Pharm Final
A patient has been taking combination antiinfective therapy to treat mycobacterium tuberculosis (TB). Which statement requires further instruction? "I will need to have my liver function monitored with blood tests during this time." " I am so glad I only need to take these drugs for a few weeks." "I will need to take these medications for 6 months or more." "I am so glad I have an IUD and use condoms with my partner."
" I am so glad I only need to take these drugs for a few weeks."
The nurse is teaching a community class about antiinfectives. What statement made by a participant indicates the nurse needs to provide additional teaching concerning the use of anti-infectives? "I could develop diarrhea as a result of taking an antibiotic." "Antibiotics are most effective with viral infections." "A bacterial culture will be done before antibiotics are prescribed for me." "I will stop taking the antibiotic as soon as I feel better."
"Antibiotics are most effective with viral infections."
A nurse is assessing the patient's home medication use. After listening to the patient list current prescribed medications, the nurse asks what priority question? "Are any of these medications orphan drugs?" "Do you take any generic medications?" "Are these medications safe to take during pregnancy?" "Do you take any over-the-counter medications?"
"Do you take any over-the-counter medications?"
The nurse is admitting a 12-year-old girl to the acute care facility and notices discolored secondary teeth. The mother says she doesn't know why the teeth are discolored because the child is very good about brushing and flossing and sees the dentist regularly. What question would the nurse ask? "Has she ever received cephalexin?" "Has she ever received gentamicin?" "Has she ever received tetracycline?" "Has she ever received ampicillin?"
"Has she ever received tetracycline?"
The nurse is teaching a client about using sublingual nitroglycerin. Which statement indicates the client understands the teaching? "I will call my healthcare provider if the pain lasts longer than 5 minutes." "I will place my nitroglycerin in a light colored bottle and carry it everywhere." "If I have chest pain, I will put a tablet under my tongue." "I will notify my healthcare provider if I develop headaches from nitroglycerin."
"If I have chest pain, I will put a tablet under my tongue."
A patient calls the clinic to talk to the nurse. The patient states he/she/they saw the physician "last week" and had been prescribed penicillin for a strep throat. Patient states, "I stopped taking them today with just a few pills left because I feel back to normal." What is the nurse's best response? "It is important that continue and take the full prescription. Otherwise your infection could return and be more difficult to treat." "Okay, thank you for letting me know. I will document in your medical record that the treatment was effective." "You will need to come to the clinic and be evaluated by your physician to make sure the infection is really gone." "What you have described is the halo effect of the drug, making you feel better when you are still infected. You'll feel sick again when the drug is out of your system."
"It is important that continue and take the full prescription. Otherwise your infection could return and be more difficult to treat."
The patient in the clinic receives a prescription for an anti-infective to treat a urinary tract infection. The patient asks the nurse, "Would you ask the doctor to give me refills on this prescription? I get a urinary tract infection almost once a year it seems and I'd like to have a refill I can store for the next time so I don't have to come back to the clinic." What is the nurse's priority response? "Sure, I'd be glad to ask. How many refills would you like to have?" "Saving antibiotics for another time and self-diagnosing when antibiotics are needed can lead to resistant organisms that may no longer respond to drugs." "Most medications, if not used, should be discarded after a year so it is better to get a new prescription next year when you need it." "This antibiotic doesn't destroy every pathogen that could cause a urinary tract infection so it is better to get the right antibiotic next time."
"Saving antibiotics for another time and self-diagnosing when antibiotics are needed can lead to resistant organisms that may no longer respond to drugs."
A mother calls the school nurse and states, "My child has chicken pox and the itching is incredible. What can I do?" What would the school nurse respond? "Talk with your pediatrician about using diphenhydramine to relieve the itching." "Talk with your pediatrician about using warm soaks and aspirin to help with itching." "Talk with your pediatrician and see if he/she/they can prescribe an opioid so your child can get some sleep." "Talk with your pediatrician about prescribing some baclofen to help with the itching. "
"Talk with your pediatrician about using diphenhydramine to relieve the itching."
The patient asks what antibiotic was ordered, and when the nurse says cefuroxime, the patient says, "Call my doctor and tell him I want vancomycin because I've been reading about drug-resistant bacteria and I don't want to take any chances." What is the nurse's best response? "I appreciate your concern but your doctor ordered the right medication for you so don't worry about it." "Vancomycin is a powerful drug with many adverse effects and it is reserved for when no other drug will work against the infection." "There are some resistant infections that require vancomycin so you are right to prefer a stronger antibiotic." "You can't believe anything you read on the Internet because most of it is just someone's opinion and not fact."
"Vancomycin is a powerful drug with many adverse effects and it is reserved for when no other drug will work against the infection."
A patient comes to the clinic to talk with the nurse about planned overseas travel where malaria is common. What should the nurse respond? "We can ask the physician to give you some anti-infectives in case you get malaria." "Don't worry, if you get malaria they have some good doctors where you are going." "If you get malaria, you can always be treated on the way home." "We will ask the physician for a prophylactic prescription for you to start taking before and while in country to reduce your susceptibility."
"We will ask the physician for a prophylactic prescription for you to start taking before and while in country to reduce your susceptibility."
