38-year-old man has come into the urgent care center with severe hip pain after falling from a ladder at work. He says he has taken several pain pills over the past few hours but cannot remember how many he has taken. He hands the nurse an empty bottle of acetaminophen (Tylenol). The nurse is aware that the most serious toxic effect of acute acetaminophen overdose is which condition? a. Central nervous system depression b. Hepatic necrosis c. Nephropathy d. Tachycardia

b. Hepatic necrosis Hepatic necrosis is the most serious acute toxic effect of an acute overdose of acetaminophen. The other options are incorrect.

The U.S. Food and Drug Administration has issued a warning for users of antiepileptic drugs. Based on this report, the nurse will monitor for which potential problems with this class of drugs? a. Indications of drug addiction and dependency b. Increased risk of suicidal thoughts and behaviors c. Signs of bone marrow depression d. Increased risk of cardiovascular events, such as strokes

b. Increased risk of suicidal thoughts and behaviors The U.S. Food and Drug Administration (FDA) has required black box warnings on all antiepileptic drugs regarding the risk of suicidal thoughts and behaviors. Patients being treated with antiepileptic drugs for any indication need to be monitored for the emergence or worsening of depression, suicidal thoughts or behavior, or any unusual changes in mood or behavior. The other options are incorrect.

A female client is receiving tamoxifen following surgery for breast cancer. She reports to the nurse the onset of hot flashes. Which is the best nursing action? a. Help the client schedule an appointment for evaluation of the need to increase the dose of medication. b. Instruct the client that hot flashes are a side effect that often occurs with the use of this medication. c. Notify the health care provider that the client needs immediate evaluation for medication toxicity. d. Encourage the client to verbalize her feelings and fears about the recurrence of her breast cancer.

b. Instruct the client that hot flashes are a side effect that often occurs with the use of this medication. Tamoxifen is an estrogen receptor blocker used to treat breast carcinoma. Hot flashes are a common side effect. If the hot flashes become bothersome, the client can be instructed in measures to reduce the discomfort.

A patient asks the nurse to explain why she is receiving lidocaine in her IV when her dentist injects it into her gums to numb the teeth before a filling. The nurse includes which information in a response? (Select all that apply). a. Lidocaine acts as a local anesthetic on nerve endings of the cardiac muscles b. Lidocaine regulates electrical activity in the heart c. Lidocaine increases the heart rate d. Lidocaine primarily treats dysrhythmias originating in the ventricles.

b. Lidocaine regulates electrical activity in the heart d. Lidocaine primarily treats dysrhythmias originating in the ventricles. Lidocaine reduced cardiac electrical activity by raising the electrical threshold of cardiac cells. Lidocaine is used to treat ventricular dysrhythmias.

While a patient is receiving antilipemic therapy, the nurse knows to monitor the patient closely for the development of which problem? a. Vitamin C deficiency b. Liver dysfunction c. Neutropenia d. Pulmonary problems

b. Liver dysfunction Antilipemic therapy can be hepatoxic, therefore the nurses needs to closely monitor liver dysfunction.

The nurse assesses the client receiving gentamicin (Garamycin) for which of the following specific toxicities? a. Hepatotoxicity and neurotoxicity b. Nephrotoxicity and ototoxicity c. Allergic reaction with risk of anaphylaxis d. Pseudomembranous colitis and crytalluria

b. Nephrotoxicity and ototoxicity Nephrotoxicity and ototoxicity are the most significant adverse effects related to aminoglycosides, like gentamycin.

The nurse is providing care to a client recently diagnosed with acute lymphocytic leukemia. The health care provider's prescription specifies that ondansetron is to be administered IV 30 minutes prior to the infusion of cisplatin. What is the most important information for the nurse to include in the client's teaching plan? a. Reduction in the risk of an allergic reaction b. Reduction or elimination of nausea and vomiting c. Promotion of diuresis to prevent nephrotoxicity d. Prevention of a secondary hyperuricemia

b. Reduction or elimination of nausea and vomiting Ondansetron is a type 3 receptor (5-HT3) antagonist that is recognized for improved control of acute nausea and vomiting associated with chemotherapy. 5-HT3 antagonists are most effective when administered IV prior to the induction of the chemotherapeutic agent(s). The other options are not therapeutic actions of ondansetron.

