pharm 2 coursepoint

A patient newly diagnosed with depression has been prescribed fluoxetine, a selective serotonin reuptake inhibitor (SSRI). Why would the physician order an SSRI for a newly diagnosed patient?

SSRIs usually produce fewer and milder adverse effects than other antidepressants.

A client has been prescribed phenelzine sulfate. When providing teaching, which food should the nurse instruct the client to avoid eating?

Salami

A client reports feelings of gloom and the inability to perform activities of daily living. The normal function of which neurotransmitter is most likely impaired?

Serotonin

A 51-year-old man is being discharged from the hospital following treatment with anticoagulants for a deep vein thrombosis. The nurse will instruct the client to:

consider safety measures to prevent bleeding and be alert for signs of bleeding.

A nursing instructor is describing the effects of CNS stimulants and their potential for addiction due to their euphoric sensations. The instructor determines that the discussion was successful when the students identify which substance as being involved with this pleasurable feeling?

dopamine

The client is 65-years-old and has a diagnosis of cancer. Morphine has been ordered for pain management. Before the administration of morphine, the initial action of the nurse would be to check which?

respiratory rate, depth, and rhythm.

A client newly diagnosed with HIV is receiving client teaching from the clinic nurse about antiretroviral medications. The nurse should teach the client to report what adverse effect to a healthcare provider mostpromptly?

full body rash

The nurse is preparing to administer a scheduled dose of levothyroxine to a client. What assessment should the nurse perform prior to giving the drug?

heart rate

The nurse is assessing a client admitted with AIDS whose current antiretroviral regimen includes a nonnucleoside reverse transcriptase inhibitor. What nursing diagnosis related to drug therapy is most likely to be appropriate for this client?

imbalanced nutrition: less than body requirements, related to gastrointestinal (GI) effects of the drugs

An otherwise healthy surgical client has developed sharply increased muscle tone and rapid increase in heart rate and core body temperature. The operating room team should proceed with assessments and interventions that address what health problem?

malignant hyperthermia

While caring for a client who is receiving antipsychotic therapy, the nurse observes lip smacking, a darting tongue, and slow and aimless arm movements. The nurse interprets this as:

tardive dyskinesia.

The nurse is caring for an older adult client who is prescribed a benzodiazepine. When planning the client's assessment, the nurse should be aware of what possible adverse effect?

unpredictable reactions

A client comes to the health care facility reporting flulike symptoms. After a thorough assessment, the client is diagnosed with influenza and is to receive oseltamivir. The nurse understands that this drug has been prescribed because the client been symptomatic for less than:

2 days.

The nurse at an urgent care clinical is reviewing local anesthetics. What drug should the nurse recognize as an amide?

Lidocaine

Anticonvulsive medications are sometimes used in the treatment of bipolar disorder. What other drug is used to treat bipolar disorder?

Lithium

A nurse is teaching a client about the prescription for acetaminophen to be taken at home. This medication consists of acetaminophen and what other likely drug that enhances the analgesic effect of acetaminophen?

Codeine

A health care provider has recommended that a client undergo thyroid diagnostic testing. During the course of therapy, the client experiences myxedema due to the administration of an inadequate dose. Which symptom should the nurse monitor for in the client?

Cold intolerance

When assessing a client's medication history, the use of which herb would alert the nurse to the potential for adverse reactions when taken with antidepressants?

St. John's wort

A nurse is caring for a client diagnosed with migraine headaches. Which nursing intervention should be implemented during an acute headache?

Administer subcutaneous sumatriptan succinate (Imitrex).

Which would a nurse have readily available should a client who is receiving morphine experience significant respiratory depression?

Naloxone

A client visits the occupational health office of the factory in which he works. He has fallen asleep on the line and has a history of muscle weakness. This instance is not the first time he has fallen asleep on the line. These behaviors support which medical diagnosis?

Narcolepsy

First-dose effect occurs when the client experiences marked hypotension and syncope with sudden loss of consciousness with the first few doses of the sympatholytic. Which intervention might be helpful for the nurse to do to decrease the risk for first-dose effect?

Administer the dose at bedtime

When reviewing the medical record of a client who is to receive dantrolene, which condition would alert the nurse to the need for close monitoring?

The client has respiratory depression from opioid analgesia

The nurse admits a client newly diagnosed with schizophrenia to the inpatient mental health unit. What is the priority reason why the nurse includes the family when collecting the nursing history?

The client may not be able to provide a sufficient history.

The nurse is caring for a client who is receiving morphine via patient-controlled analgesia. In addition to pain assessment, what assessments should the nurse prioritize?

level of consciousness and respiratory rate

A client has just been diagnosed with HIV. When developing the teaching plan, what information would the nurse share with this client related to use of alternative or complementary therapies?