The nurse is caring for a patient receiving IV aminoglycosides for an intractable infection in his or her leg. What would it be important for the nurse to monitor this patient for? Serum glucose levels Liver dysfunction 8th cranial nerve dysfunction Visual disturbances
8th cranial nerve dysfunction
The oncology nurse is reviewing a client's lab values listed below. Which medication is indicated based on these lab values? A white blood cell stimulator like filgrastim. A platelet stimulator such as oprelvekin. Erythropoietin to stimulate red blood cells. A white blood cell stimulator such as pegfilgrastim.
A platelet stimulator such as oprelvekin.
A patient with acute respiratory distress is very anxious and is not tolerating his breathing treatments or his oxygen mask. Which intervention may be helpful in reducing his anxiety? Administer albuterol Administer prn glucocorticoid Administer a prn opioid Administer a prn benzodiazepine
Administer a prn benzodiazepine
When administering anti-infectives to patients, the nurse is aware of the risk for what potentially fatal adverse effect? Eighth cranial nerve damage Toxic effects on the kidney Anaphylaxis Gastrointestinal toxicity
Anaphylaxis
A patient asks the nurse how an anti-infective produces a therapeutic effect. What key point will the nurse explain to this patient? Antiinfectives work in a variety of ways to disrupt normal functioning of the bacterial organism. Drugs used to treat infections date back to the 17th century. All anti-infectives work in the same way to destroy organisms. Selective toxicity determines the appropriate drug dosage needed.
Antiinfectives work in a variety of ways to disrupt normal functioning of the bacterial organism.
Why do people over the age of 50 take a daily aspirin? Aspirin promotes healing of cholesterol related plaques and prevents heart failure. Aspirin is an anti-inflammatory and prevents endothelial injury. Aspirin is an antiplatelet aggregator and works to prevent the formation of clots. Aspirin increases the absorption of antioxidant vitamins which enhances immunity.
Aspirin is an antiplatelet aggregator and works to prevent the formation of clots.
The nurse provides discharge teaching for a patient who will receive a prescription for cefdinir. What important information will the nurse provide this patient? Monitor for yellowing of the skin or eyes Genital itching will go away after the drug is discontinued. Avoid alcohol until 72 hours after stopping this medication. Avoid grapefruit juice when taking this medication.
Avoid alcohol until 72 hours after stopping this medication.
A COPD client has the following laboratory values, what information would the nurse teach? No special precautions needed--these are common with COPD. Plan for periods of rest to prevent fatigue. Use a soft toothbrush and an electric razor. Avoid individuals with colds or other infections.
Avoid individuals with colds or other infections.
When preparing to administer medication to a client who has had a stroke, which interventions would be completed? Ask the client to state name and date of birth, obtain medication, open medication, assist patient to take medication with a full glass of water. Check the medication against the order and review with a second nurse to ensure there is not an error, Prepare the medication in a medicine cup and ask the patient date of birth and hospital number, and then administer medication. Check medication against order, assess patient identification, ask patient to state name and date of birth, assess ability to swallow water, open the medication package and administer the medication. Assess the client's ability to swallow, review the medication order, obtain the medication and administer to the patient at the prescribed time.
Check medication against order, assess patient identification, ask patient to state name and date of birth, assess ability to swallow water, open the medication package and administer the medication.
A local bioterrorism medical team is learning about germ warfare. The team is instructed that a fluoroquinolone may be used to prevent an outbreak of anthrax infection. What fluoroquinolone would the nurse be most likely to administer for this purpose? Sparfloxacin (Zagam) Norfloxacin (Noroxin) Gemifloxacin (Factive) Ciprofloxacin (Cipro)
Ciprofloxacin (Cipro)
A 32-year-old female patient is admitted to the floor with a severe bacterial infection to be treated with cefaclor. What would be important for the nurse to educate this patient about? Gastrointestinal effects Anticholinergic effects Contraceptive interaction Sedating effects
Contraceptive interaction
When assessing a patient before starting a drug regimen, which value indicates impaired kidney function? AST 140 ALT 260 BUN 14 Creatinine 3.2
Creatinine 3.2
The nurse is preparing to contact the physician for an antibiotic order for the patient's infection. What information will the nurse be prepared to provide for the physician to choose the proper antibiotic? First day of infection symptoms Culture and sensitivity test results The patient's intake and output for past 2 days Results of complete blood count with differential
Culture and sensitivity test results
What severe adverse reaction would the nurse assess for if an older adult has been receiving trimethoprim/sulfamethoxazole (TMP/SMX) ? Diarrhea Decreased bone marrow functioning Vomiting Decreased gastrointestinal (GI) motility
Decreased bone marrow functioning
The nurse is caring for a patient who is receiving a broad-spectrum anti-infective agents. The nurse would assess the patient for what common adverse effect of broad spectrum anti-infective agents? Decrease in inflammation Destruction of the normal flora Destruction of pathogens Decrease in infection
Destruction of the normal flora
The nurse is preparing to administer the first dose of an aminoglycoside antibiotic to a client diagnosed with pneumonia. Which intervention(s) will the nurse implement first? Obtain a trough level and assess if medication is therapeutic. Teach about the risk for superinfection and secondary infection. Determine culture and sensitivity obtained and evaluate kidney function. Review the CBC report and evaluate liver function.
Determine culture and sensitivity obtained and evaluate kidney function.
The nurse collects the past medical history of a patient new to the clinic. The patient states he or she is allergic to penicillin. What would the nurse question next? (Select all that apply.) What signs and symptoms were displayed with the reaction? What treatment was required to control the allergic reaction? How was the medication administered? Did the reaction occur after one dose? Had you ever taken penicillin before?
