Pharm Sem 3 Practice Questions
A mother calls the clinic and asks to speak to the nurse regarding her 6 month old daughter who has been vomiting for the past 24 hours. The mother states that the baby is on Digoxin for a congenital heart defect and she is concerned that this may be a serious problem. What instructions should the nurse give to the mother over the phone? a. Check the infant's pulse for a HR <100bpm b. Increase the infant's fluid intake c. Check the infant for a wet diaper d. Redose the digoxin
A
A nurse reviews a client's medication history and notes that the client is taking a nonselective adrenergic bronchodilator and has a history of coronary artery disease. What is a priority nursing intervention? a. Monitor client for potential chest pain. b. Monitor blood pressure continuously. c. Assess daily for hyperkalemia. d. Assess 12-lead ECG each shift.
A
A patient is being assessed by the home care nurse on the administration of the inhalers. Which of the following will assist in proper administration of the inhaler? a. Use of a spacer b. Administer corticosteroid first c. Provide 1000mL of fluid d. Exhale after administration
A
A patient is started on digoxin therapy. The nurse will teach the patient to avoid taking which of the following food items concurrently with their daily dose? a. High fiber cereals b. Canned fruits c. Spicy foods d. Cooked vegetables
A
A patient who has a history of asthma is experiencing an acute episode of SOB and needs to take a med for immediate relief. The nurse will choose which medication that is appropriate for this situation? a. Beta agonist, such as albuterol b. Leukotriene receptor antagonist, such as motelukast c. Corticosteroid, such as fluticasone d. Anticholinergic, such as ipratroprium
A
A pt has a potassium level of 6.0 and a digoxin level of 3.0. What medication would the nurse be giving? a. Digibind b. Sodium citrate c. Epinephrine d. Lidocaine
A
A woman with asthma is experiencing postpartum hemorrhage. Which drug would not be used to treat bleeding because it may exacerbate her asthma? a. Hemabate b. Pitocin c. Fentanyl d. Nonsteroidal anti-inflammatory drugs (NSAIDs)
A
After a nebulizer treatment with the beta agonist albuterol, the patient complains of feeling a little "shaky," with slight tremors of the hands. The patient's heart rate is 98 beats/min, increased from the pretreatment rate of 88 beats/min. The nurse knows that this reaction is an a. Expected adverse effect of the medication b. Allergic reaction to the med c. Indication that he has received an overdose of the med d. Idiosyncratic reaction of the med
A
The mother of a child with chickenpox wants to know if there is a medication that will shorten the course of the illness. Which medication is sometimes used to speed healing of the lesions and shorten the duration of fever and itching? a. Zovirax (acyclovir) b. Varivax (varicella vaccine) c. VZIG (varicella-zoster immune globulin) d. Periactin (cyproheptadine)
A
Vitamin K is prescribed for a neonate. A nurse prepares to administer the medication in which muscle site? a. Vastus lateralis b. Triceps c. Deltoid d. Biceps
A
When the nurse is teaching a patient who is taking acyclovir for genital herpes, which statement by the nurse is accurate? a. "This drug will help the lesions to dry and crust over." b. "Acyclovir will eradicate the herpes virus." c. "This drug will prevent the spread of this virus to others." d. "Be sure to give this drug to your partner, too."
A
Which is the most important action for the nurse to take before administering digoxin? a. Monitor potassium level b. Assess BP c. Evaluate urinary output d. Avoid giving with a thiazide diuretic
A
Which medications may be administered by the nurse for infections in a patient with a severe penicillin allergy? (Select all that apply) a. Vancomycin b. Erythromycin c. Clindamycin d. Amoxicillin
ABC
A patient with severe sepsis is at risk for pseudomembranous colitis when taking with of the following medications? ( Select all that apply) a. Clindamycin (Cleocin) b. Ceftriaxone (Rocephin) c. Amoxicillin (Amoxil d. Miconazole (Zeasorb) e. Ampicillin (Principen
ABCE
A client has viral encephalitis and has been prescribed IV acyclovir (Zovirax). What nursing interventions should be used when administering the drug? Select all that apply. a. Administer at a slow rate. b. Assure the client is well hydrated before giving the drug. c. Observe for neurotoxicity. d. Check the apical heart rate prior to administration. e. Infuse cautiously in clients with renal insufficiency.