The nurse is preparing to give a potassium supplement. Which laboratory test should be checked before the patient receives a dose of potassium? a. Liver function studies b. Serum potassium level c. CBC d. Serum sodium level

b. Serum potassium level The nurse should check the serum potassium level before giving the next dose of potassium.

The nurse is administrating eardrops that have been refrigerated. Which action by the nurse is correct before administering the drops? a. Heat the chilled solution for 10 seconds in the microwave. b. Take the drops out of the refrigerator 1 hour before the dose is due. c. Leave the drops in the refrigerator until use. d. Place the bottle for 60 seconds in a container of very hot water.

b. Take the drops out of the refrigerator 1 hour before the dose is due. Give eardrops at room temperature. If the pharmacy indicates that the drug is to be refrigerated, it should be taken out of the refrigerator up to 1 hour before it is to be instilled so that it can warm up to room temperature. They are not to be placed in the microwave or soaked in hot water; eardrops that are overheated may lose potency. Administration of solutions that are too cold may cause a vestibular reaction that includes vomiting and dizziness. If the solution has been refrigerated, allow it to warm to room temperature.

When assessing clients in the preoperative area, the nurse knows that which client is at a higher risk for an altered response to anesthesia? a. The 40-year-old patient who is to have a kidney stone removed b. The 82-year-old client who is to have gallbladder removal c. The 21-year-old patient who has never had surgery before d. The 35-year-old patient who stopped smoking 8 years ago

b. The 82-year-old client who is to have gallbladder removal The elderly patient is more affected by anesthesia than the young or middle-aged adult patient because of the effects of aging on the hepatic, cardiac, respiratory, and renal systems.

A client has been prescribed to take both a tetracycline and a sulfonamide drug. When providing client teaching, what priority information should the nurse give the client related to adverse drug effects? a. Avoid exposure to upper respiratory infections. b. Use protective measures when exposed to the sun. c. Report signs of jaundice immediately. d. Change position slowly to avoid orthostatic hypotension.

b. Use protective measures when exposed to the sun. Photosensitivity is a side effect of both classes of antibiotics. The client should avoid sun exposure and and tannings beds.

The nurse would include which precaution when teaching a client with liver disease about the use of over-the-counter (OTC) acetaminophen, aspirin, or non-steroidal anti-inflammatory drugs (NSAIDs)? a. "Take your temperature before taking one of these drugs." b. "You should have your cholesterol level measured before using these medications." c. "Consult your health care provider before taking one of these medications." d. "Taper the discontinuance of any of these medications over a 3-day period."

c. "Consult your health care provider before taking one of these medications." A client with liver disease may be at risk for toxicity with acetaminophen, or at increased risk of bleeding if taking aspiring or NSAIDs.

The nurse has just administered the first dose of omalizumab to a client. Which statement by the client alerts the nurse of a life-threatening effect? a. "I am nauseated and may vomit" b. "This medication has minimal side effects and I can return to normal activities" c. "My lips and tongue are swollen" d. "My feet are quite swollen"

c. "My lips and tongue are swollen" Omalizumab is an anti-inflammatory and monoclonal antibody used for long-term control of asthma. Anaphylactic reactions can occur with the administration of omalizumab. The nurse administering the medication should monitor for adverse reactions of the medication. Swelling of the lips and tongue are an indication of anaphylaxis.

