Pharmacology II - RN Pharmacology Online Practice 2019 A

A nurse is caring for a client who is experiencing acute alcohol withdrawal. For which of the following client outcomes should the nurse administer chlordiazepoxide? 1. Minimize diaphoresis 2. Maintain abstinence 3. Lessen craving 4. Prevent delirium tremens

1. Minimize diaphoresis Rationale: Clonidine does this 2. Maintain abstinence Rationale: Acamprosate does this 3. Lessen craving Rationale: Propranolol does this 4. Prevent delirium tremens

A nurse is providing teaching to a client who has multiple sclerosis and a new prescription for methylprednisolone. Which of the following instructions should the nurse include? (Select all that apply) 1. Blood glucose levels will be monitored during therapy. 2. Avoid contact with people who have known infections. 3. Take the medication 1 hr before breakfast. 4. Decrease dietary intake of foods containing potassium. 5. Grapefruit juice can increase the effects of the medication.

Answer: # 1. Blood glucose levels will be monitored during therapy. 2. Avoid contact with people who have known infections. 3. Take the medication 1 hr before breakfast. Rationale: Take medication with food or milk. 4. Decrease dietary intake of foods containing potassium. Rationale: Increase dietary intake of potassium. 5. Grapefruit juice can increase the effects of the medication.

A nurse at an urgent care clinic is collecting a history from a female client who has a urinary tract infection. The nurse anticipates a prescription for ciprofloxacin. The nurse should identify that which of the following client statements indicates a contraindication for administering this medication? 1. "I have tendonitis, so I haven't been able to exercise" 2. "I take a stool softener for chronic constipation" 3. "I take medicine for my thyroid" 4. "I am allergic to sulfa"

Answer: #1 1. "I have tendonitis, so I haven't been able to exercise" Rationale: Risks tendon rupture. 2. "I take a stool softener for chronic constipation" Rationale: Not contraindicated 3. "I take medicine for my thyroid" Rationale: Not contraindicated 4. "I am allergic to sulfa" Rationale: Ciprofloxacin is a quinolone antibiotic

A nurse is preparing to administer heparin subcutaneously to a client. Which of the following actions should the nurse plan to take? 1. Administer the medication outside the 5cm (2in) radius of the umbilicus. 2. Aspirate for blood return before injecting. 3. Rub vigorously after the injection to promote absorption. 4. Place a pressure dressing on the injection site to prevent bleeding.

Answer: #1 1. Administer the medication outside the 5cm (2in) radius of the umbilicus. 2. Aspirate for blood return before injecting. Rationale: This will cause the injection site to bruise. 3. Rub vigorously after the injection to promote absorption. Rationale: This will cause the injection site to bruise. 4. Place a pressure dressing on the injection site to prevent bleeding. Rationale: This is unnecessary if pressure is held for at least 1 min to prevent bleeding.

A nurse is reviewing the medication list of a client who wants to begin taking oral contraceptives. The nurse should identify that which of the following client medications will interfere with the effectiveness of oral contraceptives? 1. Carbamazepine 2. Sumatriptan 3. Atenolol 4. Glipizide

Answer: #1 1. Carbamazepine 2. Sumatriptan Rationale: No interactions 3. Atenolol Rationale: No interactions 4. Glipizide Rationale: No interactions

A nurse is caring for a client who has cancer and is taking oral morphine and docusate sodium. The nurse should instruct the client that taking the docusate sodium daily can minimize which of the following adverse effects of morphine? 1. Constipation 2. Drowsiness 3. Facial flushing 4. Itching

Answer: #1 1. Constipation 2. Drowsiness Rationale: Not an adverse effect of morphine. 3. Facial flushing Rationale: Not an adverse effect of morphine. 4. Itching Rationale: Not an adverse effect of morphine.

A nurse is preparing to administer medications to a client who tells the nurse, "I don't want to take my fluid pill until I get home today." Which of the following actions should the nurse take? 1. Document the refusal and inform the client's provider 2. File an incident report with the risk manager 3. Contact the pharmacist to pick up the medication 4. Give the client the medication to take at home and document that it was administered.

Answer: #1 1. Document the refusal and inform the client's provider 2. File an incident report with the risk manager Rationale: Incident report is not necessary 3. Contact the pharmacist to pick up the medication Rationale: Follow protocol for discarding medication 4. Give the client the medication to take at home and document that it was administered. Rationale: False documentation.