"Alternative therapies have benefits and risks. Are there any types of alternative or complementary therapies that you follow or are there any herbs or supplements that you take?"

A client with impaired liver function secondary to hepatitis C requires a centrally acting skeletal muscle relaxant for temporary pain relief. What medication would put the least metabolic burden on the client's liver?

Baclofen

Which medication would the nurse expect to administer if prescribed to achieve skeletal muscle relaxation?

Baclofen

A patient with atrial fibrillation is receiving warfarin therapy. The patient is also prescribed ezetimibe. The nurse would instruct the patient to watch for:

Blood in urine or stool

The nurse is taking a health history on a 58-year-old client who is taking atorvastatin for high cholesterol. What assessment question should the nurse prioritize related to the safe use of this drug?

"How many alcoholic drinks do you have in a typical day or week?"

An adult client, diagnosed with depression several weeks ago, began taking citalopram 10 days ago. The client has told the nurse of the intent to stop taking the drug, stating, "I don't feel any less depressed than I did before I started taking these pills." How should the nurse best respond to the client's statement?

"I'd encourage you to continue with the drug; it can take several weeks before it improves your mood."

The nurse has provided health education related to the use of alprazolam with a 78-year-old client. What statement best suggests that the client has an accurate understanding of the drug?

"This drug will calm me down at around half an hour after I take it."

The nurse is writing a plan of care for a client receiving an alpha-specific adrenergic agonist. What is the prioritycomponent of the client's plan of care?

Monitor blood pressure and heart rate frequently.

A client is being administered heparin IV and has been started on warfarin. The client asks the nurse why both medications have been prescribed. What is the nurse's most accurate response?

"Warfarin takes 3-5 days to develop anticoagulant effects, and you still need heparin."

The health care provider has ordered 30 mg of Demerol IM for relief of a severe migraine headache. The package insert reads meperidine hydrochloride (Demerol) 50 mg/mL. How many milliliters would the nurse inject?

0.6

A nurse is giving medication instruction to a client who is taking metoprolol (Lopressor). Which statement by the client would indicate that teaching has been effective?

""I should never stop taking this drug abruptly."

What assessment should the nurse make before administering beta-adrenergic blocking agents?

Pulse and blood pressure

Which patient statement indicates the need for additional teaching about propranolol?

"I can stop the drug once my blood pressure is controlled."

The nurse is providing education to a client who has been prescribed an antipsychotic drug. Which statement suggests that the client understands the typical length of medication therapy?

"I may always have to take this medication."

The nurse is preparing a client for discharge who will receive a prescription for a hydroxymethylglutaryl-coenzyme A (HMG-CoA) inhibitor. What statement by the client demonstrates a clear understanding of the teaching provided by the nurse?

"I should plan to take this drug before bedtime, because my body makes lipids mostly at night."

A patient expresses that being diagnosed with narcolepsy has been devastating for him. Which statement by the patient should the nurse focus on initially during the assessment?

"I sometimes wonder if it is worth living a life that has so many restrictions."

A client who is receiving cholestyramine also takes digoxin. The nurse teaches the client about the drug and administration. The client demonstrates understanding of the teaching when stating:

"I will take the digoxin about an hour before the cholestyramine."

What statement by the client indicates that the client understands the nurse's teaching about diuretics?

"I will weigh myself daily and report significant changes."

An older adult client has been using levothyroxine for several years on an outpatient basis. Which client statement should the nurse attribute to the decreased effect of levothyroxine?

"I've been using a lot of antacids lately because of my indigestion."

During a teaching session on the care of the client with diabetes, the nurse should make which statement to explain the differences in insulin?

"Insulins have different onsets and durations of action."

A female client with hyperthyroidism reports nervousness and "racing" heart one week after starting antithyroid medication. How should the nurse respond to the client's report?

"It may take three to four weeks for the effects of this medication to be seen."

A female client asks why it is not legal to have a year's worth of prescription refills for Ritalin, since she has been on it for more than a year. She would also like to have the largest dose possible, so she can use the prescription for 2 months, instead of one. She explains that it is very hard to get off work and come in for appointments. The nurse's best response would be:

"The prescription dose is always started as low as possible and the refills are monitored to prevent abuse."

A nurse is to administer 175 mg of a medication intramuscularly. The label on the multidose vial states that the concentration is 100 mg/mL. What volume of the drug should the nurse administer? (Record your answer using two decimal places.)

1.75

A child is to receive 500 mg of an antibiotic suspension. The label on the bottle reads 250 mg/5 mL. The nurse should administer how much of the suspension in one dose?

10 mL

The nurse is providing discharge teaching for a client who has been prescribed 600 mg of an oral liquid medication. The mother shows the nurse the label of the medication, which reads: 250 mg/mL. The nurse would instruct the mother to give how many milliliters?