Did the reaction occur after one dose? Had you ever taken penicillin before?
Which written order would the nurse question? There are no typographical errors in this question. These medications are not for the same patient. Digoxin .5 mg orally now-give one dose only Lasix 20 mg. IV every 4 hours times 3 Gentamicin 80 mg IV to infuse over 1 hour every 12 hours Acetaminophen 325 mg PO every 4 hours as needed for pain
Digoxin .5 mg orally now-give one dose only
After administering a medication, for what would the nurse assess the patient? Allergies Preexisting conditions Drug effects Pregnancy
Drug effects
The nurse, assisting with Phase I drug studies, is talking with a young woman who asks, "Why can't I participate in this study?" What would be the nurse's best response? Drugs affect women differently than they affect women. Women are more prone to adverse effects from medications. Drugs pose a greater risk to women of reproductive age. Drugs are only tested on men because they are stronger.
Drugs pose a greater risk to women of reproductive age.
A client is prescribed erythropoietin. What patient teaching would be included? Take a vitamin C supplement and avoid being around people. Take hawthorn supplement and increase activity. Eat iron rich foods and increase fluid intake. Take a niacin supplement and rest frequently.
Eat iron rich foods and increase fluid intake.
The nurse is providing patient teaching before discharging a patient home. The patient is taking trimethoprim/sulfamethazole. What would the nurse teach this patient is the best way to prevent crystalluria? Avoid caffeine and alcohol. Spend time in the sun each day to optimize vitamin D levels. Encourage at least 2 liters of fluid intake per day. Eliminate red meat and seafood from the diet.
Encourage at least 2 liters of fluid intake per day.
A client is hospitalized in pelvic traction and strict bed rest. What is the rationale for administering enoxaparin? Enoxaparin will prevent delirium onset in those with risk for Alzheimer's disease. Enoxaparin will delay or prevent the occurrence of a myocardial infarction. Enoxaparin is not expensive and is given to everyone in the hospital. Enoxaparin is given prophylactically to prevent deep vein thrombosis.
Enoxaparin is given prophylactically to prevent deep vein thrombosis.
A client with severe respiratory infection is prescribed a corticosteroid dose pack as well as an antibiotic. What is the purpose of the dose pack for this patient? The dose pack will ensure the patient does not get a secondary infection. Ensures the patient has the full prescription available to take as needed. Ensures the medication is gradually tapered as needed and not abruptly withdrawn. The dose pack will gradually increase the medication dose until it is therapeutic.
Ensures the medication is gradually tapered as needed and not abruptly withdrawn.
The nurse receives an order to administer an unfamiliar medication and obtains a nurse's drug guide published four years earlier. What is the nurse's most prudent action? Find a more recent reference source. Ask the provider to prescribe a different drug. Ask another nurse for drug information. Verify the information in the guide with the pharmacist.
Find a more recent reference source.
In response to the patient's question about how to know whether drugs are safe, the nurse explains that all medications undergo rigorous scientific testing controlled by what organization? Joint Commission on Accreditation of Healthcare Organizations (JCAHO) Food and Drug Administration (FDA) Centers for Disease Control and Prevention (CDC) Drug Enforcement Agency (DEA)
Food and Drug Administration (FDA)
After completing a course on pharmacology for nurses, what will the nurse know? Everything necessary for safe and effective medication administration The drug actions associated with every classification of medication General drug information; the nurse can consult a drug guide for specific drug information. Current pharmacologic therapy; the nurse will not require ongoing education for 5 years.
General drug information; the nurse can consult a drug guide for specific drug information.
When completing the morning assessment, an elderly client complains of ringing in his ears and thinks his "ears are acting up". He is scheduled to receive gentamicin at 0900 via intravenous infusion. What should the nurse do? Administer the dose and document the finding in the nurse's notes. Administer the dose and speak in a louder voice when talking to the patient. Hold the dose and notify the physician immediately. Administer the dose and report this information to the oncoming nurse.
Hold the dose and notify the physician immediately.
The nurse is caring for a patient scheduled for surgery this morning who is not to be given anything orally. The nurse reviews the medication administration record and finds the patient has an important oral medication due. What is the nurse's best action? Give the medication via a different route. Hold the medication and put a note on the front of the chart for the surgeon. Give the medication with a small sip of water. Hold the medication and contact the health care provider.
Hold the medication and contact the health care provider.
A nurse collects a culture sample of infected tissue. What does the result of testing the culture contribute to the patient's care? Pinpoints the exact site of the infection Describes the length of time the patient has experienced infection Identifies the specific organism causing the infection Identifies individualized patient factors contributing to infection
Identifies the specific organism causing the infection
The nurse, writing a care plan for a patient on an aminoglycoside, includes what intervention to reduce the risk of nephrotoxicity? Increase fluids. Decrease activity. Avoid caffeine intake. Increase consumption of fruits and vegetables.
Increase fluids.