A nurse is teaching a client who is to begin taking tamoxifen for the treatment of breast cancer. Which of the following adverse effects should the nurse include in the teaching? 1. Hot flashes 2. Urinary retention 3. Constipation 4. Bradycardia

Answer: #1 1. Hot flashes 2. Urinary retention Rationale: Not an adverse effect 3. Constipation Rationale: Not an adverse effect 4. Bradycardia Rationale: Not an adverse effect

A nurse is caring for a client who is receiving filgrastim. Which of the following findings should the nurse document to indicate the effectiveness of the therapy? 1. Increased neutrophil count 2. Increased RBC count 3. Decreased prothrombin time 4. Decreased triglycerides

Answer: #1 1. Increased neutrophil count 2. Increased RBC count Rationale: No effect on RBC count 3. Decreased prothrombin time Rationale: No effect on PTT. 4. Decreased triglycerides Rationale: No effect on triglycerides.

A nurse is preparing to administer medication to a client who has gout. The nurse discovers that an error was made during the previous shift and the client received atenolol instead of allopurinol. Which of the following actions should the nurse take first? 1. Obtain the client's blood pressure. 2. Contact the client's provider. 3. Inform the charge nurse. 4. Complete an incident report.

Answer: #1 1. Obtain the client's blood pressure. 2. Contact the client's provider. Rationale: Should be done, but not FIRST. 3. Inform the charge nurse. Rationale: Should be done, but not FIRST. 4. Complete an incident report. Rationale: Should be done, but not FIRST.

A nurse is planning to teach about the use of a spacer to a child who has a new prescription for a fluticasone inhaler to treat chronic asthma. The nurse should include that the spacer decreases the risk for which of the following adverse effects of the medication? 1. Oral candidiasis 2. Headache 3. Joint pain 4. Adrenal suppression

Answer: #1 1. Oral candidiasis 2. Headache Rationale: Not affected by the spacer 3. Joint pain Rationale: Not affected by the spacer 4. Adrenal suppression Rationale: Not affected by the spacer

A nurse is assessing a client who has schizophrenia and is taking haloperidol. The nurse should report which of the following findings to the provider as a manifestation of neuroleptic malignant syndrome (NMS)? 1. Temperature of 39.7C (103.5F) 2. Urinary retention 3. Heart rate 56/min 4. Muscle flaccidity

Answer: #1 1. Temperature of 39.7C (103.5F) 2. Urinary retention Rationale: Incontinence is a manifestation of NMS. 3. Heart rate 56/min Rationale: Tachycardia is a manifestation of NMS. 4. Muscle flaccidity Rationale: Severe muscle rigidity is a manifestation of NMS.

A nurse is assessing a client who is postoperative following an outpatient endoscopy procedure using midazolam. The nurse should monitor for which of the following findings as an indication that the client is ready for discharge? 1. The client's capnography has returned to baseline. 2. The client can respond to their name when called. 3. The client is passing flatus. 4. The client is requesting oral intake.

Answer: #1 1. The client's capnography has returned to baseline. 2. The client can respond to their name when called. Rationale: The client is not at the state of arousal marked at pre-procedure. 3. The client is passing flatus. Rationale: This is pertinent for clients who received general anesthesia. 4. The client is requesting oral intake. Rationale: This can only be approved after gag reflex has returned, and is not relevant to discharge.

A nurse is caring for a client who is taking acetazolamide for chronic open-angle glaucoma. For which of the following adverse effects should the nurse instruct the client to monitor and report? 1. Tingling of fingers 2. Constipation 3. Weight gain 4. Oliguria

Answer: #1 1. Tingling of fingers 2. Constipation Rationale: Diarrhea, not constipation 3. Weight gain Rationale: Weight loss, not gain 4. Oliguria Rationale: Polyuria, not oliguria

A nurse is caring for a client who is in labor. The client is receiving oxytocin by continuous IV infusion with a maintenance IV solution. The external FHR monitor indicates late decelerations. Which of the following actions should the nurse take first? 1. Turn the client to a side-lying position. 2. Disconnect the client's oxytocin from the maintenance IV. 3. Apply oxygen to the client by face mask. 4. Increase the client's maintenance IV infusion rate.

