PHARM practice 8

A nurse is teaching a client who is taking atorvastatin daily. Which of the following statements by the client indicates an understanding of the teaching?

"I will avoid drinking grapefruit juice."

a nurse is assessing a client after admin a dose of losartan. the client has a hoarse voice, and swollen lips and tongue. List actions in order.

Assess airway and oxygen saturation, call rapid response, apply high-flow oxygen, initiate an IV site, admin epinephrine, admin antihistamines

A nurse is caring for a client who has HIV-1 infection and is prescribed zidovudine as part of antiretroviral therapy. The nurse should monitor the client for which of the following adverse effects of this medication?A) Cardiac dysrhythmiaB) Metabolic alkalosisC) Renal failureD) Anaplastic anemia

D) Anaplastic anemia

A nurse is providing discharge teaching to a client who has a new prescription for verapamil for angina. Which of the following instructions should the nurse include? a. limit your fluid intake to meal times b. don't take this med on an empty stomach c. Increase your daily intake of dietary fiber. d. you can expect swelling of the ankles while taking this med

Increase your daily intake of dietary fiber.

A nurse is caring for four clients who need to have oral medications administered in the morning. The nurse should administer which of the following medications before breakfast?a. Alendronate (Fosamax)b. Digoxin (Lanoxin)c. Myocostatin Elixir (Nystatin) mouthwashd. Divalproex (Depakote)

a. Alendronate (Fosamax)

A nurse in a coronary care unit is admitting a client who has had CPR following a cardiac arrest. The client is receiving lidocaine IV at 2 mg/min. When the client asks the nurse why he is receiving that medication, the nurse should explain that it has which of the following actions? a. Prevents dysrhythmias b. Slows intestinal motility c. Dissolves blood clots d. Relieves pain

a. Prevents dysrhythmias

a nurse on a telemetry unit is caring for a client who has unstable angina and is reporting chest pain with a severity of six on a 0 to 10 scale. The nurse administers one sub lingual nitroglycerin tablet. After five minutes the client states that his chest pain is now a severity of two. Which of the actions should the nurse take? a. admin another nitroglycerin tablet b. initiate a peripheral iv c. call rapid response team d. obtain an ECG

a. admin another nitroglycerin tablet

a nurse is assessing an older adult client who is receiving digoxin. the nurse should recognize that which of the following findings is a manifestation of digoxin toxicity? a. anorexia b. ataxia c. photosensitivity d. jaundice

a. anorexia

a nurse is teaching a client who has hypertension and a new prescription for atenolol. which of the following findings should the nurse include as adverse effects of this med? a. bradycardia b. tremor c. cough d. constipation

a. bradycardia

a client who is receiving magnesium sulfate has a urine output of 20 ml/hr. which of the following meds should the nurse expect to administer? a. calcium gluconate b. flumazenil c. naloxone d. protamine

a. calcium gluconate

a nurse is caring for a client who has congestive heart failure and is taking digoxin daily. the client refused breakfast and is complaining of nausea and weakness. which of the following actions should the nurse take first? a. check the client's vital signs b. request a dietitian consult c. suggest that the client rests before eating the meal d. request an order for an antiemetic

a. check the client's vital signs

a nurse is preparing a client for surgery. prior to administering the prescribed hydroxyzine, the nurse should explain to the client that the med is for which of the following indications? (select all that apply) a. controlling emesis b. diminishing anxiety c. reducing the amount of narcotics for pain relief d. preventing thrombus formation e. drying secretions

a. controlling emesis b. diminishing anxiety c. reducing the amount of narcotics for pain relief e. drying secretions

a nurse is caring for a client who is taking lisinopril. which of the following outcomes indicates a therapeutic effect of the med? a. decreased BP b. increase of HDL cholesterol c. prevention of bipolar manic episodes d. improved sexual fxn

a. decreased BP

a nurse is providing teaching to a client who has HTN and a new prescription for captopril. Which of the following instructions should the nurse provide? a. don't use salt substitutes while taking this med b. take the med with food c. count your pulse rate before taking the med d. expect to gain weight while taking this med

a. don't use salt substitutes while taking this med

a nurse is caring for a client who is taking digoxin for heart failure and envelops indications of severe digoxin toxicity. which of the following meds should the nurse prepare to admin? a. fab antibody fragments b. flumazenil c. acetylcysteine d. naloxone

