Pharm final
The healthcare provider prescribes morphine sulfate 8IM stat. Morphine is available in 10 mg/mL. How many milliliters should the practical nurse administer?
.8 mL
An older client is prescribed gentamycin sulfate. Which question should the practical nurse ask an older client before beginning treatment?
"Are you hard of hearing? "
A client prescribed chemotherapy as the practical nurse in "why is so much of my hair falling out each day?" Which response by the practical nurse best explains the reason for alopecia?
"Chemotherapy affect the cells of the body that grow rapidly, both normal and malignant"
A client diagnosed with angina has been prescribed nitrate isosorbide dinitrate. Which instruction should the practical nurse reinforced in this clients teaching?
"Do you not get up quickly. Always rise slowly "
A client prescribed glipizide asked why they had to take their insulin orally. How should the practical nurse respond?
"Glipizide is not an oral form of insulin and can be used only when somebody's cell function is present"
The nurse is assisting with evaluating the effectiveness of the drug amiodarone. Which client statement best indicates the drug has been effective?
"I do not notice as many irregular heartbeats as before I started taking this medication"
Phenytoin is prescribed for a client who has a seizure disorder. Which statement by the client needs to be clarified by the particle nurse?
"I should take the medicine with anti-acids if gastric upset occurs "
Famotidine 20 mg bid is prescribed for a client for gastroesophageal reflux disease. Which client statement indicates that the practical nurse that teaching was effective regarding use of this medication?
"I will take the famotidine twice a day"
Escitalopram is prescribed for a 16-year-old adolescent client who is clinically depressed. Five days later the parents tell the practical nurse that the drug is not working because their child is not feeling any better. Which explanation should the PN provide?
"It takes 1 to 4 weeks for an antidepressant medications to become effective"
The practical nurse administers to newly prescribed medications, Isosorbide dinitrate (a nitrate) and hydrochlorothiazide (a diuretic), to a client. What instructions should the PN reinforce with the client in regard to these medications?
Instruct the client to slowly rise from sitting or lying down position
The practical nurse interprets the clients PPD as a positive skin test. Which drug is considered the primary prophylaxis for client exposed to active tuberculosis?
Isoniazid
A client with productive cough and fever has been diagnosed with bacterial pneumonia and is being admitted to the unit from the emergency room. Which intervention should the practical nurse ensure that it has been done prior to the administration of anabiotic's?
Sputum specimen
A client has been diagnosed with open angle glaucoma. The healthcare provider prescribes pilocarpine 1% eyedrops. The nurse explains that which action of this drug makes it a useful treatment for the clients condition?
The ciliary muscle contracts increasing the outflow of aqueous humor in the eye
A client is receiving the medication haloperidol. Which client data would indicate to the practical nurse that the medication is therapeutic?
The client has demonstrated a decrease in paranoia behaviors.
A client who is prescribed sildenafil for pulmonary hypertension calls the clinic for advice. Which condition should the practical nurse notify the healthcare provider immediately and instruct the client to stop taking this medication?
The client is experiencing vision and hearing loss
A child has swallowed medication he found his grandmother's purse the grandmother had several tablets of pyridostigmine bromide she has been taking to treat myasthenia gravis. The nurse should observe for which indication of toxicity for this medication?
Bradycardia
A client diagnosed with seizures is prescribed phenytoin. Which medication instruction should the practical nurse reinforced this client?
Brush and floss teeth daily
A 67-year-old client is discharged from the hospital with a prescription for digoxin .25 mg daily which instruction by the practical nurse is correct?
Do not take the medication if the heartbeat is a regular or slow
A client has sub lingual nitroglycerin tablets prescribed to treat angina. The nurse realizes that the client requires further education if the client makes which statements?
1. "I will need to replace the nitroglycerin tablets in a year" 2. "I should stop taking nitroglycerin tablets if I develop a headache" 3. "I am worried I might become addicted to these tablets if I take them often"
A client has been prescribed pre-Gabalin. Which outcomes should the practical nurse anticipate a client to experience?
1. A decrease in joint pain resulting from osteoarthritis 2. Improved range of motion during physical therapy exercises
A client who is in rehabilitation facility with newly diagnosed Parkinson's disease has levodopa carbidopa prescribed. During the care planning session for this client the nurse discusses which aspects with the other members of the healthcare team?
1. Ask the physical therapy assistant to help the client avoid sudden position changes 2. Ask the evening shift nurses to get the last dose earlier in the day if the client has insomnia 3. Ask the nursing assistance to report drowsiness if it interferes with activities or becomes unsafe
The practical nurse prepares to administer ophthalmic drops to a client before cataract surgery. List the steps in order they should be implemented from first step to final step
1. wash hands and apply clean gloves 2. Place the dominant hand on the clients for head 3. Drop prescribed number of drops into the conjunctival sac 4. Ask the client to close the eye gently
The practical nurse administered 15 units of NPH insulin subcutaneously to a client before they consume their breakfast at 7:30 AM. At what time is the client at an increased risk for hypoglycemic reaction?