Answer: #1 1. Turn the client to a side-lying position. Rationale: This protects the fetus from injury due to uteroplacental insufficiency. 2. Disconnect the client's oxytocin from the maintenance IV. Rationale: This reduces uterine contractions, but is not FIRST. 3. Apply oxygen to the client by face mask. Rationale: This provides supplemental oxygen to the fetus, but is not FIRST. 4. Increase the client's maintenance IV infusion rate. Rationale: This maintains adequate blood flow and promotes placental perfusion, but is not FIRST.

A nurse is providing teaching to a client who is to begin taking oxybutynin for urinary incontinence. Which of the following adverse effects should the nurse include in the teaching? (Select all that apply) 1. Dry mouth 2. Tinnitus 3. Blurred vision 4. Bradycardia 5. Dry eyes

Answer: #1, 3, & 5 1. Dry mouth 2. Tinnitus Rationale: Not an adverse effect 3. Blurred vision 4. Bradycardia Rationale: Not an adverse effect 5. Dry eyes

A nurse is instructing a client on the application of nitroglycerin transdermal patches. Which of the following statements by the client indicates an understanding of the teaching? 1. "I should apply a patch every 5 minutes if I develop chest pain" 2. "I will take the patch off right after my evening meal" 3. "I will leave the patch off at least 1 day a week" 4. "I should discard the used patch by flushing it down the toilet."

Answer: #2 1. "I should apply a patch every 5 minutes if I develop chest pain" Rationale: These directions are for sublingual tablets. 2. "I will take the patch off right after my evening meal" 3. "I will leave the patch off at least 1 day a week" Rationale: Patch should be applied daily to sustain prophylaxis. 4. "I should discard the used patch by flushing it down the toilet." Rationale: As medication remains on the patch, fold it in on itself and discard in a closed container.

A nurse is teaching a client about warfarin. The client asks if they can take aspirin while taking the warfarin. Which of the following responses should the nurse make? 1. "It is safe to take an enteric-coated aspirin." 2. "Aspirin will increase the risk of bleeding." 3. "Acetaminophen may be substituted for aspirin." 4. "The INR lab work must be monitored more frequently if aspirin is taken."

Answer: #2 1. "It is safe to take an enteric-coated aspirin." Rationale: Salicylates inhibit platelet aggregation and increase the potential for hemorrhage. 2. "Aspirin will increase the risk of bleeding." 3. "Acetaminophen may be substituted for aspirin." Rationale: Acetaminophen is not a safe substitute for aspirin. 4. "The INR lab work must be monitored more frequently if aspirin is taken." Rationale: Follow prescription as provider has prescribed it.

A nurse is providing teaching to a client who has a prescription for ergotamine sublingual to treat migraine headaches. Which of the following information should the nurse include in the instructions? 1. "Take one tablet three times a day before meals" 2. "Take one tablet at onset of migraine" 3. "Take up to eight tablets as needed within a 24-hour period" 4. "Take one tablet every 15 minutes until migraine subsides"

Answer: #2 1. "Take one tablet three times a day before meals" Rationale: No prophylactic use due to dependency. 2. "Take one tablet at onset of migraine" 3. "Take up to eight tablets as needed within a 24-hour period" Rationale: Max of 3 tabs in a 24 hr period. 4. "Take one tablet every 15 minutes until migraine subsides" Rationale: Every 30 minutes up to 3 tabs in 24 hr.

A nurse is collecting a medication history from a client who has a new prescription for lithium. The nurse should identify that the client should discontinue which of the following over-the-counter medications? 1. Aspirin 2. Ibuprofen 3. Famotidine 4. Bisacodyl

Answer: #2 1. Aspirin Rationale: Does not react with lithium. 2. Ibuprofen 3. Famotidine Rationale: Does not react with lithium. 4. Bisacodyl Rationale: Does not react with lithium.

A nurse is caring for the parent of a newborn. The parent asks the nurse when their newborn should receive the first diphtheria, tetanus, and pertussis vaccine (DTaP). The nurse should instruct the parent that their newborn should receive the immunization at which of the following ages? 1. At birth 2. 2 months 3. 6 months 4. 15 months

Answer: #2 1. At birth Rationale: Hepatitis B vaccine is given at birth 2. 2 months 3. 6 months Rationale: Third dose of the 5-dose series DTaP 4. 15 months Rationale: Fourth dose of the 5- dose series DTaP

A nurse on the acute care unit is caring for a client who is receiving gentamicin IV. The nurse should report which of the following findings to the provider as an adverse effect of the medication? 1. Constipation 2. Tinnitus 3. Hypoglycemia 4. Joint pain

Answer: #2 1. Constipation Rationale: Not an adverse effect 2. Tinnitus 3. Hypoglycemia Rationale: Not an adverse effect 4. Joint pain Rationale: Side effect, not adverse effect.