A patient has been taking the monoamine oxidase inhibitor (MAOI) phenelzine (Nardil) for 6 months. The patient wants to go to a party and asks the nurse, "Will just one beer be a problem?" Which advice from the nurse is correct? a. "If you begin to experience a throbbing headache, rapid pulse, or nausea, you'll need to stop drinking." b. "You can drink beer as long as you have a designated driver." c. "You need to avoid all foods that contain tyramine, including beer, while taking this medication." d. "Now that you've been on the drug for 6 months, there will be no further dietary restrictions."

c. "You need to avoid all foods that contain tyramine, including beer, while taking this medication." Foods containing tyramine, such as beer and aged cheeses, should be avoided while a patient is taking an MAOI. Drinking beer while taking an MAOI may precipitate a dangerous hypertensive crisis. The other options are incorrect.

After the healthcare provider prescribed naproxen for a client with rheumatoid arthritis, the nurse explains to the client that maximum relief may take up to ___ weeks to occur. a. 1-2 b. 2-3 c. 3-4 d. 1

c. 3-4 Since the joints are inflamed, it will take some time to reduce the inflammation and thereby relieve the pain. The therapeutic effect of naproxen does not occur for 3-4 weeks.

A nurse returning to work after 10 days off is assigned to a client who has received Amphotericin B 0.3 mg/kg/day IV for 5 days. The nurse should review the client's record for which diagnostic findings? a. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) b. Sodium level and serum protein c. Blood urea nitrogen & creatinine d. Number and consistency of stools in the past 24 hours

c. Blood urea nitrogen & creatinine Amphotericin B tends to be nephrotoxic. BUN and creatinine would reveal if renal damage has occurred.

What is the disadvantage of using stimulant laxatives for a prolonged period of time? a. Are all enteric-coated and cause bowel erosion b. Can cause ulcerative colitis c. Can cause dependence d. Cause hyperkalemia

c. Can cause dependence Dependence can occur with excessive or prolonged use of stimulant laxatives, which means that if the drug is stopped, a client is likely to experience constipation. Stimulant laxatives are not all enteric-coated and do not cause bowel erosion or ulcerative colitis. Prolonged use could lead to hypokalemia, not hyperkalemia, as a result of loss of electrolytes and fluids.

The nurse is reviewing antiepileptic drug (AED) therapy. Which statements about AED therapy are accurate? (Select all that apply.) a. A dose may be skipped if the patient is experiencing adverse effects. b. AED therapy can be stopped when seizures are stopped. c. Consistent dosing is the key to controlling seizures. d. AED therapy is usually lifelong. e. Abruptly stopping AEDs may cause rebound seizure activity.

c. Consistent dosing is the key to controlling seizures. d. AED therapy is usually lifelong. e. Abruptly stopping AEDs may cause rebound seizure activity. Clients need to know that AED therapy is usually lifelong, and compliance (with consistent dosing) is important for effective seizure control. Abruptly stopping AED therapy may cause withdrawal (or rebound) seizure activity.

A patient is in the Emergency Department in acute heart failure. Blood pressure is 116/86, pulse is 98. The nurse ensure that which medication is available for immediate use once it is ordered? a. Verapamil b. Propranolol c. Digoxin d. Atropine

c. Digoxin Digoxin increase contractility of the heart, because the primary problem is heart failure which decreased contractility, digoxin is the drug of choice.

A chemotherapeutic regimen with doxorubicin is being planned for a client recently diagnosed with cancer. What diagnostic test results should the nurse review prior to initiating this treatment? a. Pelvic ultrasound b. Arterial blood gases (ABGs) c. Echocardiogram (ECHO) d. Serum cholesterol level

c. Echocardiogram (ECHO) Baseline cardiac function studies are required to monitor the irreversible cardiotoxic effects of doxorubicin HCl.

When hanging an intravenous dose of vancomycin, the nurse administers the drug over 90 minutes to prevent which speed-related adverse drug effect? a. HTN b. Projectile vomiting c. Flushing of the face, neck, and chest d. Pseudomembranous colitis

c. Flushing of the face, neck, and chest "Red man syndrome" is flushing of the face, neck, and chest associated with administering vancomycin IV too rapidly.