The nurse is gathering assessment data from a medication history of a 38-year-old man with four children. What assessment information would be most important in providing care for this patient? The medication history of the patient's mother and/or father The name of the patient's pharmacy The last time the patient was hospitalized Insurance, financial support, and stability for the patient and his family
Insurance, financial support, and stability for the patient and his family
What nutritional supplement may stain teeth in liquid form, may cause nausea, and may cause constipation? calcium Niacin Folate Iron
Iron
A 78-year-old woman, who lives alone and is forgetful, is being seen by her home health nurse. In reviewing the patient's medication, the nurse discovers that the patient is taking Azithromycin (Zithromax) for urethritis. Why would this be a good choice of antibiotics for this patient? It can be given without consideration to drug-drug interactions. The half-life of the drug is 3 to 7 hours. It has very few adverse effects. It is taken only once a day.
It is taken only once a day.
When conducting patient teaching about using antibiotic medications, what is it critical for the nurse to include? Unused antibiotics may be saved for use by family members with the same diagnosis Prescriptions for antibiotics should be readily available so they can be filled as soon as patients suspect they have an infection. Antibiotics should be used quickly to treat colds and other viral infections before the invading organism has a chance to multiply. It is very important to take the full course of an antibiotic as prescribed and not save remaining drugs for future infections.
It is very important to take the full course of an antibiotic as prescribed and not save remaining drugs for future infections.
When discussing cephalosporins with the nursing class, the pharmacology instructor explains: Those who state allergic to penicillin may not take cephalosporins. Later generations of cephalosporins may be safe for those with penicillin allergy All cephalosporins are safe for persons with penicillin allergies. There is no risk of an allergic reaction to a cephalosporin.
Later generations of cephalosporins may be safe for those with penicillin allergy
A pregnant woman presents to the clinic for her first prenatal appointment. Which of her current reported home medications would be of concern? Fluticasone 2 puffs twice daily morning and evening. Calcium 1000 mg daily Multivitamin once daily by mouth Losartan 50 mg once a day by mouth Albuterol 2 puffs every 4 to 6 hours as needed for asthma Acetaminophen 650 mg by mouth when needed for a headache
Losartan 50 mg once a day by mouth
When taking a medication history on a patient why should the nurse ask about the use of complementary or alternative therapies? Natural products may be more effective and the prescribed drug may not be needed. Many drug-alternative therapy interactions can cause serious problems. Patients starting on new drugs are usually not compliant with medical regimens. The cost of the drug and the alternative therapy may be too expensive for the patient to handle.
Many drug-alternative therapy interactions can cause serious problems.
The nurse administers a drug to treat Neisseria gonorrhoeae that works on no other bacteria. How would the nurse describe this drug? Broad spectrum Bactericidal Bacteriostatic Narrow spectrum
Narrow spectrum
A male client diagnosed with COPD is being treated with methylprednisolone. Which of the following symptoms might be a side effect of this medication and its' influence on physiology? Patient complains of urinating frequently and being thirsty. Client complains of thick, rusty colored sputum. Client presents with an oral temperature of 99.6 degrees. Client states he has difficulty initiating a urine stream.
Patient complains of urinating frequently and being thirsty.
A client enters the ED with acute asthma exacerbation. Which assessment data indicate treatment is not yet effective? Pulse oximetry reading of 94% Presence of wheezing and stridor Absence of peripheral clubbing Lung sounds are clear to the bases
Presence of wheezing and stridor
After administering an antibiotic, the nurse assesses the patient for what potentially serious, adverse effect? Pain Hypopnea Constipation Rash
Rash
A client presents to the ED with shortness of breath and dyspnea related to exercise induced asthma. Which position is contraindicated? Left lateral Supine Orthopneic Dorsal recumbent
Supine
An arterial blood gas is drawn and indicates the patient has hypoxemia and respiratory alkalosis. Which oxygen methodology would be most effective for this patient? Venturi mask Rebreather bag with oxygen setup Nasal cannula not to exceed 2 L Oxygen mask not to exceed 2 L
Rebreather bag with oxygen setup
Which is correct when applying a transdermal patch? Remove the previous patch, apply sterile gloves, clean the skin area and apply the new patch. Remove the previous patch, cleanse skin, and apply in a different area. Apply the new patch to a clean, hairless skin area. In 30 minutes, remove the previous patch. Remove the previous patch, apply sterile gloves, and apply the new patch to a dry, hairy area.
Remove the previous patch, cleanse skin, and apply in a different area.
A patient with a gram-negative infection is being treated with an aminoglycoside. What system should the nurse expect to monitor closely while the patient is taking this medication? Renal system Musculoskeletal system Ophthalmic system Respiratory system
Renal System
A client is being discharged with warfarin. Which priority discharge instructions will be included? Avoid all vitamin K rich foods. Use a soft toothbrush. Return for scheduled lab work. Increase the fiber in your diet.
Return for scheduled lab work.
A 70-year-old patient has just received a drug that can cause sedation. What would be the priority nursing diagnosis for this patient? Noncompliance: Cost of the drug Ineffective health maintenance: Need for medication Risk for injury: Related to adverse effects of the drug Deficient knowledge: Unfamiliar with drug therapy
Risk for injury: Related to adverse effects of the drug
The nurse is reviewing the patient's medication orders and finds an order stating "amoxicillin 250 mg every 8 hours." What would the nurse question regarding this order? Frequency of administration Dose Allowance for generic substitution Route
Route
The pharmacology instructor is explaining combination drugs to the nursing class. The instructor tells the students that a combination of anti-infective agents may be used for several reasons. What is one of them? Some drugs are synergistic. Increased likelihood of killing the microorganisms Absorption of drugs increased Requires larger doses of the drugs
Some drugs are synergistic.