A nurse is caring for a client who received 0.9% NaCl 1L over 4 hr instead of over 8 hr as prescribed. Which of the following information should the nurse enter as a complete documentation of the incident? 1. IV fluid infused over 4 hr instead of the prescribed 8 hr. Client tolerated fluids well, provider notified. 2. 0.9% NaCl 1L IV infused over 4 hr. Vital signs stable, provider notified. 3. 1L of 0.9% NaCl completed at 0900. Client denies shortness of breath. 4. IV fluid initiated at 0500. Lungs clear to auscultation.

Answer: #2 1. IV fluid infused over 4 hr instead of the prescribed 8 hr. Client tolerated fluids well, provider notified. Rationale: Only include factual information. 2. 0.9% NaCl 1L IV infused over 4 hr. Vital signs stable, provider notified. 3. 1L of 0.9% NaCl completed at 0900. Client denies shortness of breath. Rationale: Documentation is not complete 4. IV fluid initiated at 0500. Lungs clear to auscultation. Rationale: Documentation is not complete

A nurse receives a verbal order from the provider to administer morphine five milligrams every 4 hours subcutaneously for severe pain as needed. The nurse should identify which of the following entries as the correct format for the medication administration record (MAR)? 1. MSO4 5mg subcut every 4 hr PRN severe pain 2. Morphine 5mg subcut every 4 hr PRN severe pain 3. MSO4 5mg SQ every 4 hr PRN severe pain 4. Morphine 5.0mg subcutaneously every 4 hr PRN severe pain.

Answer: #2 1. MSO4 5mg subcut every 4 hr PRN severe pain Rationale: MSO4 is prohibited by The Joint Commission 2. Morphine 5mg subcut every 4 hr PRN severe pain 3. MSO4 5mg SQ every 4 hr PRN severe pain Rationale: MSO4 is prohibited by The Joint Commission 4. Morphine 5.0mg subcutaneously every 4 hr PRN severe pain. Rationale: Trailing zero can be mistaken as 50

A nurse in an emergency department is caring for a client who has heroin toxicity. The client is unresponsive with pinpoint pupils and a respiratory rate of 6/min. Which of the following medications should the nurse plan to administer? 1. Methadone 2. Naloxone 3. Diazepam 4. Bupropion

Answer: #2 1. Methadone Rationale: Used to decrease withdrawals, not in emergency. 2. Naloxone 3. Diazepam Rationale: Used for alcohol withdrawal, not this situation. 4. Bupropion Rationale: Antidepressant, not used in this situation.

A nurse is planning care for a client who is prescribed metoclopramide following bowel surgery. For which of the following adverse effects should the nurse monitor? 1. Muscle weakness 2. Sedation 3. Tinnitus 4. Peripheral edema

Answer: #2 1. Muscle weakness Rationale: Metoclopramide causes tardive dyskinesia, not muscle weakness. 2. Sedation 3. Tinnitus Rationale: Metoclopramide does not cause ringing in the ears. 4. Peripheral edema Rationale: Metoclopramide does not cause peripheral edema.

A nurse is caring for a 20-year-old female client who has a prescription for isotretinoin for severe nodulocystic acne vulgaris. Before the client can obtain a refill, the nurse should advise the client that which of the following tests is required? 1. Serum calcium 2. Pregnancy test 3. 24-hr urine collection for protein 4. Aspartate aminotransferase level

Answer: #2 1. Serum calcium Rationale: Not necessary 2. Pregnancy test 3. 24-hr urine collection for protein Rationale: Not necessary 4. Aspartate aminotransferase level Rationale: Only needed to start and one month after starting isotretinoin, but not necessary for a renewal.

A nurse is reviewing the ECG of a client who is receiving IV furosemide for heart failure. The nurse should identify which of the following findings as an indication of hypokalemia? 1. Tall, tented T-waves 2. Presence of U-waves 3. Widened QRS complex 4. ST elevation

Answer: #2 1. Tall, tented T-waves Rationale: Indicates hyperkalemia 2. Presence of U-waves 3. Widened QRS complex Rationale: Indicates hyperkalemia 4. ST elevation Rationale: Indication of ischemia

A nurse at a clinic is providing follow-up care to a client who is taking fluoxetine for depression. Which of the following findings should the nurse identify as an adverse effect of this medication? 1. Tingling toes 2. Sexual dysfunction 3. Absence of dreams 4. Pica

Answer: #2 1. Tingling toes Rationale: Distorted sensations in the extremities are not adverse effects of fluoxetine. 2. Sexual dysfunction 3. Absence of dreams Rationale: Absence of dreams is not associated with fluoxetine. 4. Pica Rationale: An eating disorder is not associated with fluoxetine.