A patient has been diagnosed with angina and will be given a prescription for sublingual nitroglycerin tablets. When teaching the patient how to use sublingual nitroglycerin, the nurse will include which instruction? a. Take up tp 5 doses at 15 minute intervals for an angina attack. b. If the tablet does not dissolve quickly, chew the tablet for maximal effect. c. If the chest pain is not relieved after one tablet, call 911 immediately d. Wait 1 minute between doses of sublingual tablets, up to 3 doses

c. If the chest pain is not relieved after one tablet, call 911 immediately According to current guidelines, if the chest pain or discomfort is not relieved in 5 minutes, after 1 dose, the patient (or family member) must call 911 immediately. The patient may take one more tablet while awaiting emergency care and may take a third tablet 5 minutes later, but no more than a total of three tablets. The sublingual dose is placed under the tongue, and the patient needs to avoid swallowing until the tablet has dissolved.

A patient is receiving thrombolytic therapy, and the nurse monitors the patient for adverse effects. What is the most common undesirable effect of thrombolytic therapy? a. Nausea and vomiting b. Dysrhythmias c. Internal and superficial bleeding d. Anaphylactic reactions

c. Internal and superficial bleeding Internal and superficial bleeding is the most common adverse effects of thrombolytic therapy.

While monitoring a patient who had surgery under general anesthesia 2 hours ago, the nurse notes a sudden elevation in body temperature. This finding may be an indication of which problem? a. Malignant hypertension b. Tachyphylaxis c. Malignant hyperthemia d. Postoperative infection

c. Malignant hyperthermia A sudden elevation in body temperature during the postoperative period may indicate the occurrence of malignant hyperthermia, a life-threatening emergency. The elevated temperature does not reflect the other problems listed.

A client asks the nurse why he has to take several chemotherapy agents at the same time. The nurse's response would be based on which principle? a. One medication will interact with another to reduce the incidence of side effects. b. The cost is decreased because the medications are administered at the same time. c. Multiple medications given together will attack the cancer cells at different levels. d. The more medications that can be given together, the shorter the treatment period.

c. Multiple medications given together will attack the cancer cells at different levels. Combination drug therapy is important because different drugs inhibit cancer cell growth at various phases of cellular replication. This makes each of the medications more effective. Medications are given together because this is a more effective method of treatment, not because of cost or to reduce the side effects.

A client with a history of seizure disorder is newly diagnosed with a gastric ulcers. The client has been seizure free since starting phenytoin therapy. The nurse would question a new order for which of the following medications to treat symptoms caused by the ulcer? a. Misoprostol (Cytotec) b. Calcium carbonate (Tums) c. Omeprazole (Prilosec) d. Famotidine (Pepcid)

c. Omeprazole (Prilosec) Omeprazole is a proton pump inhibitor (PPI). PPIs may increase serum levels of phenytoin.

The nurse is preparing to administer a new order for eardrops. Which is a potential contraindication to the use of many otic preparations? a. Staphylococcus aureus otitis externa infection b. Escherichia coli ear infection c. Perforated eardrum d. Ear canal itching

c. Perforated eardrum While some antibiotics can be used when an eardrum is perforated, neomycin, polymyxin B, and hydrocortisone otic preparations are contraindicated in patients with a perforated eardrum. Be sure to clarify whether the drug can be given if a perforated eardrum is present. The other options are potential indications for eardrops.

A patient with elevated lipid levels has a new prescription for nicotinic acid (niacin). The nurse informs the patient that which adverse effects may occur with this medication? a. Myalgia, fatigue b. blurred vision, headaches c. Pruritus, cutaneous flushing d. Tinnitus, odorous urine

c. Pruritus, cutaneous flushing Pruritus and cutaneous flushing are the most common side effects of nicotinic acid (niacin) and should be monitored for by nursing.