330 to 7:30 PM
A child is admitted to the emergency department for accidental ingestion of poison. The practical nurse should know that inducing vomiting is recommended for which child?
A 16 month old who drank 2 ounces of acetaminophen elixir
A client diagnosed with essential hypertension is prescribed phenylephrine nasal congestion as needed every four hours. The client is complaining about nasal congestion. Which nursing action should the practical nurse do next?
Hold the medication and consult the charge nurse
A first day post operative client vomits 30 minutes after receiving a dose of Hydromorphone. Which initial intervention is best for the practical nurse to implement?
Administer a PRN dose of ondansetron
A client diagnosed with a herniated disc as prescribed hydrocodone/acetaminophen 10 mg/300 mg PRN every 4 to 6 hours. As the practical nurse enters the clients room to administer their requested medication, the client is seen talking and laughing with his visiting family which action should the PN implement?
Administer analgesia as requested by the client
A client prescribed ephedrine nasal drops .5% PRN complains of having difficulty falling asleep to the nurse. What action should the nurse take to minimize the clients insomnia?
Administer the dose a few hours before bedtime
A client is prescribed phenobarbital 100 mg daily for the treatment of seizures. Which statement made by the client indicates an accurate understanding of the medication phenobarbital?
I will take my medication at 10 PM before retiring to bed
A client who received a prescription for cyclosporine ophthalmic emulsion for dry eyes ask the practical nurse if it is safe to continue using artificial tears. What information should the PN provide?
Allow a 15 minute interval between the administration of cyclosporine and artificial tears
A six month old infant is prescribed digoxin for the treatment of congestive heart failure. Which observation by the practical nurse warrants immediate intervention for signs of digoxin toxicity?
Apical heart rate of 60 bpm
A practical nurse is getting ready to administer digoxin to a client. Which assessment finding would require the nurse to hold the medication?
Apical pulse rate of 50 beats/min
A client who is being discharged to home ask the practical nurse for a dose of hydrocodone before leaving the hospital. How should the practical nurse respond to the clients request?
Ask him to describe the location and severity of the pain and to rate it on a scale from 1 to 10
At 1900 the nurse has received change of shift report regarding a three-year-old child who is hospitalized for observation after swallowing his older sister's dose of phenytoin. During the "recommendation" section of the report the off going nurse states "you'll need to continue monitoring his gait. So far it has been normal. "The nurse is monitoring for which adverse drug affect?
Ataxia
Benztropine is prescribed for a client with Parkinson's disease. After a few days of therapy, the client complains of constipation and abdominal distention. What response by the practical nurse should be most appropriate?
Auscultate for bowel sounds and ask the client when they last had a bowel movement
A client has vancomycin intravenous piggyback's prescribed. Which is the crucial aspect of care for this client?
Besides noting the urine output is less then the intake report increased creatinine levels
A client is prescribed clonidine .1 mg/ 24 hour via transdermal patch. Which client outcome would indicate the medication is effective?
Blood pressure changes from 180/120 to 140/70 mm HG
A client has been prescribed losartan. Which change in data indicates that the practical nurse that they desired effect of this medication has been achieved?
Blood pressure reduced from 160/90 to 130/80 mmHg
A healthcare provider prescribed in anabiotic for a client. Which of the medications listed should be used with caution when given to a client with a penicillin allergy?
Cephalosporin
A client status post hip replacement 24 hours ago who has been prescribed enoxaparin 30 mg IVP bid x 4 doses. Which intervention is most important for the practical nurse to implement?
Clarify the prescription with the RN & health care provider
A 78-year-old client with congestive heart failure receives digoxin .25 mg PO daily. Which observation by the nurse indicates that the medication has been effective?
Clear breath sounds bilaterally
A client diagnosed with a UTI has been prescribed phenazopyridine. Which data would indicate to the practical nurse a therapeutic outcome has been achieved?
Client denies pain when voiding
A female client who started taking an oral sulfonamide for a urinary tract infection the previous day reports to the nurse at the medication is causing slight anorexia. She also states that she continues to experience urinary frequency, so she takes the medication with a glass of cranberry juice and with a snack. What information should the nurse provide?
Continue to drink the cranberry juice but take the medicine on an empty stomach with a full glass of water
Which assessment finding indicates that the expected outcome of ministering donepezil To a client with Alzheimer's disease has been accomplished?