ABE
The client is also taking a diuretic that decreases her potassium level. The nurse expects that a low potassium level (hypokalemia) could have what effect on the digoxin? a. Increase the serum digoxin sensitivity level b. Decrease the serum digoxin sensitivity level c. Not have any effect on the serum digoxin sensitivity level d. Cause a low average serum digoxin sensitivity level
Answer: a
The client's serum digoxin level is 3.0 ng/mL. What does the nurse know about this serum digoxin level? a. It is in the high (elevated) range. b. It is in the low (decreased) range. c. It is within the normal range. d. It is in the low average range
Answer: a
Which assessment finding will alert the nurse to suspect early digitalis toxicity? a. Loss of appetite with slight bradycardia b. Blood pressure 90/60 mm Hg c. Heart rate 110 beats per minute d. Confusion and diarrhea
Answer: a Rationale: Early symptoms of digitalis toxicity include anorexia, nausea and vomiting, and bradycardia.
Which drug is routinely given to the neonate within 1 hour of birth? a. Erythromycin ophthalmic ointment b. Gentamycin c. Nystatin d. Vitamin A
Answer: a Rationale: Erythromycin ophthalmic ointment is given for prophylactic treatment of ophthalmic neonatorum. Vitamin K, not vitamin A, is given. Gentamycin is an antibiotic used in the treatment of an infection of the neonate. Nystatin is used for treatment of neonate thrush.
A client is taking digoxin (Lanoxin) 0.25 mg and furosemide (Lasix) 40 mg. When the nurse enters the room, the client states, "There are yellow halos around the lights." Which action will the nurse take? a. Evaluate digoxin levels b. Withhold the furosemide c. Administer potassium d. Document the findings and reassess in 1 hour.
Answer: a Rationale: Seeing yellow or green halos around lights is a symptoms of digoxin toxicity The nurse should evaluate the client's digoxin levels.
The client's serum digoxin level is drawn, and it is 0.4 ng/mL. What is the nurse's priority action? a. Administer ordered dose of digoxin b. Hold future digoxin doses c. Administer potassium d. Call the health care provider
Answer: a Rationale: Therapeutic serum digoxin levels are 0.5-2 ng/mL. The client should receive the next dose to bring the level into therapeutic range.
Acyclovir (Zovirax) has been ordered for a client with genital herpes. Which nursing interventions are appropriate for this client? (select all that apply.) a. Monitor BUN and creatinine. b. Monitor client's BP for hyptertension. c. Administer IV acyclovir over 30 minutes. d. Advise client to maintain adequate fluid intake. e. Teach client to perform oral hygiene several times a day. f. Monitor client's CBC, especially WBC, platelets, hemoglobin, and hematocrit.
Answer: a, d, e, f
A client is taking hydrochlorothiazide 50 mg/day and digoxin 0.25 mg/day. What type of electrolyte imbalance does the nurse expect to occur? a. Hypocalcemia b. Hypokalemia c. Hyperkalemia d. Hypermagnesemia
Answer: b
A client on the postpartum unit has a proctoepisiotomy. The nurse should anticipate administering which medication? a. Dulcolax suppository b. Docusate sodium (Colace) c. Methyergonovine maleate (Methergine) d. Bromocriptine sulfate (Parlodel)
Answer: b
A newly admitted client takes digoxin 0.25 mg/day. The nurse knows that which is the serum therapeutic range for digoxin? a. 0.1 to 1.5 ng/mL b. 0.5 to 2.0 ng/mL c. 1.0 to 2.5 ng/mL d. 2.0 to 4.0 ng/mL
Answer: b
Mrs. Irinowitz is taking a low-potency antipsychotic, chlorpromazine, and is experiencing the anticholinergic side effect of constipation. Which nursing intervention will best help alleviate this side effect? a. Use of sugarless gum or ice chips. b. Docusate sodium (Colace), orally, once daily. c. Oxybutynin (Ditropan), 1 mg intravenously now. d. Oxycodone 5/325 (Percocet), one tablet orally daily.