A client who has restricted fluid intake is at risk for constipation. The nurse explains that which of the following medications is the least appropriate for this client to use? a. Bisacodyl (Dulcolax) b. Polyethylene glycol (PEG) c. Psyllium (Metamucil) d. Docusate sodium (Colace)

c. Psyllium (Metamucil) Bulk-forming laxatives require adequate hydration to increase the bulk of the stool, thus increasing peristalsis. Taking bulk-forming laxatives without adequate intake could lead to formation of bowel obstruction.

An 80-year-old client who had a colon resection yesterday is receiving a constant dose of hydromorphone via a patient-controlled analgesia (PCA) pump. Which finding requires immediate nursing action? a. Pupils are 3 mm; PERRLA. b. The client is drowsy and complains of pruritus. c. Respirations decrease to 10 breaths/min. d. The area around the sutures is reddened and swollen.

c. Respirations decrease to 10 breaths/min. Hydromorphone is an opioid agonist-analgesic of opiate receptors that inhibits ascending pathways and can cause respiratory depression. Older adults are more sensitive to opioids so the "start low and go slow" approach should be taken. Drowsiness and pruritus are common side effects of opioids, particularly the opiates, which are usually harmless and often transient. Pupils that are 3 mm are within the normal range (2 to 6 cm). The suture site may be red and swollen as an inflammatory response, but no action is required if the skin around the incision is a normal color and temperature.

After a family member reported altered mental status in a client with end-stage liver disease, the health care provided prescribed lactulose (Cephulac) 30 ml PO TID. The home health nurse reviews the client's chart for which laboratory test(s) to monitor medication effectiveness? a. Blood urea nitrogen & creatinine b. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) c. Serum Ammonia levels d. Bilirubin and urobilinogen

c. Serum Ammonia levels Elevated serum ammonia levels are commonly associated with hepatic encephalopathy which presents as altered mental status. Lactulose is a laxative that binds ammonia and makes it easier to excrete via feces. By monitoring serum ammonia levels, the nurse can monitor the effectiveness of the lactulose therapy.

A client had abdominal surgery this morning. The patient is groggy but complaining of severe pain around the incision. What is the most important assessment data to consider before the nurse administers a dose of morphine sulfate to the patient? a. The client's pulse rate b. The appearance of the incision c. The client's respiratory rate d. The date of the client's last bowel movement

c. The client's respiratory rate One of the most serious adverse effects of opioids is respiratory depression. The nurse must assess the patient's respiratory rate before administering an opioid. The other options are incorrect.

During a routine appointment, a client with a history of seizures is found to have a phenytoin (Dilantin) level of 23 mcg/mL. What concern will the nurse have, if any? a. The client's seizures should be under control because this is a therapeutic drug level. b. The client's seizures should be under control if she is also taking a second antiepileptic drug. c. The drug level is at a toxic level, and the dosage needs to be reduced. d. The client is at risk for seizures because the drug level is not at a therapeutic level.

c. The drug level is at a toxic level, and the dosage needs to be reduced. Therapeutic drug levels for phenytoin are usually 10 to 20 mcg/mL (see Table 14-6). The other options are incorrect.

When a patient is taking an anticholinergic such as benztropine (Cogentin) as part of the treatment for Parkinson's disease, the nurse should include which information in the teaching plan? a. Discontinue the medication if adverse effects occur. b. Take the medication on an empty stomach to enhance absorption. c. Use artificial saliva, sugarless gum, or hard candy to counteract dry mouth. d. Minimize the amount of fluid taken while on this drug.

c. Use artificial saliva, sugarless gum, or hard candy to counteract dry mouth. Dry mouth can be managed with artificial saliva through drops or gum, frequent mouth care, forced fluids, and sucking on sugar-free hard candy. Anticholinergics should be taken with or after meals to minimize GI upset and must not be discontinued suddenly. The patient must drink at least 3000 mL/day unless contraindicated. Drinking water is important, even if the patient is not thirsty or in need of hydration, to prevent and manage the adverse effect of constipation.

