Pharm Exam 3 ATI Quiz Bank

A nurse is teaching a client who has dyspepsia about prescribed antacids. Which of the following statements should the nurse include in the teaching? A. "Take antacids 1 hour apart from other medications." B. "Increase your sodium intake to avoid hyponatremia." C. "Avoid combining antacids due to an increased risk of adverse effects." D. "Antacids are taken 3 times daily."

A. "Take antacids 1 hour apart from other medications." The nurse should include in the teaching that antacids increase gastric pH, which causes an interference with the absorption of various medications. To help minimize these interactions, the client should take the antacids at least 1 hour apart from other medications.

A nurse is providing teaching to a parent of a child who has asthma and a new prescription for a cromolyn sodium metered-dose inhaler. Which of the following statements by the parent indicates the need for further teaching? A. I will give my child a dose as soon as wheezing starts. B. My child should rinse out his mouth after using the inhaler. C. My child should exhale completely before placing the inhaler in his mouth. D. If my child has difficulty breathing in the dose, a spacer can be used.

A. I will give my child a dose as soon as wheezing starts.

A nurse is caring for a client with asthma who has been taking an inhaled glucocorticoid and long-acting beta 2 agonist combination dry-powdered inhaler (DPI) for maintenance therapy. The nurse should identify that which of the following is a disadvantage of this medication? A. Restricted dosage flexibility B. Complicated delivery device C. Serious systemic effects D. Limited efficacy over time

A. Restricted dosage flexibility

A nurse is caring for a client who has peptic ulcer disease and reports a headache. Which medication should the nurse plan to administer?

Acetaminophen No NSAIDS like aspirin, naproxen, or ibuprofen

A nurse is monitoring a client who received diphenoxylate-atropine. Which statement made by the client indicates to the nurse that the medication has been effective?

"I have not had a bowel movement today" Diphenoxylate-atropine is an opioid used to treat diarrhea. Adverse effects include morphine-like drowsiness, dry mouth, and asthma-like manifestations.

A nurse is providing teaching to a client who has a prescription for famotidine to treat a gastric ulcer. Which of the following statements should the nurse include in the teaching?

"I should take this medication at bedtime"

A nurse is providing discharge teaching for a client who has GERD. Which of the following statements by the client indicates an understanding of the teaching?

"I will decrease the amount of carbonated beverages I drink"

A nurse is teaching a client about the adverse effects of omeprazole. Which client statements indicates an understanding?

"If I experience severe diarrhea, I will call my doctor." Clients who experience diarrhea while taking PPI's should report this immediately. Omeprazole and other PPI's are associated with a risk of C Diff

A nurse is teaching a client with Peptic ulcer disease about their prescription for bismuth subsalicylate. Which statement should the client make about the drug's action?

"This medication can decrease bacteria in the gastrointestinal tract" Bismuth subsalicylate can assist by eliminating the bacteria H pylori, which can cause PUD.

A nurse is providing teaching to a client with a rx for famotidine to treat a gastric ulcer. What statement should they include in the teaching?

"This medication is less effective for people who smoke." Food doesn't affect the absorption, so famotidine can be take without regard to food intake. Do wait at least 30-60 min post antacids. Dizziness is an AE.

A nurse is reviewing the medical record of a client who has been taking a vitamin D supplement. Which of the following findings from the client's record should the nurse identify as a risk factor for developing vitamin D deficiency? A. Middle-age B. Obesity C. Dark-colored eyes D. Light- pigmented skin

B. Obesity

A nurse is caring for a client who is taking glucocorticoids. The nurse should monitor the client for which of the following adverse effects of the medication? A. Weight Loss B. Peptic Ulcer C. Hyperkalemia D. Diplopia

B. Peptic Ulcer The nurse should monitor this client who is taking glucocorticoids for peptic ulcer disease due to irritation of the gastric mucosa. The nurse should periodically check the client's stool for occult blood and instruct the client to contact the provider if any black or tarry stools occur.