Answer: b
The nurse is reinforcing teaching to a 24 year-old woman receiving acyclovir (Zovirax) for a Herpes Simplex Virus type 2 infection. Which of these instructions should the nurse give the client? a. Complete the entire course of the medication for an effective cure. b. Begin treatment with acyclovir at the onset of symptoms of recurrence. c. Stop treatment if she thinks she may be pregnant to prevent birth defects. d. Continue to take prophylactic doses for at least 5 years after the diagnosis. Review: Begin treatment with acyclovir at the onset of symptoms of recurrence. When the client is aware of early symptoms, such as pain, itching or tingling, treatment is very effective. Medications for herpes simplex do not cure the disease; they simply decrease the level of symptoms.
Answer: b
The nurse reviews a client's laboratory values and finds a digoxin level of 10 ng/mL and a serum potassium level of 5.9 mEq/L. What is the nurse's primary intervention? a. To administer atropine b. To administer digoxin immune FAB c. To administer epinephrine d. To administer Kayexalate
Answer: b Rationale: Digoxin immune FAB is indicated for treatment of severe digoxin toxicity as evidenced by a digoxin level of 0 ng/mL and hyperkalemia. Atropine and epinephrine are not indicated for digoxin toxicity. Kayexalate is not the primary intervention.
The nurse is preparing to administer digoxin to a patient with HF. In preparation, lab results are reviewed with the following findings: sodium 139 mEq/L, potassium 3.0 mEq/L, chloride 103 mEq/L, and glucose 106 mg/dl. The nurse should do which of the following at this time? a. Withhold the daily dose until the following day. b. Withhold the dose and report the potassium level. c. Give the digoxin with a salty snack, such as crackers. d. Give the digoxin with extra fluids to dilute the sodium level
Answer: b Rationale: The normal potassium level is 3.5-5.0 mEq/L. The patient is hypokalemic, which makes the patient more prone to digoxin toxicity. For this reason, the nurse should withhold the dose and report the potassium level. The physician may order the digoxin to be given once the potassium level has been treated and rises to within normal range.
Prior to administering digoxin 0.125 mg PO to a client with chronic heart failure, the nurse determines that the apical pulse if 56. Which of the following should the nurse do FIRST? a. Administer the drug and recheck the pulse in one hour b. Withhold the drug and notify the physician c. Obtain an EKG d. Send a blood sample to the laboratory for a digoxin level
Answer: b Rationale: Unless the physician's order specifies otherwise, when the client's apical pulse drops below 60 bpm, the nurse should hold the dose and notify the physician.
A nurse is administering IV acyclovir (Zovirax) to a client who has varicella and is immunocompromised. Which of the following nursing actions is appropriate? a. Administer a test dose of 0.1mg acyclovir before starting the regular infusion. b. Decrease fluid intake during and for 2 hr following acyclovir infusion to prevent fluid overload. c. Administer acyclovir infusion over at least 1 hr. d. Monitor for a severe infusion reaction within 15 min after acyclovir infusion is started.
Answer: c
A 6-month old client with a ventricular septal defect is receiving Lanoxin elixir for regulation of this heart rate. Which finding should be reported to the doctor? a. BP 126/80 b. Blood glucose 110 mg/dL c. Heart rate 60 bpm d. Respirator rate 30/min
Answer: c Rationale: A heart rate of 60 in the 6-month-old receiving digoxin should be reported immediately because bradycardia is associated with digoxin toxicity. The blood glucose, blood pressure, and respirations are not associated with administration of digoxin.
Docusate sodium (Colace) is often prescribed in the postpartum period. What is its purpose? a. To dry up milk production in non-breastfeeding women b. To prevent perineal pain after an episiotomy c. To soften stool d. To help women sleep
Answer: c Rationale: Docusate sodium (Colace) helps to prevent constipation by incorporating water into the stool so that it will be softer when passed.
Erythromycin ointment is administered to the neonate's eyes shortly after birth to prevent which disorder? a. Cataracts b. Diabetic neuropathy c. Ophthalmia neonatorum d. Strabismus
Answer: c Rationale: Eye prophylaxis is administered to the neonate immediately or soon after birth to prevent ophthalmia neonatorum. Strabismus is neuromuscular incoordination of the eye alignment. Cataracts are opacity of the lens of the eye associated with children with congenital rubella, galactosemia, and cortisone therapy. Diabetic retinopathy occurs in clients with diabetews when the retina bleeds into the vitreous causing scarring, after which neovascularization occurs.
