Pharm Proctor

A nurse is evaluating how a client who is pregnant is responding to a medication. Which of the following physiological effects of pregnancy should the nurse consider take into consideration?

Accelerated excretion of fluids

A nurse has administered a medication to a client. Which of the following circumstances should the nurse identify as a medication error that resulted from a performance deficit by the nurse?

An IM injection was given instead of a SUBQ injection

A nurse is caring for a client who has COPD and has been taking fluticasone via inhaler for many years. Which of the following findings should the nurse identify as an adverse effect of long-term use of this medication?

Anorexia and weakness **Adrenal insufficiency manifestations: anorexia, weakness, nausea, hypotension, and hypoglycemia

A nurse is reinforcing teaching with a client who has ulcerative colitis and has a new prescription for sulfasalazine. The nurse should instruct the client to monitor for which of the following adverse effects of this medication?

Arthralgia Sulfasalazine can cause nausea, vomiting, arthralgia, bloody diarrhea, anemia, agranulocytosis, and turn urine and skin an orange-yellow color

A nurse is caring for a client who reports diarrhea and abnormal cramps. The client tells the nurse, "I take a variety of vitamin supplements". The nurse should identify the client's manifestations as potential adverse effects of which of the following vitamin supplements?

Ascorbic acid Vitamin C due to direct irritation of the intestinal mucosa

A nurse is collecting data from a client who is experiencing chest pain. Which of the following medications should the nurse expect to administer to suppress the aggregation of platelets?

Aspirin

A nurse is caring for a client who is experiencing cycloplegia following the administration of atropine eye drops during an eye examination. Which of the following findings should the nurse expect as a result of cycloplegia?

Blurred vision

A nurse is assisting with the care of a client who has A-Fib and is scheduled for cardioversion. The nurse should anticipate a prescription from the provider for which of the following medications for this procedure?

Diltiazem

A nurse in a provider's office is reinforcing teaching with a client who has psoriatic arthritis and a new prescription for adalimumab. Which of the following instructions should the nurse provide about treatment with adalimumab?

Do not receive live vaccines while on this medication

A nurse is caring for a client who is taking selegiline. The nurse should monitor the client for which of the following findings as an adverse effect of selegiline and notify the HCP?

Drowsiness

A nurse is reviewing the medication administration record of a client who has a new prescription for levothyroxine. Which of the following medications should the nurse identify as needing to be administered 4 hrs after levothyroxine administration?

Ferrous sulfate - it can reduce the absorption of levothyroxine

A nurse is preparing to administer an initial dose of zileuton to a client for asthma PPX. For which of the following manifestations should the nurse monitor as a potential adverse reaction?

Hallucinations

A nurse is preparing to administer dantrolene to a client who has muscle spasticity. Which of the following findings from the client's medical history should the nurse identify as a contraindication to the administration of this medication?

History of cirrhosis

A nurse is collecting data on a client who has developed hypertension that is unresponsive to lifestyle changes. The client has no other comorbidities. Which of the following medications should the nurse expect the provider to prescribe first?

Hydrochlorothiazide It is a first line choice for treating hypertension

A nurse is caring fora client who is taking fludrocortisone. Which of the following findings indicates to the nurse that the client is experiencing an adverse effect of the medication?

Hypokalemia

A nurse is collecting data from a client with rheumatoid arthritis who has been taking high doses of prescribed hydroxycholorquine. Which of the following client statements should indicate to the nurse that the client is experiencing an AE of hydroxycholorquine?

I have had a change in my vision recently

A nurse is monitoring a client who received diphenoxylate atropine. Which of the following statements by the client should indicate to the nurse that the medication has been effective?

I have not had a bowel movement today. Diphenoxylate atropine is an opioid used to treat diarrhea. It decreases the frequency of watery stools due to reduced motility of the intestinal lining

A nurse is caring for a client who has TB and is taking rifampin. Which of the following statements should indicate to the nurse that the client is experiencing an adverse effect of the medication?

I have noticed my urine is orange in color

A nurse is reinforcing teaching with a client who has a UTI and a new prescription for phenazopyridine and ciprofloxacin. Which of the following statements by the client indicates the need for further teaching?

I should notify my HCP STAT if my urine turns orange Phenazopyridine - turns urine a reddish-orange color and does not need to be reported to HCP

A nurse is reinforcing d/c teaching with a client who has a new prescription for cyclosporine following a kidney transplant. Which of the following client statements indicates an understanding of the teaching?

I should schedule an appt with my dentist every 3 mo

A nurse is reinforcing teaching with a client who will be taking dexamethasone daily for pain due to spinal edema. The nurse should identify which of the following client statements as an indication that the client understands the instructions?

