Pharmacology HESI

The nurse administers 30 mL of lactulose for a client with stage 2 hepatic encephalopathy. Which assessment finding would indicate the medication is being therapeuitc?

A decrease in blood ammonia levels.

A client prescribed clindamycin hydrochloride intravenously asks the nurse why blood has to be drawn before the third dose and one hour after the completion of the administration of the medication. Which information should the nurse provide the client to answer the question?

A small margin exists between safe and toxic plasma levels.

Based on the blood culture and sensitivity results, the healthcare provider prescribes an IV aminoglycoside antibiotic and discontinues the current prescription for another broad spectrum antibiotic. The medication administration record indicates that the client received the broad spectrum antibiotic two hours ago. Which action should the nurse implement?

Administer the initial dose of the aminoglycoside antibiotic as soon as possible.

A mother of a child prescribed methylphenidate hydrochloride for attention-deficit hyperactivity disorder (ADHD) informs the school nurse she administers the medication at bedtime. Which instructions should the nurse recommend?

Administer the medication at least six hours before bedtime.

The nurse reviews the new prescription, phenelzine (Nardil), a monoamine oxidase inhibitor (MAOI), for a client with depression on the psychiatric unit. Which information is most important for the nurse to assess?

Consumption of any alcohol or tyramine-rich foods.

The nurse should implement which action to provide analgesic titration for a client in pain?

Determine the optimal analgesic dosage required that causes the least side effects.

A client newly prescribed esomeprazole for gastroesophageal reflux disease (GERD) asks the nurse how the medication will help. Which is the best explanation to provide the client?

It will promote rapid tissue healing.

A client with chronic pancreatitis receives a new prescription for pancrelipase (Pancrease). Which instruction is most important for the nurse to include in this client's teaching?

Take the medication when consuming food.

The healthcare provider prescribes oral antifungal therapy for a client with onychomycosis. Which information should the nurse provide the client?

The infection is difficult to eradicate and requires prolonged therapy for 3 to 6 months.

A nurse is planning a teaching session for a client newly prescribed a miotic drug for the treatment of glaucoma. Which information should the nurse include in the teaching session?

The medication enhances the aqueous humor outflow.

A client at 30-weeks gestation in labor receives two 12 mg doses of betamethasone intramuscularly 12 hours apart. The client asks the nurse why she is receiving the betamethasone. Which explanation should the nurse give the client?

The medication stimulates fetal surfactant production.

A client who is diagnosed with methillicin-resistant Staphylococcus aureus receives a prescription for vancomycin (Vancocin). Which assessment should the nurse perform to identify a potential adverse effect?

Whisper test.

A client is beginning therapy with montelukast (Singulair) PO 10 mg once a day in the evening. The client asks the nurse, "When should I begin to feel better?" How should the nurse respond?

Within 24 hours.

The nurse should withhold which medication if a client reports nausea, vomiting, and diarrhea?

Colchicine (Mitigare, Colcrys).

The nurse is administering haloperidol 0.5 mg IM PRN to a client for the first time. What side effects should the nurse assess the client for during the initial dose?

Dystonia.

A 48-year-old client is experiencing a severe anaphylactic reaction to an injection of contrast media. Which pharmacologic agent is of greatest use in this situation?

Epinephrine (Adrenalin).

The healthcare provider (HCP) prescribes a medication for an older adult client who is reporting insomnia, and the HCP instructs the client to return in two weeks. The nurse should question which prescription?

Eszopiclone (Lunesta) 10 milligrams orally at bedtime.

A client prescribed a statin and gemfibrozil (Lopid) for hyperlipidemia reports an onset of muscle pain and weakness. Which assessment is most important for the nurse to evaluate?

Serum liver enzymes.

The nurse administers the initial dose of a fentanyl (Duragesic) transdermal patch to a client. Which assessment finding should the nurse use to evaluate the effectiveness of the medication?

The number on the numeric pain scale.

Which findings should the nurse identify in an adult client with possible chronic salicylate intoxication?

Tinnitus and hearing loss.

An end-stage terminally ill client being cared for at home is receiving morphine via a patient-controlled pump for intractable cancer pain. When the hospice nurse visits, the client awakens, moans in severe pain, and asks for an increase in the morphine dosage. The client's heart rate is 80 beats/minute, respirations are 10 breaths/minute, and the blood pressure is 102/68 mmHg. Which is the best action for the nurse to implement?

Titrate the morphine dose upward until the client has adequate pain relief.

The nurse is preparing to administer esomeprazole to a client for the management of gastroesophageal reflux disease (GERD). Which finding in the client's history should the nurse hold the medication and notify the healthcare provider?

Treatment for deep vein thrombosis.

Which statement by a client warrants further instruction by the nurse about the changing insulin needs of a diabetic client during pregnancy?

"I will increase my insulin dosage by 5 units each month during the first trimester."