A patient is hospitalized with congestive heart failure exacerbation. On assessment, you note the patient has 2+ pitting edema in the lower extremities and crackles through the lung fields. The vital signs are as follows: blood pressure 180/96, heart rate 95 bpm, respirations 16, temperature 98.6 F, and oxygen saturation on room air is 90%. The patient is taking the following medications: Lasix IV, Digoxin, Miralax, and multivitamins. Which of the following findings cause the MOST concern? a. Patient's potassium level is 5.8 b. Patient states, "I've been up all night urinating" c. Patient states, "The lights look like they have halos around them" d. Patient has a blood glucose of 190
Answer: c Rationale: Potassium is slightly high but it is not common for patients taking Lasix to have issues with high potassium. Lasix will also cause the patient to urinate often, but this is not the primary concern. Answer c is a sign of digoxin toxicity and is a high concern. Blood glucose is high but not so high to cause concern and is a distracting option
The nursery nurse is putting erythromycin ointment in the newborn's eyes to prevent infection. She places it in the following area of the eye: a. Under the eyelid b. On the cornea c. In the lower conjunctival sac d. By the optic disc
Answer: c Rationale: The ointment is placed in the lower conjunctival sac so it will not scratch the eye itself and will get well distributed
A client who is taking acyclovir asks the nurse about the drug. Which instruction should the nurse include in client teaching? a. Restrict fluids to prevent complications b. Monitor blood pressure for hypertension c. Stevens-Johnson syndrome is an adverse effect d. Importance of frequent CBC, BUN, and creatinine tests
Answer: d
Docusate sodium (Colace) is ordered for an adult who had a myocardial infarction yesterday. The client asks the nurse why docusate sodium is prescribed. The nurse's response should include which information? a. Colace is prescribed to make it take longer for blood to clot b. Colace makes it easier for the client to relax and reduce stress c. Colace helps lower cholesterol levels d. Colace reduces straining at stool
Answer: d
Erythromycin has been prescribed for a client with a respiratory infection. The nurse should tell the client that which frequent side effect can occur from this medication? a. Severe diarrhea b. Yellow-colored skin c. Abdominal cramping d. Yellow discoloration to the white part of the eye
Answer: d
The nurse is assessing the client for possible evidence of digitalis toxicity. The nurse acknowledges that which is included in the signs and symptoms for digitalis toxicity? a. Pulse (heart) rate of 100 beats/min b. Pulse 72 with an irregular rate c. Pulse greater than 60 beats/min and irregular rate d. Pulse below 60 beats/min and irregular rate
Answer: d
Which of the following conditions would a nurse not administer erythromycin? a. Campylobaceriosis infection b. Legionnaire's disease c. Pneumonia d. Multiple sclerosis
Answer: d
What should the nurse instruct the patient to do to best enhance the effectiveness of a daily dose of docusate sodium (Colace)? a. Take a dose of mineral oil at the same time. b. Add extra salt to food on at least one meal tray. c. Ensure dietary intake of 10 g of fiber each day. d. Take each dose with a full glass of water or other liquid.
Answer: d Rationale: Docusate lowers the surface tension of stool, permitting water and fats to penetrate and soften the stool for easier passage. The patient should take the dose with a full glass of water and should increase overall fluid intake, if able, to enhance effectiveness of the medication. Dietary fiber intake should be a minimum of 20 g daily to prevent constipation. Mineral oil and extra salt are not recommended.
Which of the following adverse reactions may occur with the administration of erythromycin? a. Weight gain b. Constipation c. Increased appetite d. Nausea and vomiting
Answer: d Rationale: Erythromycin is an antibacterial antibiotic. Common adverse effects include nausea, vomiting, diarrhea, abdominal pain, and anorexia. It should be given with a full glass of water and after meals or with food to lessen GI symptoms.
The nurse administers erythromycin ointment (0.5%) to the newborn's eyes, and the mother asks the nurse why this is done. The nurse tells the client that this is routinely done to: a. Prevent cataracts in the neonate born to a woman who is susceptible to rubella b. Protect the neonate's eyes from possible infections acquired while hospitalized c. Minimize the spread of microorganisms to the nenonate from invasive procedures during labor d. Prevent opthalmia neonatorum from occurring after delivery to a neonate born to a woman with an untreated gonococcal infection
Answer: d Rationale: Erythromycin ophthalmic ointment 0.5% is used as a prophylactic treatment for ophthalmia neonatorum, which is caused by the bacterium Neisseria gonorrhoeae . Preventive treatment of gonorrhea is required by law. Options A, B, and C are not the purposes for administering this medication to a newborn infant.