Teach a patient about statin therapy.
Statins have been clearly shown to reduce blood cholesterol and prevent atherosclerosis, or heart disease. They work by reducing the liver's production of cholesterol. They block an enzyme called HMG CoA Reductase that the liver uses to make cholesterol.
The clinic nurse is providing health teaching to a male patient who has been prescribed tetracycline. What is a priority teaching point for this patient? Stay out of the sun. Avoid sexual activity. Take an antacid with the drug if nausea occurs. Chew the tablets completely before swallowing. Use two simultaneous methods of pregnancy prevention.
Stay out of the sun.
A parasitic infection is suspected. What type of culture is the nurse likely to collect? Urine Stool Sputum Blood
Stool
The client's laboratory values are as follows: LabControl ValueTherapeuticClient ValuePT12.91.5 to 2 times control 13.4PTT361.5 to 2.5 times control102INR1 Which intervention will the nurse implement first? Stop the heparin infusion. Notify the healthcare provider. Administer Vitamin K. Assess the client for bleeding.
Stop the heparin infusion.
The client diagnosed with tinea unguium (toenail fungus) is receiving patient education. Which would be included? Soak the affect toenail in vinegar solution twice daily and return in one month. Wear nylon socks and use a petroleum based ointment to moisturize the feet. Soak the feet in the prescribed solution daily and return in one year Take the prescribed medication 1 week a month for 3 months and return for follow-up visit.
Take the prescribed medication 1 week a month for 3 months and return for follow-up visit.
A patient is newly diagnosed with obstructive sleep apnea. Which nursing interventions will assist the patient to achieve a healthier lifestyle? Teach to use CPAP whenever he/she/they sleep whether a nap or longer periods. Teach to lose weight, avoid constrictive clothing, and to avoid CNS depressants. Teach to use CPAP equipment, lose weight and become more active. Teach to use the CPAP when tired to facilitate improved sleep and feeling more refreshed.
Teach to use CPAP equipment, lose weight and become more active.
What is the priority reason for the nurse to consider questioning an order for tetracycline in a child younger than 8 years of age? Children younger than 8 years of age cannot take tetracyclines. Liver and kidney function may be damaged when it is given to children under 8 years of age. Tetracyclines can damage developing teeth and bone in children younger than 8 years of age. Weight-bearing joints have been impaired in young animals given the drugs.
Tetracyclines can damage developing teeth and bone in children younger than 8 years of age.
Which medication order will the nurse question? The loop diuretic furosemide to a client with hypertension with a BUN of 10 and a creatinine of 0.9 The anticoagulant warfarin to a client diagnosed with heart failure who has an INR of 3.9 The anticoagulant heparin to a client a non-therapeutic pTT level The central acting alpha agonist clonidine to a client with heart failure and an apical pulse of 68
The anticoagulant warfarin to a client diagnosed with heart failure who has an INR of 3.9
What would the nurse provide when preparing a patient for discharge and home medication self-administration? A sample size package of medication to use until prescription is filled Over-the-counter medications to use to treat potential adverse effects Personal contact information to use if the patient has questions Thorough and complete medication teaching
Thorough and complete medication teaching
A client with COPD presents with cold symptoms and is prescribed amoxicillin clavulanate. What is the purpose of this medication for this patient? To boost the immune system response To prevent a secondary infection To promote health and wellness To treat the cold
To prevent a secondary infection
Why is a beta blocker frequently prescribed status post acute coronary syndrome (formerly known as myocardial infarction)? To reduce lower extremity edema To reduce cardiac remodeling and scar tissue To reduce preload and increase afterload To lower the risk of a deep vein thrombosis
To reduce cardiac remodeling and scar tissue
A student asks the pharmacology instructor if there is a way to increase the benefits and decrease the risks of antibiotic therapy. What would be an appropriate response by the instructor? Maximize antibiotic drug therapy by administering the full dose when the patient has a fever. Use antibiotics cautiously and teach patients to complete the full course of an antibiotic prescription. Taking drugs not prescribed for the particular illness tends to maximize risks and minimize benefits. Never use antibiotics in combination with other prescriptions or in combination with other antibiotics.
Use antibiotics cautiously and teach patients to complete the full course of an antibiotic prescription.
Which information would be included in patient teaching about using a nasal decongestant spray? Spray as needed until you can breathe freely. Alternate decongestant nasal spray with saline nasal spray every 1-2 hours as needed. Use for 3-5 days at most; as it may cause rebound congestion. The nasal spray may be added to a cool mist vaporizer at night to help you sleep.
Use for 3-5 days at most; as it may cause rebound congestion.
A 22-year-old female is diagnosed with mycobacterial tuberculosis. The physician orders rifampin (Rifadin) 600 mg PO daily. What should the nurse question the patient about? Type of exercise she does Use of contact lenses Sun exposure Her diet
Use of contact lenses
When teaching a patient who is taking antihypertensives to be safe and reduce the risk of orthostatic hypotension, what would be important to include? When awakening in the morning, transition slowly from lying to sitting to standing and then to walking. When rising from a chair, sit on the edge and use the arms of the chair to push to a standing position. To reduce the risk of injury, always get help from someone to safely ambulate. When rising from bed, keep your body in good body alignment to prevent impaired circulation and injury.
When awakening in the morning, transition slowly from lying to sitting to standing and then to walking.