The nurse is instructing a client to avoid which product while taking carisoprodol for muscle spasms. The client verbalizes an understanding of the instructions if they state they will not consume which type of product?

Alcoholic beverages.

A client who is receiving chemotherapy is prescribed ondansetron (Zofran). Which side effect should the nurse include in the teaching plan?

Headache.

A healthcare provider prescribes cefadroxil (Duricef) for a client with a postoperative infection. It is most important for the nurse to assess for what additional drug allergy before administering this prescription?

Penicillins.

A client receives a new prescription for nitroglycerin (Nitrostat) tablets. Which instruction should the nurse include in this client's teaching?

Place under the tongue as needed every 5 minutes up to 3 times.

A client calls the clinic and states that she forgot to take her oral contraceptives for the past two days. Which instruction is best for the nurse to provide to this client?

Take 2 pills a day for 2 days and use an alternate method of contraception for 7 days.

A client is diagnosed with peptic ulcer disease and receives a prescription for esomeprazole (Nexium) 20 mg capsule daily. When providing this client with discharge teaching, the nurse should include which instruction?

Take at same time each day one hour before eating a meal.

A client prescribed furosemide for the past six months is scheduled to receive digoxin for heart failure. Which laboratory serum levels should the nurse review before administering the digoxin?

Potassium.

A client prescribed danazol (Danocrine) for endometriosis calls the clinic nurse and reports having a dark, swollen, and painful leg. Which instructions should the nurse provide the client?

Proceed to the closest emergency room.

A client prescribed sulfisoxazole for a urinary tract infection (UTI) reports nausea and gastric upset since starting the medication. Which additional assessment finding should the nurse report to the healthcare provider immediately?

Rash.

A client receives a new prescription for an angiotensin-converting enzyme (ACE) inhibitor. Which client history contraindicates its use?

Renal artery stenosis.

A resident of a long-term care facility is taking lithium carbonate (Eskalith) to treat bipolar disorder. Which instruction should the nurse provide to this client's caregivers?

Report symptoms of hypothyroidism such as fatigue and constipation.

A client receives a new prescription for pentazocine (Talwin), a mixed opioid agonist-antagonist, after an opioid agonist is discontinued. What is the advantage for the client when the new prescription is implemented?

Respiratory depression is less.

The nurse receives a unit of blood from the blood bank for a postoperative client who is currently in the X-ray department. Which action should the nurse implement?

Return the blood to the blood bank for refrigeration within 30 minutes.

The nurse is providing medication teaching for a client who recently received a prescription for clozapine (Clozaril). Which instruction should be included in this client's teaching plan?

Rise slowly from a lying position.

An emergency department triage nurse is interviewing a female client who has a history of epilepsy with tonic-clonic seizures controlled by phenytoin (Dilantin). Which information is most significant in planning this client's care?

She ran out of her medication 4 days ago.

The nurse is planning discharge instructions for a client prescribed pyridostigmine bromide tablets for myasthenia gravis (MG). Which instruction should the nurse include in the instructions?

Take the medication 30 to 45 minutes before eating.

A client who is recently diagnosised with myasthenia gravis receives a prescription for pyridostigmine (Mestinon), a cholinergic agent. Which information should the nurse instruct the client to implement when taking this medication?

Take the medication at least 30 minutes before eating meals.

What teaching should the nurse provide a client who has received a new prescription for sildenafil (Viagra)? (Select all that apply.)

Take within 30 to 60 minutes of sexual stimulation. Report rebound priapism that occurs for 4 hours or more. Can cause facial flushing and headache.

A client's prescription of prednisone for the management of asthma is to be discontinued. Which information is important for the nurse to give the client?

The dose of the medication should be tapered over the course of 7 to 10 days.

A client prescribed risperidone 10 mg/day for the past three months is being admitted to the hospital. Which physical assessment findings should the nurse report to the healthcare provider?

Tremors and muscle twitching.

The nurse is performing a physical assessment for a client who received fentanyl via an epidural infusion eight hours ago. Which finding should the nurse anticipate?

Urinary retention.

A client is prescribed cefadroxil (Duricef) for a urinary tract infection. The client informs the nurse that she is currently taking oral contraceptives (OCP). Which client information should the nurse provide?

Use an additional form of contraception until your menstrual cycle.

A client is administered an injection of medroxyprogesterone acetate (Depo-Provera). Which physical finding should the nurse instruct the client is an expected side effect of the medication?

Vaginal bleeding or spotting.

A client prescribed ipratropium reports nausea, blurred vision, headaches, and insomnia after using the inhaler. Which action should the nurse implement first?

Withhold medication and report symptoms and vital signs to healthcare provider.

A client receives a new prescription for ciprofloxacin (Cipro), a synthetic quinolone. When teaching about this drug, which information in the client's history requires special emphasis by the nurse?

Works twenty hours a week as a lifeguard at the local pool.