A 3-year-old sister of a newborn baby is diagnosed with pertussis. The mother has a history of having been immunized as a child. Which of the following information should be included in teaching the mother about possible infection of her neonate? a. The baby will inevitably contract pertussis b. Immune globulin is effective in protecting the infant c. The risk to the infant depends on the mother's immune status d. Erythromycin should be administered prophylactically to the infant
Answer: d Rationale: In exposed, high-risk persons such as neonates, erythromycin may be effective in preventing or lessening severity of the disease if administered during the preparoxysmal stage. Immune globulin isn't indicated as it's used as an immunization against hepatitis A. Neonates exposed to pertussis are at considerable risk for infections, regardless of the mother's immune status; however, infection isn't inevitable.
On a tour of the labor and delivery suite, a prospective couple asks the nurse when do you put the erythromycin ointment in the baby's eyes. The correct response would be: a. "It is only done if the mother has a Chlamydia infection at the time of delivery." b. "It is only used if the baby has signs or symptoms of an eye infection." c. "It is placed in the eyes immediately after the delivery." d. "It is placed in the eyes after the parents have had a chance to hold the baby."
Answer: d Rationale: The medication may irritate the baby's eyes, thereby, the bonding process should be initiated before the medication is instilled in the eyes.
Vitamin K is administered to the newborn shortly after birth for which of the following reasons? a. To stop hemorrhage b. To treat infection c. To replace electrolytes d. To facilitate clotting
Answer: d Rationale: Vitamin K is given after delivery because the newborn's intestinal tract is sterile and lacks vitamin K needed for clotting. Answer a is incorrect because vitamin K is not directly given to stop hemorrhage. Answers b and c are incorrect because vitamin K does not prevent infection or replace electrolytes.
The nurse is preparing to administer a scheduled dose of docusate sodium (Colace) when the patient complains of an episode of loose stool and does not want to take the medication. Which of the following is the appropriate action by the nurse? a. Write an incident report about this untoward event. b. Attempt to have the family convince the patient to take the ordered dose. c. Withhold the medication at this time and try to administer it later in the day. d. Chart the dose as not given on the medical record and explain in the nursing progress notes.
Answer: d Rationale: Whenever a patient refuses medication, the dose should be charted as not given with an explanation of the reason documented in the nursing progress notes. In this instance, the refusal indicates good judgment by the patient, and the patient should not be encouraged to take it today.
A home care nurse is making a routine visit to a client receiving digoxin (Lanoxin) in the treatment of heart failure. The nurse would particularly assess the client for : a. Thrombocytopenia and weight gain b. Anorexia, nausea, and visual disturbances c. Diarrhea and hypotension d. Fatigue and muscle twitching
B
A nurse is caring for a patient who routinely takes warfarin (Coumadin). Which of the following food choices should the nurse advise the patient to limit in their diet? a. Ice cream b. Broccoli c. Orange juice d. Chicken
B
A nurse is preparing for the admission of a client with heart failure who is being sent directly to the hospital from the physician's office. The nurse would plan on having which of the following medications readily available for use? a. Diltiazem (Cardizem) b. Digoxin (Lanoxin) c. Propranolol (Inderal) d. Metoprolol (Lopressor)
B
A nurse is providing instruction sto the parent of an adolescent client who has a new prescription for albuterol (Proventil) PO. Which of the following instructions should the nurse include? a. "You can take this medication to abort an acute asthma attack." b. "Tremors are an adverse effect of this medication." c. "Prolonged use of this medication can cause hyperglycemia." d. "This medication can slow skeletal growth rate."
B
A nurse is providing instructions to a client who has been prescribed albuterol (Proventil) and beclomethasone (QVAR) inhalers for the control of asthma. Which of the following should the nurse include in the teaching? a. Alternate which inhaler is used so that both are not taken the same time of day. b. Use the albuterol inhaler prior to using the beclomethasone inhaler. c. Only use beclomethasone if experiencing an acute episode. d. Use the beclomethasone inhaler first and immediately follow with the albuterol inhaler.