Teach a 15 year old newly diagnosed with asthma how to correctly use metered dose inhalers (a corticosteroid and a bronchodilator).
With a bronchodilator you will always shake it well before you use it. Then prime it by pressing down on the inhaler and making sure it is functioning. Then place it 1-2in from your mouth and expel all your air. Take a deep breath in while you press down on the inhaler and hold it for 3-5 seconds. Take as needed when you feel you are having an asthmatic attack. Rinse out mouth after use. The process for corticosteroids is very similar, but make sure to wash these inhalers after EACH USE to prevent infection in the mouth. Also rinse out your mouth after using.
Explain to a 16 year old track and field athlete the purpose of the flow meter, how to use it correctly, and how he should interpret the findings...(green, yellow, red).
You blow three times. If one of them falls far below the others...you blow four times. Then when you are in the yellow zone you need a nebulizer treatment or whatever your rescue is. If you are red...you need to contact your care provider...considered an emergency.
This diuretic is a carbonic anhydrase inhibitor used to treat glaucoma and reduce intra-ocular pressure. Its' trade name is Diamox. What is its' generic name? cholinesterase dicyclomine acetazolamide azithromycin
acetazolamide
a post op patient is receiving opioids for pain. what med is indicated to reduce risk of constipation? mucosal protectant ppi H2 antagonist stool softener
stool softener
a client is admitted is severe hypoglycemia which med is indicated? offering 6 oz of milk administering glucagon IV, IM, or subQ offering 4 oz of prune juice offering 4 oz of diet soda
administering glucagon IV, IM, or subQ
A client is prescribed an antihypertensive and takes the first dose orally. Which of the following reactions would be considered an emergency? eupnea an abdominal rash angioedema nasal congestion
angioedema
A client presents with a heart rate of 47, a potassium level of 3.2, and a serum digoxin level of 3.0. What nursing interventions are indicated? Hint: Ask yourself what are the normals for each of these findings? What do these findings represent? anticipate administering a cardiac glycoside anticipate administering digoxin immune fab anticipate administering a thiazide diuretic anticipate administering a beta blocker
anticipate administering digoxin immune fab
a type 1 diabetic complains of a dry mouth extreme thirst and increased urination. skin feels warm to the touch and the client is flushed. what action will the nurse implement? prepare to monitor vital signs prn anticipate administering intravenous regular insulin perpare to administer 50% glucose solution initiate IV fluid therapy with 3% hypertonic saline
anticipate administering intravenous regular insulin
a nurse is preparing to administer omeprazole to a client. Which intervention should the nurse implement? monitor for signs of angioedema raise the foot of the bed ask the client his name and dob instruct the client to lie down flat after taking the medication
ask the client his name and dob
a patient has a blood glucose of 280 which med would be administered if fastest therapeutic effects were needed? metformin NPH aspart glargine
aspart
which of the following would be unsafe storage of insulin? in my purse with my sliding scale in the trunk of my car in my refrigerator insulin is safe at room temp for 28 days
in the trunk of my car
Which lab value indicates the prescribed HMG-CoA reductase inhibitor is having a therapeutic effect? increased triglycerides increased cholesterol increased high density lipoproteins (HDL) decreased serum aminotransferases
increased high density lipoproteins (HDL)
What is a potential side effect of albuterol? increased myocardial oxygen demand bradycardia dyspnea eupnea
increased myocardial oxygen demand
which medication is contraindicated for children? amoxicillin bismuth salicylate iron vitamin c
bismuth slicylate
a type 1 diabetic receives regular insulin at 0700. which meal will prevent hypoglycemia? breakfast lunch dinner nighttime snack
breakfast
A long term care client is waiting to go to the hospital for surgery in one week. Which medication must be held (and yes...you would notify the healthcare provider) and not administered at this time? osmitrol digoxin nifedipine clopidogrel
clopidogrel
which of the following is a common side effect of an antidiarrheal? homeostasis eupnea bradycardia constipation
constipation
What medication is given to prevent rejection of transplanted organs? cyclosporine ampicillin cefdinir cephalexin
cyclosporine
the nurse administers desmopressin to the patient to treat diabetes insipidus. what assessment finding indicates the desmopressin is producing a therapeutic effect? tachycardia decreased urine output bradycardia increased urine output
decreased urine output
a patient is prescribed 12 units of regular insulin and 34 units of NPH at 0700. what is the explanation for two different types of insulin? different onsets and peak effects will facilitate blood glucose control two insulins together reduces the risk of adverse effects like an allergic reaction two insulins together are better than just one two insulins make it less likely the patient will experience hypoglycemia
different onsets and peak effects will facilitate blood glucose control
an elderly client is newly diagnosed with diverticulosis and is prescribed the bulk laxative psyllium. which question is most important for the nurse to ask? do you have any difficulty swallowing? when was your last bowel movement? do you drink coffee or tea daily? how much water do you usually drink?
do you have any difficulty swallowing?