A nurse is administering a client's first dose of sucralfate. Which of the following explanations should the nurse provide about the action of sucralfate? A. Sucralfate decreases gastric acid secretions. B. Sucralfate forms a gel-like substance that protects ulcers. C. Sucralfate inactivates Helicobacter pylori. D. Sucralfate inhibits the production of gastric acid.

B. Sucralfate forms a gel-like substance that protects ulcers.

A nurse is reinforcing teaching with a client who has a new prescription for sertraline. The client asks the nurse if he should continue to take St. John's wort for depression. Which of the following instructions should the nurse give the client? A. take the medication and herbal supplement together. B. stop taking the herbal supplement while taking the medication. C. take the herbal supplement and the medication at least 2 hours apart. D. take an antacid with both the herbal supplement and the medication.

B. stop taking the herbal supplement while taking the medication. Taking the antidepressant sertraline and St. John's wort together puts the client at risk for serotonin syndrome.

A nurse is caring for a client who has osteoporosis and has been taking a vitamin D supplement. The nurse notes that the client reports also taking a multivitamin daily. Which of the following findings should indicate to the nurse that the client might be experiencing vitamin D toxicity? A. hyperkalemia B. hypermagnesemia C. hypercalcemia D. hypernatremia

C. hypercalcemia

A client is about to start taking aluminum hydroxide tablets to reduce gastric acid. Which instructions should you include?

Chew the tablet thoroughly, drink a glass of water after taking, and increase fluid and fiber. Advise eating 6 small meals, can be taken up to 6x/day

A client is about to start taking omeprazole to treat a duodenal ulcer. Which instruction should you include?

Consume adequate amounts of fluids. Take PPIs 1 hour before meals and with plenty of fluids.

A nurse is planning care for a client who took an overdose of acetaminophen. Which of the following laboratory values should the nurse plan to monitor for adverse effects of the overdose? A. hematocrit B. high-density lipoproteins (HDL) C. pancreatic enzymes D. liver enzymes

D. liver enzymes

You're about to administer ondansetron to prevent anesthesia-induced nausea and vomiting. You monitor the client for which adverse effect?

Dizziness ondansetron is a serotonin antagonist, can cause dizziness, lightheadedness and sedation

A nurse is caring for a client who has been taking cimetidine for the treatment of a duodenal ulcer. What manifestation should the nurse report?

Emesis that looks like coffee grounds Coffee-ground emesis is a manifestation of a GI bleed as a result of the duodenal ulcer. Other adverse effects of cimetidine that don't require reporting include myalgia, muscle pain, erectile dysfunction, and gynecomastia.

What is an adverse effect of fludrocortisone?

Hypokalemia due to excess sodium and water retention, resulting in the loss of excessive potassium.

A patient has a new rx for sucralfate for a duodenal ulcer. Which statement indicates an understanding?

I should wait at least 30 min before taking this medicine after I take an antacid. Sucralfate should also be taken 1 hour before meals and at bedtime for optimal effectiveness.

A nurse is providing teaching to a newly licensed nurse about metoclopramide. The nurse should highlight that which of the following conditions is a contraindication?

Intestinal obstruction Metoclopramide, aka Reglan, reduces nausea and vomiting by increasing gastric motility and promoting gastric emptying.

A client is about to start taking sulfasalazine to treat IBD. You instruct the client to report?

Sore throat, fever. Sulfasalazine is an anti-inflammatory that can cause agranulocytosis. Tell patients to avoid crowds, people with communicable infections and report fever, sore throat, or other indications of infection. it doesn't typically cause arthralgia, dry mouth, or diarrhea.

A nurse is teaching a client about the adverse effects of omeprazole. Which of the following client statements indicates an understanding of the teaching? a. "If I experience severe diarrhea, I will call my doctor." b. "Pneumonia is associated with long-term use of this medication." c. "I will need to take this medication with food." d. "I should take vitamin B12 while using this medication."

a. "If I experience severe diarrhea, I will call my doctor." Clients who experience diarrhea while taking omeprazole or other proton pump inhibitors (PPIs) should report this finding to the provider immediately. Omeprazole and other PPIs are associated with a dose-related increase in the risk of infection with Clostridium difficile, which is a bacterium that can cause severe diarrhea.