A child is prescribed phenytoin for epilepsy. The nurse would monitor for a deficiency in which of the following? a. Vitamin C b. Calcium c. Vitamin D d. Vitamin K

c. Vitamin D Many potential drug interactions can occur with phenytoin. It interferes with vitamin D metabolism, can lead to osteomalacia, and interferes with folic acid. Other drugs whose efficacy is impaired by phenytoin include corticosteroids, anticoagulants, digoxin, doxycycline, estrogens, furosemide, oral contraceptives, paroxetine, quinidine, rifampin, and theophylline.

The nurse is reviewing conditions caused by nutrient deficiencies. Conditions such as infantile rickets, tetany, and osteomalacia are caused by a deficiency in which vitamin or mineral? a. Cyanocobalamin (Vitamin B12) b. Vitamin C c. Vitamin D d. Zinc

c. Vitamin D Vitamin D deficiencies can cause infantile rickets, tetany, and osteomalacia.

A client has been receiving chemotherapy for treatment of breast cancer. She is now to start receiving daily injections for filgrastim. The nurse would assess for a therapeutic response to this drug by monitoring which laboratory value test result? a. Serum potassium b. Platelets c. White blood cell count (WBC) d. Blood urea nitrogen (BUN)

c. White blood cell count (WBC) Filgramstim is initiated 24 hours after chemotherapy to help prevent bone marrow suppression. Therefore the WBC is the best indicator that this medication is achieving its intended therapeutic effect.

Which assessment data indicates to the nurse that a dose of granisetron administered IV prior to chemotherapy has had the desired effect? a. client denies diarrhea b. client denies pain c. client denies nausea d. oral mucosa pink and intact

c. client denies nausea Granisetron is an antiemetic administered before chemotherapy to prevent chemotherapy-induced nausea and vomiting. Chemotherapy can cause oral sores, but granisetron does not prevent this problem.

During an infusion of albumin, the nurse monitors the patient closely for the development of which adverse effect? a. transfusion reaction b. dehydration c. fluid volume overload d. hypernatremia

c. fluid volume overload Because of the action of Albumin, the nurse must monitor the patient for fluid overload.

The nurse is caring for a client receiving an albuterol/ipratropium nebulized breathing treatment. Which report from the client should the nurse note as an expected side effect of this combination medication? a. "my eyes have been watering lately" b. "I havent had a bowel movement in 4 days" c. "I feel more bloated than usual" d. "I feel like my heart is racing"

d. "I feel like my heart is racing" Albuterol/ipratropium is a combination agent- one is a beta2- adrenergic agonist and the other is an anticholinergic medication, and in combination they produce an overall bronchodilation effect. Common side and adverse effects include, headache, dizziness, dry mouth, tremors, nervousness, and tachycardia. The other options are not specifically associated with this medication.

That patient states, "I always put my nitroglycerin (NTG) patch in the same place so I do not forget to take it off." What is the best response by the nurse? a. "Change the patch every 24 hours" b. "Massage into skin if ointment comes in contact with your hands" c. "After removing the patch, scrub the area vigorously with soap and water." d. "Rotate the NTG patch to a different hairless area each day"

d. "Rotate the NTG patch to a different hairless area each day" Nitroglycerin patches should be rotated to a different hairless area each day to reduce skin irritation.

A nurse is caring for a client with a second-degree burn of the skin on the right forearm. After an examination in the urgent care center, the health care provider ordered silver sulfadiazine cream (Silvadene) for the burned area. Which of the followings steps will the nurse take when applying this topical medication? a. Applying a thick layer over the burned area, and then leaving the area open b. Massaging the cream completely into the wound c. Gently patting a moderate amount over the burned area d. Applying a thin layer with a sterile, gloved hand to clean and debrided areas

d. Applying a thin layer with a sterile, gloved hand to clean and debrided areas Apply a thin layer of medication with a sterile, gloved hand to clean and debrided wounds. The other options are incorrect.