A nurse is caring for a client who has acute acetaminophen toxicity. The nurse should anticipate administering which of the following medications? 1. Vitamin K 2. Acetylcysteine 3. Benztropine 4. Physostigmine

Answer: #2 1. Vitamin K Rationale: Treats increased warfarin serum levels 2. Acetylcysteine 3. Benztropine Rationale: Treats adverse effects of Parkinson's disease, reduces rigidity and tremors. 4. Physostigmine Rationale: Antidote for antimuscarinic poisoning.

A nurse is caring for a client who is receiving heparin therapy via continuous IV infusion to treat pulmonary embolism. Which of the following findings should the nurse identify as an adverse effect of the medication and report to the provider? 1. Vomiting 2. Blood in the urine 3. Positive Chvostek's sign 4. Ringing in the ears

Answer: #2 1. Vomiting Rationale: Vomiting is not an expected adverse effect. 2. Blood in the urine 3. Positive Chvostek's sign Rationale: This indicates hypocalcemia or hypomagnesemia. 4. Ringing in the ears Rationale: Ringing in the ears is not an expected adverse effect.

A nurse is planning care for a client who has hypertension and is to start taking metoprolol. Which of the following interventions should the nurse include in the plan of care? 1. Weigh the client weekly 2. Determine apical pulse prior to administering 3. Administer the medication 30 min prior to breakfast 4. Monitor the client for jaundice

Answer: #2 1. Weigh the client weekly Rationale: Weigh client daily 2. Determine apical pulse prior to administering 3. Administer the medication 30 min prior to breakfast Rationale: Give med after meals or at bedtime 4. Monitor the client for jaundice Rationale: Monitor for hypotension, jaundice is not associated with metoprolol.

A nurse is providing discharge instructions to a client who has heart failure and a new prescription for captopril. Which of the following client statements indicates an understanding of the teaching? 1. "I should take the medication with food." 2. "I should take naproxen if I develop joint pain." 3. "I should tell my provider if I develop a sore throat." 4. "I should expect the medication to cause my urine to look orange."

Answer: #3 1. "I should take the medication with food." Rationale: Food reduces absorption of the medication. 2. "I should take naproxen if I develop joint pain." Rationale: NSAIDs can interact with captopril, causing decreased effect of antihypertensive action and increased risk of kidney dysfunction. 3. "I should tell my provider if I develop a sore throat." 4. "I should expect the medication to cause my urine to look orange." Rationale: Captopril does not affect the color of urine.

A nurse is teaching a client about cyclobenzaprine. Which of the following client statements should indicate to the nurse that the teaching is effective? 1. "I will have increased saliva production" 2. "I will continue taking the medication until the rash disappears" 3. "I will taper off the medication before discontinuing it" 4. "I will report any urinary incontinence"

Answer: #3 1. "I will have increased saliva production" Rationale: Dry mouth is a side effect. 2. "I will continue taking the medication until the rash disappears" Rationale: Medication does not affect skin rashes. 3. "I will taper off the medication before discontinuing it" 4. "I will report any urinary incontinence" Rationale: Report urinary retention.

A nurse is providing teaching to a client who has a gastric ulcer and a new prescription for famotidine. Which of the following instructions should the nurse include? 1. "Take the medication on an empty stomach for full effectiveness." 2. "You may discontinue this medication when stomach discomfort subsides." 3. "Report yellowing of the skin." 4. "You will be taking this medication for 2 weeks."

Answer: #3 1. "Take the medication on an empty stomach for full effectiveness." Rationale: Food does not affect the medications effectiveness. 2. "You may discontinue this medication when stomach discomfort subsides." Rationale: Famotidine inhibits gastric secretion and if stopped abruptly, symptoms will return. 3. "Report yellowing of the skin." 4. "You will be taking this medication for 2 weeks." Rationale: For gastric ulcers, a minimum of 6 weeks up to a year is prescribed.