A nurse is preparing a discharge teaching plan for a 6 year old client who has asthma and several prescription medication using metered dose inhalers (MDIs). Which of the following interventions should the nurse include in the plan? a. Add a spacer to each MDI. b. Instruct the child to inhale more rapidly than usual when using an MDI. c. Request that the provider change the child's medications from inhaled to oral formulation. d. Administer oxygen by facemask along with the MDI.

a. Add a spacer to the MDI

A nurse is planning discharge teaching for a client who has Major Depressive Disorder and a new prescription for Phenelzine. Which of the following foods should the nurse include in the plan as safe for the client to consume while taking Phenelzine? a. Broiled beef steak b. Macaroni and cheese c. Pepperoni pizza d. Smoked salmon

a. Broiled beef steak

A nurse is providing teaching to a group of new parents about medications. The nurse should include that aspirin is contraindicated for children who have a viral infection due to the risk of developing which of the following adverse effects? a. Reye's syndrome b. Visual disturbances c. Diabetes mellitus d. Wilms' tumor

a. Reye's syndrome Aspirin should not be given to children or adolescents who have a viral infection like chickenpox or influenza due to the risk of developing Reye's syndrome.

A nurse is assessing a client who has cystic fibrosis. Which of the following pieces of information indicates a therapeutic response to pancreatic enzyme replacement? a. The client is having 1-2 bowel movements per day b. The client's glucose level is elevated c. The client has experienced weight loss d. The client has abdominal distention

a. The client is having 1-2 bowel movements per day One to two bowel movements per day indicates adequate absorption of food and a therapeutic response to pancreatic enzyme replacement for clients who have cystic fibrosis. Frequent stalling, defined as more the one to two bowel movements per day, indicates inadequate replacement.

A nurse is providing discharge teaching to a client who has been hospitalized for major depressive disorder and has a prescription or Amitriptyline. Which of the following statements by the client indicates an understanding of the teaching? a. "I will take amitriptyline in the morning because I'm likely to have trouble falling asleep if I take it in the evening." b. "I will move slowly when I stand up because amitriptyline can cause my blood pressure to decrease." c. "I can drink a glass of beer or wine with my evening meal because amitriptyline doesn't interact with alcohol." d. "I will avoid foods high in fiber because amitriptyline can cause diarrhea."

b. "I will move slowly when I stand up because amitriptyline can cause my blood pressure to decrease."

A nurse is reviewing the medication history of a client who has mild intermittent asthma. The nurse should anticipate a prescription for which of the following inhalers for the client? a. Ipratropium b. Albuterol sulfate c. Tiotropium d. Budesonide

b. Albuterol sulfate The nurse should anticipate a client who has had mild intermittent asthma to be prescribed albuterol sulfate. Albuterol sulfate is a short-acting beta2-agonist that activates beta2-receptors in the smooth muscle of the lung, allowing the client's airway and lungs to dilate, thereby relieving bronchospasm and allowing the client to breathe.

A nurse is collecting data from a client who is experiencing chest pain. Which of the following medications should the nurse expect to administer to suppress the aggregation of platelets? A. nitroglycerin B. Aspirin C. Morphine D. Metoprolol

b. Aspirin

A nurse is caring for a client who is receiving IV famotidine. Which of the following adverse effects should the nurse report to the provider immediately? a. Nausea b. Bloody stools c. Drowsiness d. Headache

b. Bloody stools When using the urgent vs nonurgent approach to client care, the nurse should determine that the priority finding is bloody stools because adverse effects of treatment with famotidine might include dyscrasias (e.g. thrombocytopenia), which can lead to bleeding. This finding should be reported to the provider immediately.

A nurse is monitoring a client who has asthma, takes albuterol, and recently stated taking propranolol to treat a cardiovascular disorder. The client reports that the albuterol has been less effective. Which of the following factors should the nurse identify as a possible explanation for this change? a. Potentiative interaction b. Detrimental inhibitory interaction c. Increased adverse reaction d. Toxicity-reducing inhibitory interaction

b. Detrimental inhibitory interaction A detrimental inhibitory interaction can occur with the concurrent use of propranolol and albuterol. When a client takes propranolol and albuterol together, propranolol can interfere with albuterol's therapeutic effects.