A severely dehydrated patient in hypovolemic shock with a blood pressure of 84/60 is admitted to the ED. What medication is safest to improve perfusion in this patient? nitroglycerin lisinopril dobutamine labetalol
dobutamine
A patient with 40% total body surface area burns was admitted six hours ago to the hospital and has received fluid resuscitation. His blood pressure remains low and urine output is diminished. Which medication would be most therapeutic in increasing perfusion at this time? dolasetron dobutamine dopamine regitine
dopamine
what should the client do if the pre-exercise blood sugar is less than 100? immediately check urine for ketones eat a balanced carb and protein snack and carry glucose tablets to the gym avoid checking glucose before exercising check during and after only drink 16 oz of glucose electrolyte solution
eat a balanced carb and protein snack and carry glucose tablets to the gym
which lab results indicate an increase in levothyroxine is needed to treat hypothyroidism? reduced TSH, elevated T3 T4 reduced TSH, normal T3 T4 elevated TSH, reduced T3 T4 elevated TSH, T3 T4
elevated TSH, reduced T3 T4
what assessment findings would the nurse expect to see in a patient who overdosed on levothyroxine? somnolence, bradycardia, parasthesias nervousness, tachycardia, tremors buffalo hump, constipation, sodium loss hyperglycemia, hypertension, edema
nervousness, tachycardia, tremors
a type 1 diabetic receives 25 units of humulin N at 1600 which intervention is most important to prevent hypoglycemia? ensure the client eats the evening snack before bed recheck serum glucose by finger stick every 4 hours check the clients serum glucose every 30 min immediately serve the dinner tray and record amount eaten
ensure the client eats the evening snack before bed
the nurse is preparing to administer rapid acting insulin to a client with type 1 diabetes. which intervention will the nurse implement? ensure the client is alert and oriented to person place time and situation ensure the client eats the meal tray at the bedside ensure the client is wearing a medalert bracelet ensure the client does not have signs or symptoms of hyperosmolar hyperglycemia nonketotic come
ensure the client eats the meal tray at the bedside
which of the following is true of type 1 diabetes? if insulin doesnt work, oral glucose agents may be helpful exogenous insulin will be needed on a daily basis for life usually blood glucose can be controlled with diet and exercise and glucose monitoring only children can be diagnose with type 1 diabetes
exogenous insulin will be needed on a daily basis for life
which of the following patients does not need insulin? post surgical patient with a fasting blood glucose of 180 pregnant women with a 3 hour glucose tolerance test of 325 type 1 diabetic with a fasting sugar of 130 gestational diabetic with a gylcosylated hemoglobin of 5.8
gestational diabetic with a gylcosylated hemoglobin of 5.8
what would the nurse anticipate administering to the patient who was admitted in crisis with Addison's disease? antiepileptics lincosamides glucocorticoids aminoglycosides
glucocorticoids
What medication is indicated to treat a deep vein thrombosis and prevent further thrombi from forming? nifedipine heparin atenolol codeine
heparin
a conscious stranger experiences cold clammy sweating confusion lightheadedness and tremors. when rendering first aid what does the nurse initiate treatment for? hyperglycemia orthostatic hypotension hypoglycemia hypertensive crisis
hypoglycemia
A patient has been taking digoxin as prescribed for 6 months. This morning they awakened and were experiencing visual disturbances and feeling sick to their stomach. What may be the cause? hypokalemia and digoxin toxicity heart failure and hypernatremia hyperkalemia and digoxin toxicity heart failure and hyponatremia
hypokalemia and digoxin toxicity
the nurse is caring for a pregnant client who has just been diagnosed with gestational diabetes. which statement indicated the client understands diabetes teaching? getting diabetes during pregnancy means i will be diabetic forever if my blood sugars dont stay in range my baby could be born small and premature i need to exercise and eat right and i may not need to take insulin i am going to need to monitor my glucose my diet and my exercise and may need to control my blood sugar
i am going to need to monitor my glucose my diet and my exercise and may need to control my blood sugar
which of the following patient health history statements indicate a possible reason for late morning hypoglycemia? i like to eat an early lunch with my gf i run 2 miles before work every day i usually eat steel cut oats with blueberries for breakfast i usually take a nap before eating my evening meal
i run 2 miles before work every day
when a pregnant patient receives a diagnosis of gestational diabetes, what med will be prescribed, if needed to control maternal glucose and reduce risk of complications to fetus? insulin acarbose metformin gluburide
insulin
which statement indicates patient understanding of insulins purpose? insulin allows water to enter and exit the cell so the cells dont get too big insulin interacts with ribonucleic acid and informs cells what to do insulin breaks down glucose and prepares it to be excreted by the kidneys insulin is like a key to open the cells permeability to let the glucose in
insulin is like a key to open the cells permeability to let the glucose in
A patient is admitted with metabolic alkalosis due to hyperemesis (excessive vomiting). What medication is most appropriate initially? oral antiemetic intravenous antiemetic an antiemetic is not indicated rectal antiemetic
intravenous antiemetic
how does a hyper osmotic laxative work? it stimulates peristalsis and reduces risk of IBS it pulls cholesterol into the bowel and lubricates stool it slows peristalsis and increases risk of fecal impaction it increases water retention in the bowel and softening of the stool
it increases water retention in the bowel and softening of the stool
A patient comes to the clinic and reports, "I feel like I ran a marathon. All of my muscles are achy and I feel weak and fatigued all over." Which prescribed medication from his home medications list may be causing him to experience these complaints? nitroglycerin nifedipine lovastatin sildenafil
lovastatin
A post major surgery patient who was discharged from the hospital four days ago is found unconscious by family members with a respiratory rate of 6. What medication would be most appropriate for paramedics to administer? diphenhydramine dobutamine dopamine naloxone
naloxone
Describe the patient teaching which is included with MAWDS teaching.