A client experiencing ventricular dysrhythmias is admitted to the intensive care unit status post a myocardial infarction. The nurse should anticipate the healthcare provider to prescribe which medication?

Amiodarone.

A client receives a prescription for tetracycline (Sumycin). Which instruction should the nurse include in the client's teaching?

Avoid diary products for 2 hours after taking the medication.

The nurse is planning discharge instructions for a client newly prescribed amitriptyline for depression. Which instruction is important for the nurse to include in the client's teaching?

Avoid the consumption of alcohol.

The mother of a newborn refuses to have her newborn administer the vitamin K injection. Which information should the nurse provide the mother?

Bacteria that synthesize vitamin K are not present in the newborn's intestinal tract.

A client experiencing pain from metastatic cancer is prescribed morphine. Which route of administration should the nurse clarify with the healthcare provider prior to administering the medication?

Oral.

A male client with meningitis is prescribed cefotaxime (Claforan) IV and asks the nurse why he cannot receive an oral drug, such as cefaclor (Ceclor) or cefadroxil (Duricef), that he has taken before for infections. How should the nurse respond when considering the actions of cephalosporins?

Cefotaxime (Claforan) provides therapeutic CNS concentrations.

A client is diagnosed with peptic ulcer disease caused by Helicobacter pylori. Which medications should the nurse anticipate the healthcare provider to prescribe for the client? (Select all that apply.)

Clarithromycin (Biaxin). Omeprazole (Prilosec). Metronidazole (Flagyl).

While reviewing the client's electronic medical record (EMR), the nurse assesses a client who is at risk for a possible interaction with an over-the-counter (OTC) decongestant. Which client health history should the nurse report to the healthcare provider concerning the OTC medication? (Select all that apply.)

Closed angle glaucoma. Chronic hypertension.

A client prescribed cyclosporine for the past nine months to prevent renal allograft rejection has a blood urea nitrogen level of 36 mg/dL. Which additional finding should the nurse notify the healthcare provider?

Creatinine level of 2.8 mg/dL.

A client is admitted for atrial fibrillation, and the healthcare provider prescribes disopyramide (Norpace). After explaining the action of this antidysrhythmic agent, which complaint should the nurse instruct the client to report?

Daily weight gain of 2 pounds.

A client being treated with imipramine, an anti-depressant for chronic cancer pain asks the the nurse, "What is the reason for the antiepressant medication?" Which explanation should the nurse provide the client?

Decreases transmission of pain impulses by altering serotonin and norepinephrine activity at nerve synapses.

A pediatric client diagnosed with partial seizures receives a prescription for topiramate. Which information should the nurse provide to the child's parents?

Do not crush the tablet prior to administration.

A client receives a prescription for sulfamethoxazole-trimethoprim (Septra) for a urinary tract infection (UTI). Which instruction should the nurse provide the client?

Drink at least 8 glasses of water a day.

A client diagnosed with multiple sclerosis is experiencing profound weakness, blurry vision, and shooting pains in both legs. Which medication is considered the best course of treatment for the nurse to administer?

High dose methylprednisolone intravenously.

An older client is taking warfarin sodium (Coumadin) PO 2.5 mg twice a day. Which laboratory value should the nurse identify as a therapeutic response of the medication?

INR of 2 to 3.

When assessing a client prior to the administration of digoxin (Lanoxin, APO-Digoxin), which data is most important for the nurse to consider?

Irregular apical pulse with a rate of 87.

The nurse is teaching a client who is newly diagnosed with Type 1 diabetes about neutral protamine Hagedor (NPH) insulin. Which statement by the client indicates an understanding of how the medication works?

It facilitates the transport of glucose into the cells.

A nurse is providing medication education for a client prescribed a beta-blocking agents for treatment of glaucoma. Which statement by the client demonstrates an understanding of the mechanism of the medication?

It inhibits the aqueous humor production.

A client with chronic gouty arthritis prescribed allopurinol is experiencing an acute attack of gouty arthritis. The healthcare provider prescribes concurrent low-dose colchicine. Which information should the nurse provide the client that best explains the action of the colchicine?

It reduces the inflammation at the affected site.

A client with rheumatoid arthritis is receiving a prescription for minocycline (Minocin). Which side effect is most important for the nurse to instruct the client to report?

Loss of balance and dizziness.

A 38-year-old gravida 2 para 2 is diagnosed with bacterial vaginosis 9-months postpartum. A prescription is written for metronidazole (Flagyl). Which information is most important for the nurse to obtain from the client before initiating treatment?

Method of infant feeding.

Which side effects should the nurse monitor for a client who is receiving dexamethasone (Decadron) following neurosurgery? (Select all that apply.)

Mood swings. Increased weight gain. Delayed incisional wound healing. Serum hemoglobin level of 9 mg/dl.

A client with Paget's disease is started on calcitonin (Calcimar) 500 mcg subcutaneously daily. During the initial treatment, what is the priority nursing action?

Observe the client for signs of hypersensitivity.