I should stay away from people who are ill

A nurse is reinforcing teaching with a client who has a prescription for sucralfate for a duodenal ulcer. Which of the following client statements indicates an understanding of the teaching?

I should wait at least 30 min before taking this medication after I take an antacid. To minimize interactions between antacids, sucralfate should be taken at least 30 min apart from antacids. Prevent gastric pH being above 4. -Sucralfate should be taken 1hr before meals and at bedtime for optimal effectiveness -Treatment lasts 4-8weeks -Can be broken down or dissolved

A nurse is preparing to administer warfarin to a client who has a new onset of A-Fib. The client states, "I forget what the other nurse told me this medication does." Which of the following pieces of information should the nurse reinforce with the client?

It can reduce your risk of having a stroke

A nurse is administering a medication to a client. The nurse should identify that which of the following medication distribution factors facilitates the effective passage of the medication across the client's cell membranes?

Lipid solubility

A nurse is reviewing the medication administration record of a client who is receiving an opioid medication for pain. Which of the following prescriptions should the nurse identify as a contraindication to administering an opioid medication?

Lorazepam

A nurse is collecting data from a client who has TB and a prescription for ethambutol. The nurse should inform the client that he is likely to develop which of the following alterations as an adverse effect of this medication?

Loss of red/green color discrimination Ethambutol impairs ribonucleic acid synthesis

A nurse working in a mental health facility is admitting a client with opioid use disorder is experiencing withdrawal. The nurse should anticipate a prescription for which of the following medications from the provide?

Methadone

A nurse is reinforcing medication teaching to a client who has a new diagnosis of rheumatoid arthritis. Which of the following medications in the therapy regimen will take weeks to months to be effective?

Methotrexate - a disease modifying anti rheumatic drug (DMARD)

A nurse is caring for a client who has dry mouth resulting from radiation therapy and a new prescription for oral pilocarpine. The nurse should identify a potential incompatibility with which of the following medications?

Metoprolol

A nurse is reinforcing teaching with a client who has asthma and a new prescription for a SABA bronchodilator. Which of the following pieces of information should the nurse provide in the teaching?

Notify the HCP if the SABA is needed more than 2x per week

A nurse is reinforcing teaching about glucocorticoid therapy with the parent of a child who has severe reactive airway disease. The parent asks why her child has to inhale the medication instead of taking it orally. Which of the following pieces of information should the nurse provide the parent?

Oral glucocorticoids are more likely to slow linear growth in children

A nurse is assessing a client who was recently admitted and has a Hx of alcohol use disorder. The client displays ataxia, an altered LOC, and nystagmus. Which of the following medications should the nurse anticipate administering to the client?

Parenteral thiamine The client is displaying manifestations of Wernicke-Korsakoff syndrome due to a thiamine deficiency

A nurse is caring for a client who is at 6wks of gestation and has just received diagnosis of hyperthyroidism. The nurse should anticipate a prescription from the provider for which of the following medications?

Propylthiouracil

A nurse is reviewing new medication prescriptions for 4 clients. Which of the following prescriptions should the nurse verify with the provider?

Ranitidine 300 mg PO, on call from surgery The nurse should verify this prescription with the provider since clients who are scheduled for surgery are usually maintained on an NPO status.

A nurse is reviewing the medical record of a client. The medication administration record shows the client is taking clopidogrel. Which of the following events should the nurse expect to be reported in the client's medical history?

Recent myocardial infarction Clopidogrel is an anti-platelet that inhibits the aggregation of platelets to prevent thrombotic events

A nurse is contributing to the plan of care for a client who is receiving phenytoin to treat seizures. Which of the following recommendations should the nurse make to counteract potential AE of the medication?

Reinforce teaching with the client about how to perform gum massage

A nurse is caring for a client with asthma who has been taking an inhaled glucocorticoid and long-acting beta 2 agonist combination dry powdered inhaler (DPI) for maintenance therapy. The nurse should identify that which of the following is a disadvantage of this medication?

Restricted dosage flexibility

A nurse is preparing to administer an initial dose of etanercept for a client who has rheumatoid arthritis. For which of the following manifestations should the nurse monitor as a potential adverse effect of the medication?

Rhinitis The nurse should also monitor for upper respiratory infection, pharyngitis, and a cough

A nurse is caring for a client with type 1 DM who has a prescription to administer regular insulin subcutaneously. Which of the following insulin durations should the nurse identify for regular insulin?

Short duration, slow acting

A nurse is caring for an adolescent who has cystic fibrosis and has a prescription for high dose ibuprofen daily. The nurse should identify that which or the following is an expected outcome for the client receiving this medication?