2.4 mL

A client is to receive 150 mL of intravenous solution over the next hour using a microdrip delivery system. How much fluid would the client receive in 1 minute?

2.5 mL

A client weighs 110 lb. What is this weight in kilograms?

50 kg

Which patient is at the greatest risk for developing skin breakdown following a procedure that uses a neuromuscular junction (NMJ) blocking agent?

A 73-year-old man with a history of hypertension

When the nurse is engaging in teaching with clients taking anti-psychotic medications and their families, what would be important to include to decrease adverse effects of the medication?

Alcohol should be avoided.

The client has been ordered a nonselective beta-blocking agent called propranolol, PO. Propranolol is used in the treatment of which disorders?

All the above (it won't show me the actual answers)

The nurse is caring for a client who has been prescribed glyburide. Which factor, if identified in the client history, would cause the nurse to inform the health care provider of a contraindication to use?

Allergy to sulfonamides

A client is scheduled to undergo craniofacial surgery, a procedure that will necessitate the use of propofol. The operating room nurse should be aware that alternative medications will be absolutely necessary in order to produce what effect in the client?

Analgesia

A surgical client's balanced anesthesia includes the use of vecuronium. What nursing action should the operating room nurses prioritize?

Assessing and protecting the client's airway

What is one of the registered nurse's primary roles in the administration of general anesthetic?

Assessing the client's status during recovery from anesthetic

A client taking methimazole develops a rash. What is the nurse's best recommendation to treat the rash?

Apply a soothing cream until the rash subsides.

When describing the action of atorvastatin, which would the nurse include?

Blocking the enzyme that is involved in cholesterol synthesis

The nurse should recognize that maraviroc belongs to what category of antiretroviral?

CCR5 antagonists

A client has been admitted to the cardiac unit for heart failure and has been ordered carvedilol (Coreg). The client's blood pressure is 80/50. What should the nurse do?

Call the provider and advise them of the client's blood pressure prior to administering the medication.

Which condition would predispose a client to experience a prolonged action of succinylcholine?

Cirrhosis

The nurse works in a long-term care facility. When administering narcotics to clients, the nurse must monitor for which side effect?

Constipation

Elevated blood lipids are a major risk factor for atherosclerosis and vascular disorders. From where are blood lipids derived?

Diet

The nurse is caring for a client who is taking adefovir to treat hepatitis B. The nurse's most recent assessment reveals that the client's skin and sclerae are visibly jaundiced. What is the nurse's best action? Select all that apply.

Document the finding as expected in a client with hepatitis.

The diabetes nurse educator describes type 1 diabetes with what statement?

Exogenous insulin is required for life.

Blood coagulation results from the activation of one of two pathways: one pathway occurs in tissue, and the other occurs in the vascular system. What are the names of these pathways?

Extrinsic and intrinsic pathways

A client is diagnosed as having an elevated cholesterol level. The nurse is aware that plaque on the inner lumen of arteries begins as what?

Fatty streaks

A client is to receive a narcotic that will be applied transdermally. The nurse identifies this as which agent?

Fentanyl

A nurse is caring for a client receiving warfarin therapy. The nurse instructs the client and family that certain foods must be ingested in moderation because of the possible interference with the effect of the therapy. Which foods must be taken in limited quantity?

Foods rich in vitamin K

What would alert the nurse to suspect that a client is developing ketoacidosis?

Fruity breath odor

The client is currently receiving a continuous IV infusion of heparin. Which procedure should the nurse avoid when possible?

Giving intramuscular injections

A client taking atorvastatin presents to the clinic reporting acute muscle pain not associated with exercise or injury. The nurse asks questions to determine if this client has been taking what contraindicated substance?

Grapefruit juice

A nurse is providing care to a client who has elevated levels of low-density lipoprotein (LDL). A review of the client's history reveals a sedentary lifestyle and a history of being overweight. The nurse understands that this combination of factors places the client at risk for which condition?

Heart disease

Which assessment finding from a patient's history is significant for the nurse to report to the physician before surgery using a neuromuscular junction (NMJ) blocking agent?

Hepatitis

What is the best position for the client after the administration of a bisphosphonate medication?

High Fowler's

A patient is admitted to the emergency room with combativeness, hypertension, tremors, and hallucinations. His friends state he has taken 10 to 20 Adderall tablets. What treatment should the nurse be prepared to administer?

IV mannitol

A female client comes to the clinic for an examination after being on benzphetamine for 6 weeks with a weight loss of 30 pounds. The priority nursing diagnosis for this client would be which?

Imbalanced nutrition

A nurse is caring for a client receiving warfarin drug therapy. The client informs the nurse that he is also taking chamomile, which is an herbal remedy. The nurse would alert the client to which adverse effects?