A nurse is preparing to administer a scheduled antibiotic at 0800 to a client and discovers the antibiotic is not present in the client's medication drawer. The nurse should identify that administration of the medication can occur at which of the following time periods without requiring and incident report? 1. 1000 2. 0900 3. 0830 4. 1200

Answer: #3 1. 1000 Rationale: 2 hours is too late 2. 0900 Rationale: 1 hour is too late 3. 0830 4. 1200 Rationale: 4 hours is too late

A nurse is providing teaching to a client who has peptic ulcer disease and is to start a new prescription for sucralfate. Which of the following actions of sucralfate should the nurse include in the teaching? 1. Decreases stomach acid secretion 2. Neutralizes acids in the stomach 3. Forms a protective barrier over ulcers 4. Treats ulcers by eradicating H. pylori

Answer: #3 1. Decreases stomach acid secretion Rationale: This is done by H2 receptor antagonists, like famotidine. 2. Neutralizes acids in the stomach Rationale: This is done by antacids, like aluminum hydroxide. 3. Forms a protective barrier over ulcers 4. Treats ulcers by eradicating H. pylori Rationale: This is done by antibiotics.

A nurse is assessing a client's vitals signs prior to the administration of PO digoxin. The client's BP is 144/86 mmHg, heart rate is 55/min, and respiratory rate is 20/min. The nurse should withhold the medication and contact the provider for which of the following findings? 1. Diastolic BP 2. Systolic BP 3. Heart rate 4. Respiratory rate

Answer: #3 1. Diastolic BP Rationale: Digoxin increases cardiac output and reduces heart rate. 2. Systolic BP Rationale: Digoxin increases cardiac output and reduces heart rate. 3. Heart rate 4. Respiratory rate Rationale: Digoxin increases cardiac output and reduces heart rate.

A nurse is assessing a client after administering a second dose of cefazolin IV. The nurse notes the client has anxiety, hypotension, and dyspnea. Which of the following medications should the nurse administer first? 1. Diphenhydramine 2. Albuterol inhaler 3. Epinephrine 4. Prednisone

Answer: #3 1. Diphenhydramine Rationale: Decreases angioedema and urticaria following anaphylaxis, but not priority medication. 2. Albuterol inhaler Rationale: Fixes dyspnea, but not the priority medication. 3. Epinephrine 4. Prednisone Rationale: Helps with urticaria following anaphylaxis, but not the priority medication.

A nurse is reviewing the medication administration record of a client who has hypocalcemia and a new prescription for IV calcium gluconate. The nurse should identify that which of the following medications can interact with calcium gluconate? 1. Felodipine 2. Guaifenesin 3. Digoxin 4. Regular insulin

Answer: #3 1. Felodipine Rationale: Does not interact 2. Guaifenesin Rationale: Does not interact 3. Digoxin 4. Regular insulin Rationale: Does not interact

A nurse in an emergency department is caring for a client whose family reports the client has taken large amounts of diazepam. Which of the following medications should the nurse anticipate administering? 1. Ondansetron 2. Magnesium sulfate 3. Flumazenil 4. Protamine sulfate

Answer: #3 1. Ondansetron Rationale: Antiemetic 2. Magnesium sulfate Rationale: Electrolyte replacement for seizure activity 3. Flumazenil 4. Protamine sulfate Rationale: Antidote for heparin

A nurse in an emergency department is caring for a client who has myasthenia gravis and is in a cholinergic crisis. Which of the following medications should the nurse plan to administer? 1. Potassium iodide 2. Glucagon 3. Atropine 4. Protamine

Answer: #3 1. Potassium iodide Rationale: Thyroid hormone antagonist used to treat radioactive iodine exposure. 2. Glucagon Rationale: Anti-hypoglycemic medication treating low blood glucose levels. 3. Atropine 4. Protamine Rationale: Heparin antagonist to reverse heparin toxicity.

A nurse administers a dose of metformin to a client instead of the prescribed dose of metoclopramide. Which of the following actions should the nurse take first? 1. Report the incident to the charge nurse 2. Notify the prescriber 3. Check the client's blood glucose level 4. Fill out an incident report.

Answer: #3 1. Report the incident to the charge nurse Rationale: Not FIRST choice 2. Notify the prescriber Rationale: Not FIRST choice 3. Check the client's blood glucose level 4. Fill out an incident report. Rationale: Not FIRST choice

A nurse is teaching a group of unit nurses about medication reconciliation. Which of the following information should the nurse include in the teaching? 1. The client's provider is required to complete medication reconciliation. 2. Medication reconciliation at discharge is limited to the medication ordered at the time of discharge. 3. A transition in care requires the nurse to conduct medication reconciliation. 4. Medical reconciliation is limited to the name of the medications that the client is currently taking.