B
A patient is started on albuterol (Proventil). What reaction should the patient be instructed on? a. Polydipsia will occur. b. Tachycardia will occur. c. Hypotension will occur. d. Diarrhea will occur.
B
Blurred vision or halos are signs of: a. Beta blocker toxicity b. Digoxin toxicity c. Diuretic toxicity d. Ace inhibitor toxicity
B
Dr. Jones prescribes albuterol sulfate (Proventil) for a patient with newly diagnosed asthma. When teaching the patient about this drug, the nurse should explain that it may cause: a. nasal congestion b. nervousness c. lethargy d. hyperkalemia
B
Hypokalemia is a potential side effect of Digoxin. You need to educate your pt on consuming potassium-rich foods. Which of the following will you include in your list of potassium-rich foods? a. Eggs b. Strawberries c. Whole grain bread
B
The health care provider orders ipratropium bromide (Atrovent), albuterol (Proventil), and beclomethasone (Vanceril) inhalers for a client. What is the nurse's best action? a. Question the order; three inhalers should not be given at one time. b. Administer the albuterol first, wait 5 minutes, and administer ipratropium bromide, followed by beclomethasone several minutes later. c. Administer beclomethasone first, wait 2 minutes, and administer ipratropium bromide, followed by the albuterol several minutes later. d. Administer each inhaler at 30-minute intervals.
B
The nurse is monitoring a pt taking digoxin (Lanoxin) for treatment of heart failure. Which assessment finding indicates a therapeutic effect of the drug? a. HR110 beats/min b. HR 58 beats/min c. Urinary output 40mL/hr d. BP 90/50 mm Hg
B
The nurse reviews lab studies of a pt receiving digoxin (Lanoxin). Intervention by the nurse is required if the results include which of the following laboratory results? a. Serum digoxin level of 1.2 ng/dL b. Serum potassium level of 3 mEq/L c. Hemoglobin of 14.4 g/dL d. Serum sodium level of 140 mEq/L
B
When a pt is experiencing digitalis toxicity, in which of the following situations would it be appropriate to treat with digoxin immune Fab (Digibind)? a. Hypokalemia b. Hyperkalemia c. Apical heart reate of 60 bpm d. Supraventricular dysrhythmias
B
When teaching the pt about signs and symptoms of cardiac glycoside toxicity, the nurse should alert the pt to watch for : a. Visual changes b. Flickering lights or halos c. Dizziness when standing up d. Increased urine output
B
Which of the following co-morbidities increase a patient's risk in developing digoxin toxicity? a. Heart failure b. Renal failure c. Parkinson's disease d. Dementia
B
Your pt is currently taking Digoxin. What should you, as a nurse be prepared to administer in the even of digitalis toxicity? a. Potassium b. Digibind c. Protamine sulfate d. Heparin
B
As a part of the nursing process, the nurse will evaluate for therapeutic effects of digoxin therapy for the treatment of heart failure. Desired outcomes would include (Select all that apply). a. Apical heart rate greater than or equal to 100 beats/min b. Increased urinary output c. Diminished peripheral pulses d. Decreased dyspnea and pulmonary crackles e. Improved activity tolerance
BDE
A client is discharged on Digoxin (Lanoxin) following hospitalization for Atrial Fibrillation. In preparing a Discharge Teaching Plan, the nurse would NOT include which of the following? a. Take pulse correctly and count for one full minute b. Report any signs and/or symptoms such as ocular disturbances, anorexia, etc., to MD promptly. c. Take another dose of medication if first dose is vomited. d. Withhold drug if heart rate falls below 60 bpm.
C
A client with a history of asthma is short of breath and says, "I feel like I'm having an asthmatic attack." What is the nurse's best action? a. Call a code. b. Ask the client to describe the symptoms. c. Administer a beta2 adrenergic agonist. d. Administer a long-acting glucocorticoid.