a. fab antibody fragments

a nurse is preparing to administer potassium chloride to a client who is receiving diuretic therapy. the nurse reviews the client's serum potassium level results and discovers the client's potassium level is 3.2 mEq/L. Which of the following actions should the nurse take? a. give the ordered KCL b. omit the KCL dose and document that it was not given c. hold the prescribed dose and notify the provider of serum potassium level d. call the lab to verify the client's reults

a. give the ordered KCL

a nurse is assessing a client prior to administering atenolol. which of the following findings should prompt the nurse to withhold the med? a. heart rate 46/min b. oxygen saturation 95% c. respiratory rate 18/min d. bp 160/94 mmHg

a. heart rate 46/min

a nurse is teaching a client who has a new prescription for captopril. which of the following instructions should the nurse include in the teaching? a. monitor for a cough b. hold med for heart rate less than 60/min c. take this med with food d. avoid grapefruit juice

a. monitor for a cough

a nurse is teaching a client who has a new prescription for bumetanide. which of the following instruction should the nurse include in the teaching? a. report changes in hearing b. avoid foods high in K c. take the prescribed second dose at nighttime d. limit your fluid intake to no more than 1.5 L/day

a. report changes in hearing

a nurse is monitoring a client who received epinephrine for angioedema after a first dose of losartan. which of the following data indicates a therapeutic response to the epinephrine? a. respirations are unlabored b. client reports decreased groin pain of 3 on a 1 to 10 scale c. the client's BP when arising from resting position is at premedication levels d. the client tolerates a second dose of medication with no greater than 1+ peripheral edema

a. respirations are unlabored

a nurse is teaching a client who has a new prescription for simvastatin. which of the following instructions should the nurse include? a. expect brown urine b. avoid grapefruit juice c. monitor for ringing in the ears d. take the med in the morning

b. avoid grapefruit juice

Nurse is reviewing the health history for a client who has angina pectoris and a script for propranolol hydrochloride PO 40 mg twice daily. Which of the following findings in the history should the nurse report to the provider? a. hypothyroidism b. bronchial asthma c. htn d. migraine headaches

b. bronchial asthma

a nurse is caring for four clients. after administering morning meds, she realizes that the nifedipine prescribed for one client was inadvertently administered to another client. which of the following actions should the nurse take first? a. notify the client's provider b. check the client's VS c. fill out an occurrence form d. admin the med to the correct client

b. check the client's VS

a nurse is reviewing the medical record of a client who has hypertension and a new prescription for metoprolol. which of the following findings should the nurse investigate further? a. diet-controlled type 2 dm b. hx of left-sided hf c. concurrent prescription for tadalafil d. recently treated bilateral pneumonia

b. hx of left-sided hf

a nurse is preparing to administer verapamil by iv bolus to a client who is having cardiac dysrhythmias. for which of the following adverse effects should the nurse monitor when giving this med? a. hyperthermia b. hypotension c. ototoxicity d. muscle pain

b. hypotension

a nurse is providing teaching to a client who has a new prescription for transdermal nitroglycerin paste. which of the following statements by the client indicates the need for further teaching/ a. i should measure the dosage on the supplied paper b. i should leave the patch in place until it is time for the next dose c. i should get up slowly when i stand d. i might have a headache when i first start taking this medication

b. i should leave the patch in place until it is time for the next dose

a nurse is caring for a client who is experiencing severe nausea and vomiting after a course of chemo. the nurse should monitor the client for which of the following clinical manifestations? a. metabolic acidosis b. metabolic alkalosis c. respiratory acidosis d. respiratory alkalosis

b. metabolic alkalosis

a client is teaching a client who has a new prescription for hydrochlorothiazide for management for hypertension. which for the following instructions should the nurse include? a. take this med before bedtime b. monitor for leg cramps c. avoid grapefruit juice d. reduce intake of potassium-rich foods

b. monitor for leg cramps

a nurse is assessing a client who has hypercholesterolemia and is receiving simvastatin. which of the following findings should date nurse recognize as a potential adverse effect? a. urinary retention b. muscle weakness c. orthostatic hypotension d. blurred vision

b. muscle weakness

a nurse is assessing a client who is taking lisinopril to treat hypertension. which of the following findings is a priority to report? a. dry cough b. swelling of the tongue c. nausea d. nasal congestion

b. swelling of the tongue

a nurse is reviewing the med record for a client who has chronic kidney disease. which of the following meds should the nurse id as having the potential to cause nephrotoxicity? a. omeprazole b. vancomycin c. ondansetron d. diphenhydramine