Answer: #3 1. The client's provider is required to complete medication reconciliation. Rationale: 2. Medication reconciliation at discharge is limited to the medication ordered at the time of discharge. Rationale: 3. A transition in care requires the nurse to conduct medication reconciliation. 4. Medical reconciliation is limited to the name of the medications that the client is currently taking. Rationale:

A nurse is teaching a client about the use of risedronate for the treatment of osteoporosis. The nurse should identify which of the following statements as an indication that the client understands the teaching? 1. "I will drink a glass of milk when I take the risedronate." 2. "I will take the risedronate 15 minutes after my evening meal." 3. "I should take an antacid with the risedronate to avoid nausea." 4. "I should sit up for 30 minutes after taking the risedronate."

Answer: #4 1. "I will drink a glass of milk when I take the risedronate." Rationale: Risedronate should be taken with water. 2. "I will take the risedronate 15 minutes after my evening meal." Rationale: Risedronate should be taken in the morning and 30 min prior to a meal. 3. "I should take an antacid with the risedronate to avoid nausea." Rationale: Risedronate will not be absorbed properly if taken with an antacid. 4. "I should sit up for 30 minutes after taking the risedronate."

A nurse is providing teaching to a client who is to start treatment for asthma with beclomethasone and albuterol inhalers. Which of the following instructions should the nurse include in the teaching? 1. "Take beclomethasone to avoid an acute attack." 2. "Use beclomethasone 5 minutes before using albuterol." 3. "Limit your calcium and vitamin D intake when taking beclomethasone." 4. "Rinse your mouth after inhaling beclomethasone."

Answer: #4 1. "Take beclomethasone to avoid an acute attack." Rationale: Take albuterol for acute asthma attack. 2. "Use beclomethasone 5 minutes before using albuterol." Rationale: Use albuterol first to enhance absorption. 3. "Limit your calcium and vitamin D intake when taking beclomethasone." Rationale: Increase calcium and Vitamin D intake to minimize bone loss. 4. "Rinse your mouth after inhaling beclomethasone."

A nurse is reviewing the laboratory results of a client who is taking digoxin for heart failure. Which of the following results should the nurse report to the provider? 1. Calcium level 9.2 mg/dL 2. Magnesium level 1.6 mEq/L 3. Digoxin level 1.1 ng/mL 4. Potassium level 2.8 mEq/L

Answer: #4 1. Calcium level 9.2 mg/dL Rationale: Within normal range 2. Magnesium level 1.6 mEq/L Rationale: Within normal range 3. Digoxin level 1.1 ng/mL Rationale: Within normal range 4. Potassium level 2.8 mEq/L

A nurse is providing discharge teaching about handling medication to a client who is to continue taking oral transmucosal fentanyl raspberry-flavored lozenges on a stick. Which of the following information should the nurse include in the teaching? 1. Chew on the medication stick to release the medication. 2. Leave the medication stick in one location of the mouth until melted. 3. Allow the medication 1 hr for analgesia effects to begin. 4. Store unused medication sticks in a storage container.

Answer: #4 1. Chew on the medication stick to release the medication. Rationale: Keep stick between cheek and gum, then suck on it. 2. Leave the medication stick in one location of the mouth until melted. Rationale: Move stick around for best absorption. 3. Allow the medication 1 hr for analgesia effects to begin. Rationale: Analgesia effects take 10-15 min. 4. Store unused medication sticks in a storage container.

A nurse is assessing a client 1 hr after administering morphine for pain. The nurse should identify which of the following findings as the best indication that the morphine has been effective? 1. The client's vital signs are within normal limits. 2. The client has not requested additional medication. 3. The client is resting comfortably with eyes closed. 4. The client rates pain as 3 on a scale from 0 to 10.

Answer: #4 1. The client's vital signs are within normal limits. Rationale: Patient can still have pain 2. The client has not requested additional medication. Rationale: Patient can still have pain 3. The client is resting comfortably with eyes closed. Rationale: Patient can still have pain 4. The client rates pain as 3 on a scale from 0 to 10.