medication - teach them when is the correct time to take the medication, teach them how to take the medications when they need to contact their HCP activity - teach them make slow transitions to avoid orthostatic hypotension weight - teach them to monitor weight fluctuations and notify doctor if they are gaining a lot of weight in a short amount of time diet - teach them to have low fat diet, not high in salts, avoid processed foods, avoid substances that thin the blood if taking anticoagulants/anti-platelets symptoms - teach them to watch for symptoms of hematuria or black tarry stools which could indicate internal bleeding
a client is scheduled for an elective MRI with contrast next week what med will need to be held 72 hrs prior to and after the diagnostic study? phenobarbital phenytoin metformin dicyclomine
metformin
a patient had a myocardial infarction yesterday and is transferred from ICU to your unit this morning. Which medication do you anticipate seeing on his medication administration record to prevent straining with defecation? ondansetron methylcellulose fluoxetine atenolol
methylcellulose
a patient is on multiple medications. which med would be given 2 hours after all other medications listed below? acetaminophen warfarin atenolol methylcellulose
methylcellulose
which is a priority when caring for a client with N/V/D? monitoring intake monitoring respiratory rate monitoring output monitoring electrolytes
monitoring electrolytes
A client with a brain tumor is complaining of severe pain. All of the following medications are ordered. Which one would be most appropriate to treat the level of pain at this time? acetaminophen 325 mg p.o. hydrocodone 2 tablets p.o. morphine 4 mg IVP lorazepam 1 mg IVP
morphine 4 mg IVP
A laboring woman was administered betamethasone prior to the birth of her newborn. What would indicate this medication has not achieved the desired therapeutic effect? newborn with abdominal distention and absent bowel sounds newborn with nasal flaring and intercostal retractions newborn with hyperbilirubinemia newborn with an inability to maintain thermoregulation
newborn with nasal flaring and intercostal retractions
a patient experiences emesis. Which medication may be ordered to decrease future emetic episodes? dilaudid benztropine ondansetron demerol
ondansetron
A nurse assesses a client who has chronic emphysema and hypertension. Which ABG would be most consistent with this client's medical history? pH 7.27, PaCO2 44, HCO3 16, PaO2 = 91 pH 7.24, PaCO2 83, HCO3 24, PaO2 = 58 pH 7.37, PaCO2 62, HCO3 36, PaO2 = 65 pH 7.36, PaCO2 30, HCO3 19, PaO2 = 85
pH 7.37, PaCO2 62, HCO3 36, PaO2 = 65
An older adult client has been vomiting for the past 4 days. The client is febrile, tachycardic, and has postural hypotension. Which ABG results should the nurse recognize as consistent with this client's history? pH 7.48, PaCO2 46, HCO3 32 pH 7.49, PaCO2 29, HCO3 22 pH 7.27, PaCO2 32, HCO3 16 pH 7.24, PaCO2 83, HCO3 42
pH 7.48, PaCO2 46, HCO3 32
an alcoholic is admitted with pancreatitis. what supplement is needed to promote digestion and absorption of nutrients? penicillin pancrelipase pantoprazole piperacillin tazobactam
pancrelipase
What are the 3 P's of Diabetes?
polyuria, polydipsia, polyphagia
a patient with an NG tube has been prescribed sucralfate to reduce the risk of developing an ulcer while the NG tube is in place. How does sucralfate work? increases GI motility slows gastric emptying prevents degradation of mucus, promotes bicarbonate production relaxes cardiac sphincter and pyloric sphincter
prevents degradation of mucus, promotes bicarbonate production
What is happening if a patient is currently on antibiotics or has a history of taking antibiotics and develops sudden onset of 4-6 watery stools per day? colostridium difficile staphylococcus fecalis enterococcus pseudomembranous colitis
pseudomembranous colitis
which of the following are histamine H2 antagonists and may be prescribed to prevent stress ulcers? SATA ranitidine omeprazole cimetidine furosemide famotidine spironalactone dicylcomine
ranitidine cimetidine famotidine
a patient is admitted with a glucose level of 485. which type of insulin may be given intravenously
regular only
when preparing to administer a medication which is in suspension form, what is the priority action? pour some waste over the lip and then measure the dose shake the suspension well to mix thoroughly measure the suspension accurately to prevent under or over dosing wipe the top of the bottle with alcohol before opening it
shake the suspension well to mix thoroughly
which statement would be included in patient teaching about levothyroxine? take levothyroxine every night before you go to bed take the medication with a full glass of water remain in an upright position for 30 min after taking take med after breakfast
take the medication with a full glass of water
which recent assessment data best indicates the type 1 diabetic client is adhering to the clinical treatment plan? the clients glycosylated hemoglobin is 5.8% the client does not have ketones in the urine this morning the clients fasting blood glucose was 100 this morning the clients current glucometer reading is 110
the clients glycosylated hemoglobin is 5.8%
a patient is prescribed pancreatic enzymes with each meal and each snack. why is this necessary? to promote peristalsis and increased risk of intestinal infections to promote fatty frothy floaty foul smelling stools to promote digestion of carbohydrates, proteins and fats to promote weight loss and increased muscle mass
to promote digestion of carbohydrates, proteins and fats
a pregnant woman is diagnosed with gallstones and is not a candidate for surgery. what med may be prescribed to promote bile flow and prevent biliary cirrhosis? mannitol atenolol sucralfate ursodiol
ursodiol