A nurse is assessing a client who has oral Theophylline for relief of chronic bronchitis. The nurse should recognize that which of the following findings indicates toxicity to Theophylline? a. Constipation b. Tremors c. Fatigue d. Bradycardia

b. Tremors Theophylline is a xanthine-derivative bronchodilator. An early manifestation of toxicity is CNS stimulation, often seen as tremors. Seizures can occur if blood levels continue to rise.

A nurse is caring for a client who has bronchitis and a prescription for a mucolytic agent. Which of the following findings should the nurse identify as an adverse effect of this type of medication? a. fluid overload b. bronchospasm c. electrolyte imbalance d. tachycardia

b. bronchospasm Mucolytic agents such as hypertonic saline solution or acetylcysteine can irritate the airways, resulting in bronchospasm while producing a cough and thinning mucous secretions.

A nurse is providing discharge teaching about lithium toxicity to a client who has a new prescription for lithium. Which of the following statements by the client indicates an understanding of the teaching? a. "I should take naproxen if I have a headache because aspirin can cause lithium toxicity." b. "I can develop lithium toxicity if I eat foods with lots of sodium." c. "I can develop lithium toxicity if I experience vomiting or diarrhea." d. "I might need to take a daily diuretic along with my lithium to prevent lithium toxicity."

c. "I can develop lithium toxicity if I experience vomiting or diarrhea."

A nurse is providing teaching to a client who has a prescription for ranitidine to treat a gastric ulcer. Which of the following statements should the nurse include in the teaching? a. "This medication is more effective when taken on an empty stomach." b. "You should take this medication with an antacid for pain control." c. "This medication is less effective for people who smoke." d. "You should expect to experience dizziness when taking this medication."

c. "This medication is less effective for people who smoke." The nurse should explain that smoking interferes with the effectiveness of ranitidine. If a client taking ranitidine smokes, the nurse should encourage the client to quit smoking or to avoid smoking after the last dose of the day.

A nurse is providing discharge teaching to a client who had a bleeding duodenal ulcer and is prescribed Omeprazole. Which of the following statements should the nurse include in the teaching? a. "You will need to take this medication for the next 6 months." b. "Taking this medication will decrease your risk for acquiring pneumonia." c. "You should take this medication before breakfast every day." d. "Watch for the serious adverse effects of tachycardia and heart palpitations while taking this medication."

c. "You should take this medication before breakfast every day." Omeprazole, a protein pump inhibitor used for duodenal ulcer or GERD, should be taking once daily before meals. Food decreases effectiveness. Omeprazole shouldn't be used for longer than 8 weeks because it can cause hypomagensium and fractures.

A nurse is caring for an older adult client who has a new prescription for amitriptyline to treat depression. Which of the following diagnostic tests should the nurse plan to perform prior to starting the client on this medication? a. Hearing examination b. Glucose tolerance test c. Electrocardiogram d. Pulmonary function tests

c. Electrocardiogram Amitriptyline can cause tachycardia and ECG changes. An older adult client is at risk for cardiovascular effects while using amitriptyline; therefore, an ECG should be performed prior to the start of therapy to obtain a baseline of the client's cardiovascular status.

A nurse is teaching the parent of a child who has severe reactive airway disease about glucocorticoid therapy. The parent asks why her child has to inhale the medication instead of taking it orally. Which of the following pieces of information should the nurse provide to the parent? a. Inhaled glucocorticoids are less likely to cause thrush b. Oral glucocorticoids are hazardous during times of stress c. Oral glucocorticoids are more likely to slow linear growth in children d. Inhaled glucocorticoids are more effective for acute bronchospasm

c. Oral glucocorticoids are more likely to slow linear growth in children The chronic use of oral glucocorticoids in high doses by children can result in decreased linear growth. Inhaled glucocorticoids deliver the anti-inflammatory agent directly to the local target area (the client's airways), resulting in a decreased risk for adrenal suppression.