Slowed progression of pulmonary damage

A nurse is caring for a school aged child who has cystic fibrosis and has been using a corticosteroid inhaler for long term treatment. Which of the following findings should the nurse identify as an adverse effect of long term use of this medication?

Small stature for age Long term use of inhaled glucocorticoids can be a slowing in the rate of growth in children

A nurse is caring for a client who has osteoporosis and is taking raloxifene. Which of the following findings should the nurse indicate to the client is experiencing an adverse effect of this medication?

Sudden onset of dyspnea

A nurse is reinforcing teaching with a client who is postmenopausal and has a prescription for aldendronate. Which of the following statements should the nurse include in the teaching?

Take this medication on an empty stomach Because it can decrease absorption

A nurse is evaluating a 20month old child who received a hepatitis A immunization 3 days ago. The parent reports that the child has exhibited a loss of appetite following the immunization. Which of the following actions should the nurse take?

Tell the parent that this reaction should only last for a couple of days

A nurse is reinforcing teaching with a guardian of a school-aged child about growth hormone therapy. Which of the following statements should the nurse include in the teaching?

The hormone injections are administered

A nurse is reviewing the medication history of a client who has asthma. Which of the following medication combinations should the nurse identify as incompatible?

Theophylline and zileuton

A nurse is reinforcing teaching with a client who has a new diagnosis of peptic ulcer disease (PUD) and prescription for bismuth subsalicylate. The client asks the nurse, "How will this medication help my ulcer?" Which of the following statements should the nurse make?

This medication can decrease bacteria in the GI tract

A nurse is teaching a client who is experiencing age-related vaginal atrophy and has a prescription for estradiol cream. Which of the following statements should the nurse include in the teaching?

This medication has fewer systemic effects than oral estrogen

A nurse is reinforcing teaching with a client who has a new prescription for lisinopril. Which of the following should the nurse include in the teaching as an adverse effect of lisinopril?

Tongue swelling

A nurse is collecting data from a client who uses an albuterol inhaler to treat asthma. For which of the following findings should the nurse withhold the medication and notify the provider?

Wheezing - it can indicate a paradoxical bronchospasm

A nurse is caring for an 18 month old toddler who has Kawasaki disease (KD). The child is receiving intravenous immune globulin (IVIG). The guardian asks the nurse to administer the child's scheduled measles, mumps, and rubella (MMR) vaccine before d/c. Which of the following statements should the nurse provide?

Your child will not be able to receive the MMR vaccine for at least 3 mo after d/c

A nurse is caring for a client who has been receiving G-Tube feedings and insulin. The client is scheduled to receive a tube feeding at 0700. At which of the following times should the nurse plan to administer insulin lispro SUB Q?

0645 Lispro is a rapid-acting insulin with an onset of 15 min

A nurse is preparing to administer timolol eye drops to a client who has primary open-angle glaucoma (POAG). Prior to administering the medication, the nurse should recognize that which of the following conditions in the client's medical history is a contraindication to receiving this medication?

Asthma

A nurse in a postpartum unit is caring for a client who plans to breastfeed her newborn exclusively. The client has a new prescription for depot medroxyprogesterone acetate (DMPA). At which of the following times should the nurse schedule the client to receive the first dose of the medication?

At 6 wks postpartum

A nurse is caring for a client who taking an agonist medication. The nurse should expect which of the following actions from this type of medication?

Binds to receptors and mimics regulatory molecules

A nurse is caring for a client who has bronchitis and a prescription for a mucolytic agent. Which of the following findings should the nurse identify as an adverse effect of this type of medication?

Bronchospasm

A nurse is checking a client who is receiving an IV infusion of telavancin for Streptococcus pyogenes. Which of the following actions should the nurse perform?

Check for pruritus

A nurse is collecting data from a client who has been taking methimazole for a thyroid disorder over the past month. Which of the following findings demonstrates an expected response to methimazole?

Decreased body temp

A nurse is monitoring a client who is receiving lactulose for cirrhosis. Which of the following lab values related to this medication should indicate to the nurse that the treatment is effective?

Decreased serum ammonia Lactulose improves the client's condition by decreasing ammonia levels through enhancing intestinal secretion of ammonia so that it can be eliminated from the body

A nurse is caring for a client who has a new diagnosis of benign prostatic hyperplasia (BPH). Which of the following prescriptions should the nurse expect?

Finasteride -Should be administered to reduce the size of the prostate within 3-6 months of therapy

A change nurse is reinforcing teaching with a newly licensed nurse about the purpose of a client being prescribed a transdermal fentanyl patch. Which of the following clients should the charge nurse include in the teaching as a client who requires this medication?