C
A client with pulmonary edema has been on diuretic therapy. The client has an order for additional furosemide (Lasix) in the amoung of 40 mg IV push. Knowing that the client also will be started on Digoxin (Lanoxin), a nurse checks the client's most recent: a. Digoxin level b. Sodium level c. Potassium level d. Digoxin level
C
A female client with herpes zoster is prescribed (Zovirax), 200 mg P.O. every 4 hours while awake. The nurse should inform the client that this drug may cause: a. Palpitations b. Dizziness c. Diarrhea d. Metallic taste
C
A nurse prepares to administer a vitamin K injection to a newborn infant. The mother asks the nurse why her newborn infant needs the injection. The best response by the nurse would be: a. "Your infant needs vitamin K to develop immunity." b. "Newborn infants have sterile bowels, and vitamin K promotes the growth of bacteria in the bowel." c. "Newborn infants are deficient in vitamin K, and this injection prevents your infant from abnormal bleeding." d. The vitamin K will protect your infant from being jaundiced."
C
A patient in CCU (Coronary Care Unit) is receiving Digoxin (Lanoxin) and Furosemide (Lasix). In assessing the patient's lab values, which of the following might the nurse expect to see? a. Increase specific gravity of urine b. Hyperkalemia c. Hypokalemia d. Hypernatremia
C
A patient is experiencing an acute asthma attack. What is the first-line therapy for relief of an acute asthma attack? a. Inhaled steroid b. Leukotriene modifier c. Beta2-adrenergic agonist d. Xanthine
C
A pt is taking digoxin and furosemide (Lasix) to manage congestive heart failure. The nurse determines that the pt understands diet therapy when the pt makes which meal choice? a. Veggie beef soup, mac and cheese, and a roll b. Beef ravioli w/bread c. Baked white fish, mashed potatoes, and carrot salad d. Roasted chicken, brown rice, and stewed tomatoes
C
A pt with congestive heart failure is receiving digoxin. What is the desired effect? a. Neck vein distention b. Decreased appetitie c. Increased urinary output d. Increased pedal edema
C
Albuterol (Proventil) is administered for bronchodilation. What is stimulated to be increased in production with the administration of this beta2-adrenergic agonist? a. Leukotrienes b. Cortisol c. Cyclic AMP d. Glucagon
C
During assessment of a pt who is receiving digoxin, which finding would indicate an increased possibility of toxicity? a. Apical pulse rate of 60 bpm b. Digoxin level 1.5 c. Serum potassium level of 2.0 d. Serum potassium level of 4.8
C
Positive inotropic action does which of the following? a. Decreases heart rate b. Decreases cellular conduction c. Increases contractility
C
The action of medication is inotropic when it: a. Decreases afterload b. Increases heart rate c. Increases force of contraction d. Is used to treat CHF
C
The client receives warfarin (Coumadin). The nurse notes that the client's morning international normalized ratio (INR) is 7. What are the priority nursing interventions at this time? a. Administer protamin sulfate and hold the next dose of warfarin (Coumadin). b. Hold the next dose of warfarin (Coumadin) and contact the physician. c. Administer vitamin K and hold the next dose of warfarin (Coumadin). d. Hold the next dose of warfarin (Coumadin) and repeat the international normalized ration (INR).
C
What is the most important thing for the nurse to teach the client with a history of diabetes and asthma who has started on albuterol PRN? a. Take Tylenol for headaches when taking albuterol. b. Monitor for orthostatic hypotension every 2 hours when taking albuterol. c. Monitor blood glucose levels every 4 hours when taking albuterol. d. An antianxiety agent may be prescribed to help with nervousness.
C
Which instruction will the nurse include when teaching a client about the proper use of metered-dose inhalers? a. "After you inhale the medication once, repeat until you obtain relief." b. "Make sure that you puff out air repeatedly after you inhale the medication." c. "Hold your breath for 10 seconds if you can after you inhale the medication." d. "Hold the inhaler in your mouth, take a deep breath, and then compress the inhaler."
C
Which of the following classes of drugs would most likely predispose a client to digitalis toxicity? a. Salicylate analgesics b. Tetracycline antibiotic c. Diuretics d. Barbituates
C
Which of the following is a contraindication for digoxin administration? a. BP 140/90 b. HR>80 c. HR<60 d. RR18
C
Which of the following is the priority intervention for the nurse prior to administering digoxin (Lanoxin)? a. Palpate pedal pulses for quality and strength b. Monitor renal function lab values c. Auscultate the apical pulse for one full minute d. Assess serum potassium levels
C
Which vitamin might the nurse be required to give to a patient with an abnormal bleeding time due to cefmatazole? a. Vitamin B12 b. Vitamin C c. Vitamin K d. Vitamin E
C
. A nurse is caring for four clients who are each taking digoxin (Lanoxin). The client who is taking which of the following medications concurrently is at risk for digoxin toxicity? a. Procainamide (Pronestyl) for premature ventricular contractions. b. Ranitidine (Zantac) for peptic ulcer disease. c. Phenytoin (Dilantin) for a seizure disorder. d. Amiodarone (Cordarone) for ventricular dysrhythmias.