A client who is allergic to aspirin (ASA), has acute diarrhea. The nurse concludes that which antidiarrheal medication should not be given to this client? a. Loperamide (Imodium) b. Attapulgite (Kaopectate) c. Diphenoxylate with atropine (Lomotil) d. Bismuth subsalicylate (Pepto-Bismol)

d. Bismuth subsalicylate (Pepto-Bismol) Bismuth subsalicylate has a salicylate base and is contraindicated in clients who are allergic to aspirin, also known as acetylsalicylic acid.

A patient has been given a prescription for levodopa-carbidopa (Sinemet) for a new diagnosis of Parkinson's disease. The patient asks the nurse, "Why are there two drugs in this pill?" The nurse's best response reflects which fact? a. Carbidopa is the biologic precursor of dopamine and can penetrate into the central nervous system. b. There are concerns about drug-food interactions with levodopa therapy that do not exist with the combination therapy. c. Carbidopa allows for larger doses of levodopa to be given. d. Carbidopa prevents the breakdown of levodopa in the periphery.

d. Carbidopa prevents the breakdown of levodopa in the periphery. When given in combination with levodopa, carbidopa inhibits the breakdown of levodopa in the periphery and thus allows smaller doses of levodopa to be used. Lesser amounts of levodopa result in fewer unwanted adverse effects. Levodopa, not carbidopa, is the biologic precursor of dopamine and can penetrate into the CNS.

A patient has been placed on a milrinone (Primacor) infusion as part of the therapy for end-stage heart failure. What adverse effect of this drug will the nurse watch for when assessing this patient during the infusion? a. Nausea & vomiting b. HTN c. Hyperkalemia d. Cardiac dysrhythmias

d. Cardiac dysrhythmias The primary adverse effects seen with milrinone are cardiac dysrhythmias, mainly ventricular. It may also cause hypotension, hypokalemia, and other effects, but not nausea and vomiting.

Antineoplastic drugs are dangerous because they affect normal tissue as well as cancer tissue. Normal cells that divide and proliferate rapidly are more at risk. Which of the following areas of the body would be least at risk? a. Lining of the GI tract b. Hair follicles c. Bone marrow d. Connective tissue

d. Connective tissue Connective tissue would be the least affected. Bone marrow, hair follicles, and the lining of the GI tract are the most affected because they divide and proliferate more rapidly than other cells/tissues in the body.

A client who is HIV-positive is receiving epoetin alfa for the management of anemia secondary to zidovudine (AZT) therapy. Which laboratory finding is most important for the nurse to report to the health care provider? a. Serum potassium level of 5 mEq/L b. White blood cell count of 5000 mm3 c. Hemoglobin of 10.8 g/dL d. Hematocrit (HCT) of 58%

d. Hematocrit (HCT) of 58% A hematocrit (HCT) of 58% should be reported to the health care provider immediately because of the likelihood of a hypertensive crisis and because seizure activity increases with an increase in HCT of more than 4 points, or an HCT above 36%. Epoetin alfa stimulates erythropoiesis (production of red blood cells), thereby decreasing the need for blood transfusions. Uncontrolled hypertension can occur if erythropoietin levels are too high.

Zafirlukast is prescribed for a client with bronchial asthma. Which laboratory test does the nurse expect to be prescribed before the administration of this medication? a. Neutrophil count b. CBC c. Platelet count d. Liver function tests

d. Liver function tests Zafirlukast is a leukotriene receptor antagonists used in the prophylaxis and long-term treatment of bronchial asthma. Zafirlukast is used in caution in clients with impaired hepatic function. Liver function laboratory tests should be performed to obtain a baseline, and the levels should be monitored during administration of the medication. It is not necessary to perform the other laboratory tests before administration of the medication.

A nurse is caring for a pediatric client that has honey-crusted lesions around their mouth and nose. Which of the following medications does the nurse anticipate the health care. provider to order to treat this skin infection? a. Acycylovir (Zovirax) b. Nystatin (Mycostatin) c. Spinosad (Natoba) d. Mupirocin (Bactroban)

d. Mupirocin (Bactroban) Mupirocin (Bactroban) is used on the skin for treatment of staphylococcal and streptococcal impetigo. Spinosad (Natroba) is used for pediculosis; nystatin is an antifungal drug; and acyclovir is an antiviral drug.