Decreased confusion and improved mood
And adolescent client with a seizure disorder is prescribed the anticonvulsant medication carbamazepine. The nurse should notify the healthcare provider if the client develops which condition?
Develops a sore throat
A client who has been taking lithium carbonate to treat symptoms of the manic phase of bipolar disorder. The nurse is monitoring for which early manifestation of lithium toxicity?
Diarrhea
A client whose seizure disorder has been managed with Phenytoin is admitted to the emergency department with status epilepticus. Which drug should the practical nurse anticipate to be prescribed for administration to treat these seizures?
Diazepam
The nurse is caring for a client who was newly prescribed insulin aspart Seven units subcutaneously prior to each meal. Which nursing intervention has the highest priority when planning the clients care
Ensure that the clients meal will be available within the next 15 minutes before administration of insulin
An immobile client is prescribed dalteparin Subcutaneously and has been receiving the medication for five days. Which finding indicates 30 p.m. should hold the prescribed dose?
Guaiac-positive stool
The healthcare provider has prescribed is 74 your old client to be vaccinated with the influenza vaccine prior to discharge. Which client condition will make the practical nurse not to vaccinate the client and consult with the charge nurse?
History of an allergy to eggs
A 59-year-old client is prescribed furosemide 40 mg twice a day for the management of heart failure. The practical nurse should monitor the client for the development of which complication?
Hypokalemia
A 78-year-old client prescribed furosemide 40 mg PO twice daily is demonstrating EKG changes. Which condition should the practical nurse suspect in causing these changes?
Hypokalemia
The practical nurse is assigned a client on digoxin therapy. Which finding is likely to predispose this client to developing digoxin toxicity?
Hypokalemia
A client who is taking hydrochlorothiazide is admitted to the hospital and is experiencing muscle weakness and cramps. Which condition should the practical nurse suspect is causing these changes?
Hyponatremia
A client with angina pectoris has been prescribed nitroglycerin tablets PRN for chest pain. Which statement by the client causes the practical nurse to clarify instructions for this client?
I should ensure that I chew the pill completely before swallowing it
A client receiving the antibiotic vancomycin is prescribed to have a peek in trough level done with the next dose. What time should the practical nurse obtain the blood specimen for the trough level?
Immediately before the next antibiotic dose is given
The practical nurse administered cyclobenzaprine to a client. Which outcome would indicate a therapeutic response?
Improved range of motion during physical therapy exercises
A client with pulmonary tuberculosis has been taking rifampin for three weeks. The client reports orange urine. What should be the nurses next action?
Inform the client that this is not harmful
The practical nurse administered carbidopa levodopa to a client diagnosed with Parkinson's disease. Which outcome by the client would indicate a therapeutic response?
Lessening of tremors
A client is prescribed an anti-acid for the treatment of a peptic ulcer disease. What is the action of this medication that is effective in treating the clients ulcer?
Maintenance of a gastric pH of 3.5 or above
The healthcare provider recommends the over-the-counter expectorant guaifenesin for a client who has dry nonproductive cough and congested nasal passages. The client reports that they usually have a glass of wine with dinner nightly. Which information should the practical nurse provide to this client?
Notify the HCP if the cough persists longer than seven days
A client has been taking Simba Staten for three days, And phones The nurse at the clinic to report extreme muscle tenderness and pain. Which is the most appropriate action?
Notify the healthcare provider
A client with metastatic breast cancer who has been using morphine patches for several weeks reports to the nurse that the medication is not effectively controlling the pain. Which action should the nurse initiate?
Notify the healthcare provider of the need to increase the dose
A client who is diagnosed with oral thrush calls the clinic saying the medication bottle broke and all the medication was spilled. The client is requesting a refill order. The nurse should contact the healthcare provider about a refill for which medication?
Nystatin
A client diagnosed with a urinary tract infection is prescribed in ampicillin. Which nursing intervention is most important for the practical nurse to do first before administering the clients medication?
Obtain a clean catch urine specimen
A client has metoprolol prescribed. The nurse should reinforce instructions that this medication has which potential adverse effect?
Sexual dysfunction
A client is admitted to a long-term care facility and the nurse and a new employee are conducting medication reconciliation.The nurses note that the oxybutynin has been prescribed. That's a nurse realizes that the new employee understands the drug effect if the new employee explains that this medication is prescribed to treat which condition?
Over active bladder
A client is experiencing adverse effect of gastrointestinal stimulant metoclopramide HCl. Which assessment finding would require immediate intervention by the nurse?
Parkinson like symptoms
A client is receiving heparin to treat a deep vein thrombosis. The nurse should monitor which laboratory result to assist in evaluating the efficacy of the drug
Partial thromboplastin time
The dosing of heparin intravenous infusion is guided by which laboratory value?