A nurse is preparing a discharge teaching plan for a client who is to being long-term oral prednisone for asthma. Which of the following instructions should the nurse include in the plan? a. Stop taking the medication if a rash occurs. b. Take the medication on an empty stomach to enhance absorption. c. Schedule the medication on alternate days to decrease adverse effects. d. Treat shortness of breath with an extra dose of the medication.

c. Schedule the medication on alternate days to decrease adverse effects.

A nurse is caring for a client who is taking diphenhydramine for allergies. The client reports, "I feel sleep during the day." Which of the following responses should the nurse make? a. "You will find that all antihistamines cause sedation." b. "You should avoid taking the antihistamine with food." c. "The effects of sedation will occur with each dose." d. "You should try antihistamines with non-sedative effects."

d. "You should try antihistamines with non-sedative effects." The nurse should tell the client to try second-generation antihistamines that have no sedative effect, as these are large molecules with low lipid solubility that cannot cross the blood-brain barrier. Diphenhydramine is a first-generation antihistamine and has a common adverse effect of sedation.

A nurse is providing teaching to the parents of a school-age child who has asthma about medications for bronchospasm. Which of the following inhaled medications should the nurse instruct the parents to use to relieve and acute asthma attack? a. Salmeterol b. Cromolyn c. Fluticasone d. Albuterol

d. Albuterol

A nurse is caring for a client who has a dry nonoproductive cough. Which of the following types of medication should the nurse recommend? a. Expectorant b. Mucolytic c. Bronchodilator d. Antitussive

d. Antitussive (dextromethorphan) Antitussives suppress the cough reflex.

A nurse is planning to administer Diphenhydramine 50 mg via IV bolus to a client who is having an allergic reaction. The client has an IV infusion containing a medication that is incompatible with diphenhydramine in solution. Which of the following actions should the nurse take? a. Choose an IV port for IV bolus injection of the diphenhydramine as near as possible to the client's hanging IV bag. b. Flush the IV tubing with 2 mL of 0.9% sodium chloride before and after administering diphenhydramine. c. Allow the IV infusion to keep running while administering the diphenhydramine via IV bolus. d. Aspirate to check for IV patency before administering the diphenhydramine.

d. Aspirate to check for IV patency before administering the diphenhydramine.

A nurse is caring for a client who is taking budesonide to treat Crohn's disease. Which of the following findings should indicate to the nurse that the treatment is effective? a. Decreased blood glucose b. Increased potassium c. Increased prostaglandin synthesis d. Decreased inflammation

d. Decreased inflammation For a client who has Crohn's disease, a decrease in inflammation of the gastrointestinal lining of the client's large intestine is a therapeutic effect of taking budesonide. Budesonide is a glucocorticoid that works by suppressing the immune system. Glucocorticoids inhibit the actions of prostaglandins and leukotrienes.

A nurse is administering oral hydroxyzine to a client. Which of the following adverse effects should the nurse instruct the client to expect? a. Diarrhea b. Anxiety c. Nausea and vomiting d. Dry mouth

d. Dry mouth

A nurse is caring for a client who is experiencing an acute asthma exacerbation. Which of the following medications should the nurse identify as being contraindicated for this client? a. Dextromethorphan b. Montelukast c. Ciprofloxacin d. Propranolol

d. Propranolol The nurse should identify that a client who is experiencing an acute asthma exacerbation requires the use of a beta2-agonits to alleviate bronchospasm and relax the client's airway. Therefore, propranolol is contraindicated for this client. Propranolol is a beta-blocker that is used to treat cardiac conditions, including hypertension. Blocking the beta receptors prevents the action of beta2-agonists such as albuterol.

A nurse administered an antibiotic 10 min ago to a client who is now reporting wheezing and swelling of the eyelids. Which of the following actions should the nurse perform first? A. give oral corticosteroids B. administer dopamine c. give diphenhydramine IV d. administer epinephrine subcutaneously

d. administer epinephrine subcutaneously

A nurse is providing discharge teaching for a client who has a new prescription for medications to treat peptic ulcer disease. the nurse should identify that which of the following medications inhibits gastric acid secretion?

famotidine