A client who is opioid tolerant

A nurse is assisting with preparing to administer a hydromorphone IV infusion to a client for pain. Which of the following actions should the nurse take?

Administer the medication over 4-5 minutes

A nurse is caring for a client who is receiving sumatriptan for cluster headaches. Which of the following findings should the nurse expect as an adverse effect?

Chest pressure

A nurse is caring for a client who takes sulfasalazine twice daily for rheumatoid arthritis. Which of the following values should the nurse review prior to the administration of the medication?

Complete blood count Sulfasalazine can cause bone marrow suppression

A nurse is assisting with the administration of an epinephrine IV bolus to a client. Which of the following should the nurse verify before initiating the IV medication?

Concentration of the formulation

A nurse is monitoring a client who has asthma, takes albuterol, and recently started taking propranolol to treat a cardiovascular disorder. The client reports that the albuterol has been less effective. Which of the following factors should the nurse identify as a possible explanation for this change?

Detrimental inhibitory interaction Propranolol interferes with albuterol

A nurse is caring for a client who is taking streptomycin. Which of the following medications should the nurse identify as increasing the risk of developing ototoxicity when taken with streptomycin?

Furosemide

A nurse is caring for a client who has a new prescription for levothyroxine to treat hypothyroidism. Which of the following findings should the nurse identify as an indication that the client requires intervention?

HR 106/min

A nurse is reinforcing teaching with a client who has a new prescription for nitroglycerin via a transdermal patch. Which of the following client statements indicates an understanding of the teaching?

I need to rotate the location of my patch every few days

A nurse is reinforcing teaching with a female client who has a new prescription for misoprostol to treat peptic ulcer disease. Which of the following client statements should indicate to the nurse that the teaching was effective?

I should avoid becoming pregnant while taking this medication

A nurse is reinforcing teaching with a client who is about to start taking PTU to treat hyperthyroidism. Which of the following statements should the nurse identify as an indication that the teaching has been effective?

I will need laboratory tests to check my liver function PTU is hepatotoxic and can cause sever liver injury. The nurse should instruct the client to report dark urine and yellowing of the eyes, which can indicate an injury to the liver.

A nurse in a provider's office is reinforcing teaching with a client who has elevated prostate-specific antigen level and a new prescription for finasteride. Which of the following statements by the client indicates an understanding of the teaching?

I will skip donating blood while I am taking this medication

A nurse is reinforcing teaching with a client about the adverse effects of omeprazole. Which of the following client statements indicated an understanding of the teaching?

If I experience severe diarrhea, I will call my doctor They are at an increased risk for infection with c diff

A nurse is reinforcing teaching about the adverse effects of ergotamine with a client who has migraine headaches. Which of the following client statements should indicate an understanding of the teaching?

If I overuse this medication, I might become addicted to it

A nurse is reviewing the medical record for a client who has a migraine and a prescription for sumatriptan. Which of the following factors in the client's medical history should the nurse identify as a contraindication to receiving sumatriptan?

Ischemic heart disease

A nurse is reviewing the medical record of a client who is scheduled for induction of labor and has a prescription for misoprostol. Which of the following conditions should thew nurse identify as a contraindication to administering this medication?

Past cesarean delivery

A nurse is caring for a client who received spinal anesthesia 30 min ago. The client reports feeling dizzy, and the nurse notes that the client's BP is 84/54 mmHg. Which of the following actions should the nurse take?

Place the client in the head-down position ***Hypotension is a common AE of spinal anesthesia due to the loss of venous tone and decreased venous return to the heart; therefore, place the client in a head-down position to rapidly promote venous return to the heart and increase BP

A nurse is teaching a client who has type 1 DM about a new SUBQ insulin infusion pump. Which of the following pieces of information should the nurse reinforce in the teaching?

Plan to use a type of short-duration insulin in the infusion pump

A nurse suspects that a client is having an allergic reaction to a medication. Which of the following factors should the nurse identify as increasing the likelihood of an allergic reaction to this medication?

The client has had previous exposure to the medication

A nurse is collecting data from an infant who is scheduled to receive the rotavirus vaccine. Which of the following criteria should the nurse identify as a potential contraindication for administering this vaccine?

The infant has a hx of intussusception

A nurse is caring for a client who has recently diagnosed with rheumatoid arthritis. The nurse should expect the provider to prescribe methotrexate at which of the following times?

Within 3 months of initial diagnosis

A nurse is reinforcing teaching with a client who has a prescription for a combination oral contraceptive that uses a 28day cycle. Which of the following instructions should the nurse include in the teaching?

You can miss up to 7 pills with little risk in getting pregnant as long as you have taken the pills regularly for the previous 3 weeks