D
A client has been receiving digoxin (Lanoxin) 0.125 mgm daily for a week. When the nurse visits the client at home, he tells the nurse about several problems that have been developing over the last few days. Which of these complaints is most suggestive of digoxin toxicity? a. Constipation b. Urinary frequency c. Ankle edema d. Loss of appetite
D
A client with AIDS is taking Zovirax (acyclovir). Which nursing intervention is most critical during the administration of acyclovir? a. Limit the client's activity. b. Encourage a high-carbohydrate diet. c. Use an incentive spirometer to improve respiratory function. d. Encourage fluids.
D
A nurse is preparing to administer albuterol inhaled to a 11-year-old with asthma. Which assessment by the nurse indicates there is a need for the health care provider to adjust the medication? a. Lethargy b. Temp 101 c. Lower extremity edema d. Apical pulse 112
D
A patient is admitted to the intensive care unit with status asthmaticus. The patient is administered high doses of nebulized albuterol (Proventil). What electrolyte imbalance should the nurse expect with this patient? a. Hyperkalemia b. Hypermagnesemia c. Hypocalcemia d. Hypokalemia
D
A patient is prescribed an adrenergic bronchodilator for airway constriction. Which of the following conditions will require it to be administered cautiously? a. Liver failure b. Renal failure c. Respiratory constriction d. Seizure disorder
D
A patient is using an albuterol (Proventil) inhaler, which is a bronchodilator. Which of the following patient teaching interventions is important for the patient who is experiencing shortness of breath related to constriction of airways? a. Administer insulin to decrease hand shaking. b. Administer ibuprofen (Advil) to decrease inflammation. c. Exercise should be limited to one time per week. d. Stop smoking due to the bronchoconstriction.
D
Discharge teaching to a client receiving a beta-agonist bronchodilator should emphasize reporting which side effect? a. Hypoglycemia b. Nonproductive cough c. Sedation d. Tachycardia
D
The nurse is caring for a young child who has been prescribed an inhaler for control of her asthma. The child is having difficulty using the inhaler. What is the nurse's best action? a. Tell the parent to hold the inhaler for the child. b. Ask the health care provider to switch to oral medications. c. Tell the parent that young children should not use inhalers. d. Teach the child to use a spacer.
D
The nurse is providing care for a client who is receiving digoxin (Lanoxin). Which of the following symptoms should the nurse recognize as digoxin (Lanoxin) toxicity? a. Hyperkalemia b. Increased hunger c. Constipation d. Visual disturbances
D
The nurse is scheduled to administer a does of digoxin to a adult pt with atrial fibrillation. The pt has a potassium level of 4.3 mEq/L. The nurse should perform which of the following activities nest? a. Withhold dose only for that day b. Obtain order for dose of potassium before giving digoxin c. Withhold dose and notify prescriber d. Administer dose as ordered
D
The therapeutic drug level for digoxin is: a. 0.1-2.0 b. 1.0-2.0 c. 0.1-0.5 d. 0.5-2.0
D
Which of the following pts is at greatest risk for digital toxicity? a. A 25-year old pt w/congestive heart disease b. A 50 year old pt w/CHF c. A 60 year old pt who had an MI d. An 80 year old pt with CHF
D
Which of these clients would the nurse monitory for the complication of C. difficile diarrhea? a. An adolescent taking medications for acne. b. An elderly client living in a retirement center taking prednisone. c. A young adult at home taking a prescribed aminoglycoside. d. A hospitalized middle aged client receiving clindamycin.
D
Number the nursing actions below in order of priority for the step-by-step management of digoxin toxicity. Use all actions listed below. a. Administer potassium supplements for hypokalemia, as ordered. b. Begin continuous ECG monitoring for cardiac dysrythmias. c. Administer digoxin antidote (digoxin immune FAB, digibind), if indicated, as ordered. d. Discontinue administration of the drug. e. Determine serum electrolytes and serum digoxin levels
DBEAC