Partial thromboplastin time
An 18 month old toddler with a three day history of diarrhea was administered Lopermide by their parent. What intervention is most important for the PN to implement initially?
Question the parent how many wet diapers has the child had in 24 hours
A client diagnosed with a sinus infection is prescribed ampicillin sodium. The practical nurse should instruct the client to notify the healthcare provider immediately if which symptom occurs?
Rash
A client arrives to the emergency department experiencing diabetic ketoacidosis. The healthcare provider prescribes an insulin intravenous drip. The nurse locates which type of insulin for the registered nurse to mix into the intravenous fluids?
Regular
A client who takes Met Forman for diabetes type 2 is taking nothing by mouth for surgery. The practical nurse anticipate which preop prescription for this clients glucose management.
Regular insulin subcutaneously per sliding scale
The practical nurse is reviewing the plan of care for a client who is prescribed glucocorticoid methylprednisolone to treat in activation of chronic obstructive pulmonary disease (COPD). The nurse expect to see which intervention is emphasized in the plan of care?
Remind staff to wash hands before patient care.
A client diagnosed with asthma as prescribed methylprednisolone 40 mg IV daily. Which laboratory test results should the practical nurse closely monitor for increasing values?
Serum glucose
The nurse has administered albuterol as an inhaled medication. The nurse should monitor the client for which possible adverse reaction?
Tachycardia
A 43-year-old female client who has had a thyroidectomy due to Graves' disease is prescribed a thyroid replacement hormone. Which signs and symptoms are associated with thyroid hormone toxicity and should be reported promptly to the healthcare provider?
Tachycardia and chest pain
Daily dose of Alendronate is prescribed for a 54-year-old post menopausal client. Which instruction should the nurse provide to the client regarding taking the prescribe medications?
Take the medication 30 minutes before breakfast and remain in an upright position for 30 minutes after taking the medication
A practical nurse is reviewing teaching with the client and or significant others about the concurrent use of benzotropine and olanzapine To manage psychotic behavior. Which information should the practical nurse reinforce?
The benztropine is used to control the side effects of olanzapine
A client diagnosed with vaginal trichominiasis is prescribed oral metronidazole. What instructions should the practical nurse review with the client while taking this medication?
The clients sexual partner should also be treated
A healthy 68-year-old client asks The practical nurse should they take the pneumococcal vaccine. Which statement should the PN offer to the client that provides the most accurate information about this vaccine?
The immunization is recommended for children younger than two years older and all adults 65 years or older
A client has been using bimatoprost Eye drops for several months. Which change is the nurse most likely to note with this client?
The iris has become browner in color
A client is in do you immediate postoperative period is prescribed morphine the patient controlled analgesia (PCA) pump. Which findings should the PN consider the highest priority in this client?
The rate and depth of the clients respirations
A client undergoing hemodialysis for chronic kidney disease is taking the medication Erythropoietin. The nurse should reinforce instructions to explain which is the reason for this medication to be prescribed?
This drug helps to stimulate production of red blood
The practical nurse is obtaining the medical history of a client starting a new prescription for conjugated estrogens PO daily. which medical condition is not treated by this medication?
Thromboembolic diseases
Phenazopyridine is commonly prescribed for clients with urinary tract infections. Which statement by the practical nurse describes the purpose for the administration of phenazopyridine?
To relieve the painful symptoms caused by the UTI
A client with diagnosis of diabetes and gastroesophageal reflux disease is newly prescribed atenolol for hypertension. Which information should the nurse provide to this client?
To use glucometer frequently throughout the day
The nurse is caring for a client who is taking prednisone to treat rheumatoid arthritis the nurse expects which aspect of care to be emphasized with this client?
Treating infections as soon as they occur
The practical nurse administers lactulose to a client. Which client outcome would indicate a therapeutic response?
Two or three soft stools per day
The nurse will be administering an intramuscular injection of iron to a client who is experiencing a postpartum blood loss and is refusing a blood transfusion citing religious objections. Which action should the nurse take when administering this medication?
Use the Z track method of administration
On the medical unit multiple clients are taking warfarin. The nurse should have which medication readily available in the event it is needed to treat a client who has taken an excessive dose?
Vitamin K
While taking a clients history the practical nurse discovers at the client who takes warfarin daily for a fib has added a Saint johns wort to their daily regimen. What recommendation should the PN provide to this client?
You need to discontinue the use of the herb and consult with your healthcare provider
A client taking long term steroids also has ranitidine Prescribed. The nurse provides which explanation as to why these drugs are given together?
ranitidine reduces the risk of ulcers associated with steroids