A 4-year-old child is receiving chemotherapy for acute lymphocytic leukemia. Which laboratory result should the nurse examine to assess the child's risk for infection? a. Lymphocyte count b. Platelet count c. Reticulocyte count d. Neutrophil count

d. Neutrophil count During chemotherapy, granulocytes are significantly suppressed. Because neutrophils comprise 60% to 70% of the granulocyte count, these levels are the most useful laboratory results of the options presented to determine the child's risk for infection. The platelet, reticulocyte, and lymphocyte counts are not as useful as neutrophil counts in determining risk of infection.

The nurse is reviewing the orders for a patient and notes a new order for an angiotensin-converting enzyme (ACE) inhibitor. The nurse checks the current medication orders, knowing that this drug class may have a serious interaction with what other drug class? a. Nitrates b. Diuretics c. Calcium channel blockers d. Nonsteroidal anti-inflammatory drugs

d. Nonsteroidal anti-inflammatory drugs NSAIDs interact negatively with ACE inhibitors and can harm the liver.

A client is experiencing an adverse effect of the gastrointestinal stimulant metoclopramide HCl. Which assessment finding would require immediate intervention by the nurse? a. Dizziness when first getting up b. Inability to see well at night c. An unpleasant metallic taste in the mouth d. Parkinson-like symptoms

d. Parkinson-like symptoms Metoclopramide HCl blocks dopamine receptors in the brain, which can cause the extrapyramidal symptoms associated with Parkinson disease. Reglan has been associated with hypertension, not dizziness when first getting up. A metallic taste in the mouth is often associated with metronidazole, not metoclopramide HCl. An inability to see well at night, and other vision problems, have not been associated with metoclopramide HCl.

A patient has received an overdose of intravenous heparin, and is showing signs of excessive bleeding. Which substance is the antidote for heparin overdose? a. Vitamin K b. Vitamin E c. Potassium chloride d. Protamine sulfate

d. Protamine sulfate Protamine sulfate is the agent that reverses heparin toxicity.

The preoperative nurse is preparing a client for bariatric surgery and is prepping the client's abdominal skin with povidone-iodine (Betadine). Which of the following allergies would be a contraindication to the povidone-iodine (Betadine) skin prep? a. Pet dander b. Avocado c. Latex d. Shellfish

d. Shellfish Povidone-iodine, a widely used antiseptic, cannot be used in patients who are allergic to iodine or have shellfish allergies.

A nurse has an order to administer theophylline PO to a client. The nurse determines that a theophylline level drawn yesterday was 22 mcg/mL. Based on this information, which action should the nurse take first? a. redraw the theophylline level to confirm the level b. start the client on a half-dose of theophylline PO c. the theophylline dose can be administered as planned d. hold the theophylline dose and notify the HCP

d. hold the theophylline dose and notify the HCP The therapeutic range for theophylline is 10 to 20 mcg/mL, so the theophylline dose should be held for fear of causing toxicity. The dose should be held and the HCP should be contacted.

A client is taking calcium carbonate for peptic ulcer disease. Which electrolyte imbalance is the client at risk for? a. hypocalcemia b. hyperkalemia c. hypokalemia d. hypercalcemia

d. hypercalcemia A client taking calcium carbonate is at risk for hypercalcemia.

During administration of theophylline, the nurse should monitor for signs of an adverse reaction. Which symptom(s) would cause the nurse to suspect theophylline toxicity? a. Sedation b. urinary retention c. dry mouth d. nausea and vomiting

d. nausea and vomiting Signs of toxicity are anorexia, nausea, vomiting, insomnia, tachycardia, arrhythmias, and seizures. The other options are common side effects of antihistamines but do not indicate an adverse reaction to theophylline.