b. vancomycin

A nurse is providing teaching for a client who has hypertension and a prescription change form metoprolol to metoprolol/hydrochlorothizide. which of the following statements by the client indicates an understanding of the teaching? a. now i will not have to diet to lose weight b. with the new med, i should experience fewer side effects c. i will not have to do anything different because it is the same med d. the extra letters after the name of the med means it is a stronger dose

b. with the new med, i should experience fewer side effects

A nurse is providing discharge teaching for a client who has pulmonary edema and is about to start taking furosemide. Which of the following instructions should the nurse include? a. take aspirin if headaches develop b.Eat foods that contain plenty potassium c. expect some swelling in the hands and feet d. take the med at bedtime

b.Eat foods that contain plenty potassium

A nurse is providing dietary teaching for a client who has a new prescription for monoamine oxidase inhibitor (MAOI). When the client develops a sample lunch menu, which of the following items requires intervention by the nurse?a. Glass of whole milkb. Celery sticksc. Bologna sandwichd. Sliced apples

c. Bologna sandwich

a nurse is caring for a client who has atrial fibrillation and receives digoxin daily. Before administering this medication which of the following actions should the nurse take? a. Offer the client a light snack b. Measure the clients blood pressure c. Measure the clients apical pulse d. Weigh the client

c. Measure the clients apical pulse

a nurse is caring for a client who will begin using transdermal nitroglycerin to treat angina pectoris. when speaking to the client about the drug, which of the following instructions should the nurse include? (select all that apply) a. apply a new patch at the onset of anginas pain b. apply the patch to dry skin and cover the area with plastic wrap c. apply the patch to a hairless area and rotate sites d. apply a new patch when you start your daye. remove patches for 10 to 12 hrs ea day e. remove patches for 10 to 12 hrs ea day

c. apply the patch to a hairless area and rotate sites d. apply a new patch when you start your daye. remove patches for 10 to 12 hrs ea day e. remove patches for 10 to 12 hrs ea day

a nurse is caring for a client who has heart failure and a new prescription for furosemide. for which of the following adverse effects should the nurse monitor? a. hypervolemia b. hypertension c. hypokalemia d. hypoglycemia

c. hypokalemia

a nurse is providing teaching to a client who has breast cancer about the adverse effects of chemotherapy. which of the following client statements indicates an understanding of the teaching? a. i will take the anti emetic as soon as the chemo infusion is complete b. i will run my toothbrush in the dishwasher every month c. i'll call my doc if i notice any unusual menstrual bleeding d. i will avoid crowds to keep from infecting others.

c. i'll call my doc if i notice any unusual menstrual bleeding

a nurse is providing teaching to a client who has a new diagnosis of parkinson's disease. on which of the following medications should the nurse prepare to instruct the client? a. piperacillin/tazobactam b. levothyroxine c. levodopa/carbidopa d. carbamazepine

c. levodopa/carbidopa

a nurse is caring for a client who has a new prescription for propranolol. the nurse should monitor the client for which of the following adverse reactions to this med? a. ototoxicity b. tachycardia c. postural hypotension d. hypokalemia

c. postural hypotension

a nurse is caring for a client who has heart failure and a new prescription for furosemide. which of the following laboratory values should the nurse review before administering furosemide? a. bicarbonate b. carbon dioxide c. potassium d. phosphate

c. potassium

a nurse is teaching a client who has angina pectoris about starting therapy with SL nitroglycerin tablets. the nurse should include which of the following instructions regarding how to take the med? a.take after each meal and at bed b. take one tablet every 15 min during an acute attack c. take one tablet at the first indication of chest pain d. take this medication with 8 oz of water

c. take one tablet at the first indication of chest pain

a nurse is providing teaching to a client who has hypertension and a new prescription for hydrochlorothiazide. which of the following instructions should the nurse provide? a. weigh weekly to monitor therapeutic effect b. take the med on an empty stomach c. take the med early in the day d. muscle pain is an expected adverse effect

c. take the med early in the day

a nurse is providing teaching for a client who is on diuretic therapy and has anew prescription for potassium chloride 20 mEq extended release PO daily. which of the following instructions should the nurse provide about the new prescription? a. take the xr tablets on an empty stomach b. add an antacid if the med causes indigestion c. take the xr tablets whole d. expect urinary output to decrease while on this med

c. take the xr tablets whole

a nurse in a provider's clinic is assessing a client who takes sublingual nitroglycerin for stable angina. the client reports getting a headache each time he takes the medication. which of the following statements should the nurse make? a. take only one dose of nitroglycerin to reduce the risk of getting a headache b. there's nothing that can be done to relieve the headaches that nitroglycerin causes c. try taking a mild analgesic to relieve the headache d. we will ask the provider to prescribe a different med for you

c. try taking a mild analgesic to relieve the headache

a hospice nurse is caring for a client who has terminal cancer and take po morphine for pain relief. the client reports that he had to increase the dose of morphine this week to obtain pain relief. which of the following scenarios should the nurse document as the explanation for this situation?