Increased risk for bleeding

A client with diabetes has started thyroid hormone replacement therapy. The nurse should monitor closely for which effects?

Increased thirst

When administering insulin, what would be most appropriate?

Insert the needle at a 45-degree angle for injection.

The black box warning associated with warfarin concerns its risk of causing what condition?

Major or fatal bleeding

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

Metformin

Which drug would be indicated for the treatment of narcolepsy?

Modafinil

The nurse is preparing a patient for an endoscopic procedure that will use a nondepolarizing neuromuscular junction (NMJ) blocking agent. Which condition in the patient's history will require a change in anesthetic medication?

Myasthenia gravis

A group of students are reviewing information about antiviral agents used to treat influenza and respiratory virus infections. The students demonstrate understanding of the material when they identify which drug as appropriate for treating Avian flu?

Oseltamivir

A client who lives with chronic pain has just learned that she is pregnant. What narcotic analgesic is most appropriate for this client?

Oxycodone

A client is taking warfarin to prevent clot formation related to atrial fibrillation. How are the effects of the warfarin monitored?

PT and INR

An ED nurse is caring for a patient who is receiving furosemide for treatment of pulmonary edema. What will the nurse monitor to observe for adverse effects of the drug?

Potassium levels

An older adult resident of a long-term care facility has been prescribed calcium citrate to address decreasing bone density. The nurse should review the resident's medication administration record knowing that what medication may decrease the effects of calcium?

Prednisone

A male client is receiving heparin by continuous intravenous infusion. The nurse will instruct the client and family members to report what should it occur?

Presence of blood in urine or stools

The nurse is caring for a client who is going home on warfarin. What lab test(s) will the client require to evaluate therapeutic effects of the drug?

Prothrombin time (PT) and international normalized ratio (INR)

Prior to administering morphine sulfate to a client in the postanesthesia recover unit (PACU), what information must the nurse obtain? (Select all that apply.)

Pulse Respirations Blood pressure

What client characteristic may contraindicate the use of tramadol for the treatment of a client's pain following traumatic injuries?

The client has a history of crack cocaine addiction

A client's health care provider is considering the addition of efavirenz to the client's drug regimen for the treatment of recently diagnosed HIV. Which aspects of the client's medical history should prompt the nurse to question the use of this drug?

The client has hepatitis C and a history of heavy alcohol use.

A nurse educating a client and their family about levothyroxine (Synthroid) for the treatment of hypothyroidism should include which information? (Select all that apply.)

Therapy is lifelong. Weigh weekly and report significant changes to the health care provider.

Which client should the nurse expect to receive a lower-than-usual dose of benzodiazepines?

a client with alcoholic liver disease

Atomoxetine has been selected as the primary pharmacologic treatment for a young adult client diagnosed with attention deficit hyperactivity disorder (ADHD). What characteristics make this a good drug of choice for this population of clients? Select all that apply.

a lower potential for abuse is administered orally a low risk for dependency

A presurgical client has reported a history of illicit amphetamine use. The nurse is concerned because of the effect this type of abuse has on what physiological functions? Select all that apply.

central nervous system (CNS) sympathetic nervous system (SNS)

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

insulin glargine

When compared with benzodiazepines, buspirone stands out as unique among antianxiety drugs because of what therapeutic advantage?

lacks muscle relaxant and sedative effects

A client with multiple sclerosis asks the nurse to explain why deep tissue massages do not relieve spasticity. The nurse should explain that spasticity is caused by:

nerve damage in the brain and spinal cord, and it is a permanent condition.

A 72-year-old man is taking Adderall XR for the treatment of narcolepsy. He is currently having problems with not being able to swallow large tablets or capsules. The man also wears dentures, which makes it even more difficult for him to swallow medication. He is in the clinic to talk to the nurse about his problem. The nurse will instruct him to

open the capsule and sprinkle the beads in applesauce.

A 58-year-old male client, diagnosed with diabetes at age 14, reports having pain in both feet and hands. What is this pain most likely a result of?

peripheral neuropathy

A hospital client's current medication administration record specifies oral administration of propylthiouracil (PTU) every 8 hours. What sign or symptom may have originally prompted the care provider to prescribe this drug?

persistent tachycardia

The nurse is caring for an adult client who experienced a seizure 30 minutes before coming into the emergency room, where the client begins to have another. What barbiturate would achieve the fastest therapeutic effect?

phenobarbital

The nurse is caring for a client who is taking insulin. The nurse suspects the client is experiencing hypoglycemia when the client displays what signs?

weakness, sweating, and decreased mentation.

The nurse is caring for a pregnant woman diagnosed with HIV on prenatal drug screening. What medication should the nurse expect to administer to reduce the risk of maternal to fetal transmission of the virus?

zidovudine