ct has tolerance to med

a nurse is preparing to administer digoxin to a client who has heart failure. which of the following actions is appropriate? a. withhold med if hr is above 100/min b. tell client to eat foods that are low in potassium c. measuring apical pulse rate for 30 sec before admin d. evaluate the client for nausea, vomiting, and anorexia

d. evaluate the client for nausea, vomiting, and anorexia

a nurse is providing teaching to a client who has hypertension and a new prescription for verapamil. which of the following beverages should the nurse tell the client to avoid while taking this medication? a. milk b. OJ c. coffee d. grapefruit juice

d. grapefruit juice

A nurse is caring for a client who has heart failure and a prescription for digoxin. Which of the following statements by the client indicates an adverse effect of the medication? a. i can walk a mile a day b. i've had a backache for several days c. i am urinating more frequently d. i feel nauseated and have no appetite

d. i feel nauseated and have no appetite

a nurse is providing teaching to a client who has a new prescription for lisinopril. which of following statements by the nurse indicates an understanding of the teaching? a. i should increase my intake of k rich foods b. i should expect to have facial swelling when taking this medication c. i should take this medication with food d. i should report a cough to my provider

d. i should report a cough to my provider

a nurse is providing teaching to a client who has angina pectoris and a new prescription for nitroglycerin sublingual tablets. which of the following statements by the client indicates an understanding of the teaching? ill dial 911... a. if i still have pain after taking 3 nitroglycerin tablets 5 min apart b. if i still have pain after taking 4 nitroglycerin tablets over a 20 min period c. when i have pain and then take the nitroglycerin tablets d. if 1 nitroglycerin tablet does not relieve my pain, and then take up to 2 more tablets 5 min apart while waiting

d. if 1 nitroglycerin tablet does not relieve my pain, and then take up to 2 more tablets 5 min apart while waiting

a nurse is assessing a client who has heart failure and is prescribed furosemide. which of the following findings is an adverse effect of this med? a. weight gain b. increased BP c. hypoglycemia d. leg cramps

d. leg cramps

a nurse is caring for a client who has traumatic head injury and is exhibiting signs of increasing intracranial pressure. which of the following medications should the nurse plan to administer? a. albumin 25% b. dextran 70 c. hydroxyethyl glucose d. mannitol 25%

d. mannitol 25%

a nurse is teaching a client who has a new prescription for aspirin to prevent cardiovascular disease. which of the following instructions should the nurse include in the teaching? a. take the tablets on an empty stomach b. expect stools to turn black c. anticipate the tablets to smell like vinegar d. monitor for tinnitus

d. monitor for tinnitus

a nurse is teaching a client who has angina about nitroglycerin sublingual tablets. which of the following statements should the nurse include in the teaching? a. place one tablet under your tongue every 5 min for 30 min to relieve chest pain b. nitroglycerin decreases chest pain by dissolving blood clots that are occluding the arteries c. you can store the bottle of tablets in your bathroom medicine cabinet d. nitroglycerin dilates cardiac blood vessels to deliver more oxygen to the heart

d. nitroglycerin dilates cardiac blood vessels to deliver more oxygen to the heart

a nurse is providing instruction to a new nurse about caring for clients who are receiving diuretic therapy to treat heart failure. The nurse should explain that which of the following meds puts client at risk for both hyperkalema and hyponatremia? a. furosemide b. hydrochlorothiazide c. metolazone d. spironolactone

d. spironolactone

a nurse is providing teaching to a client who has stable angina and a new prescription for nitroglycerin oral, sustained-release capsules. Which of the following instructions should the nurse include? a. take 1 capsule at the onset of anginal pain b. stop taking the med if side effects are troublesome c. take the med with meals d. swallow the capsules whole

d. swallow the capsules whole

A nurse is teaching about necessary baseline examinations with a female client who is to start taking atorvastatin. Which of the following baseline examinations should the nurse include in the teaching? a. liver function tests b. hearing test c. papanicolaou test d. dental exam

liver function tests