A nurse is providing teaching to a client who is taking bupropion as an aid to quit smoking. Which of the following findings should the nurse identify as an adverse effect of the medication? 1. Cough 2. Joint pain 3. Alopecia 4. Insomnia

Answer: #4 1. Cough Rationale: Not an adverse effect 2. Joint pain Rationale: Not an adverse effect 3. Alopecia Rationale: Not an adverse effect 4. Insomnia

A nurse is assessing a client who is taking propylthiouracil for the treatment of Graves' disease. Which of the following findings should the nurse identify as an indication that the medication has been effective? 1. Decrease the WBC count 2. Decrease in amount of time sleeping 3. Increase in appetite 4. Increase in ability to focus

Answer: #4 1. Decrease the WBC count Rationale: This is an adverse effect that can cause myelosuppression. 2. Decrease in amount of time sleeping Rationale: Insomnia is a neurological manifestation of Graves' disease. 3. Increase in appetite Rationale: Increased appetite is a gastrointestinal manifestation of Graves' disease. 4. Increase in ability to focus

A nurse is administering donepezil to a client who has Alzheimer's disease. Which of the following findings should the nurse report to the provider immediately? 1. Dyspepsia 2. Diarrhea 3. Dizziness 4. Dyspnea

Answer: #4 1. Dyspepsia Rationale: Should be reported, but not FIRST. 2. Diarrhea Rationale: Should be reported, but not FIRST. 3. Dizziness Rationale: Should be reported, but not FIRST. 4. Dyspnea

A nurse is preparing to administer PO sodium polystyrene sulfonate to a client who has hyperkalemia. Which of the following actions should the nurse plan to take? 1. Hold the client's other oral medications for 8 hr post administration. 2. Inform the client that this medication can turn stool a light tan color. 3. Keep the solution in the refrigerator for up to 72 hr. 4. Monitor the client for constipation.

Answer: #4 1. Hold the client's other oral medications for 8 hr post administration. Rationale: Hold meds for 6 hr. 2. Inform the client that this medication can turn stool a light tan color. Rationale: This medication will not alter stool color. 3. Keep the solution in the refrigerator for up to 72 hr. Rationale: Solution is only stable for 24 hr. 4. Monitor the client for constipation.

A nurse is reviewing the laboratory results for a client who is receiving heparin via continuous IV infusion for deep-vein thrombosis. The nurse should discontinue the medication infusion for which of the following client findings? 1. Potassium 5.0 mEq/L 2. aPTT 2 times the control 3. Hemoglobin 15 g/dL 4. Platelets 96,000/mm3

Answer: #4 1. Potassium 5.0 mEq/L Rationale: Within normal range 2. aPTT 2 times the control Rationale: Within therapeutic range 3. Hemoglobin 15 g/dL Rationale: Within normal range 4. Platelets 96,000/mm3

A nurse is assessing a client who has myasthenia gravis and is taking neostigmine. Which of the following findings should indicate to the nurse that the client is experiencing an adverse effect? 1. Tachycardia 2. Oliguria 3. Xerostomia 4. Miosis

Answer: #4 1. Tachycardia Rationale: Bradycardia , not tachycardia 2. Oliguria Rationale: Urinary urgency, not decreased output. 3. Xerostomia Rationale: Increased salivation, not dry mouth 4. Miosis

A nurse is teaching a client who is to start taking hydrocodone with acetaminophen tablets for pain. Which of the following information should the nurse include in the teaching? 1. The medication should be taken 1 hr prior to eating. 2. It takes 48 hr for therapeutic effects to occur. 3. Tablets should not be crushed or chewed. 4. Decreased respirations might occur.

Answer: #4 1. The medication should be taken 1 hr prior to eating. Rationale: Take medication with food. 2. It takes 48 hr for therapeutic effects to occur. Rationale: Medication takes 20 min to reach therapeutic level and lasts 4-6 hr. 3. Tablets should not be crushed or chewed. Rationale: Avoid crushing or chewing EC/ER/IR tablets, but if no coating, it can be crushed if needed. 4. Decreased respirations might occur.

A nurse is planning care for a client who is receiving mannitol via continuous IV infusion. The nurse should monitor the client for which of the following adverse effects? 1. Weight loss 2. Increased intraocular pressure 3. Auditory hallucinations 4. Bibasilar crackles.

Answer: #4 1. Weight loss Rationale: Weight loss is a therapeutic effect 2. Increased intraocular pressure Rationale: This is an indication to use mannitol as it reduces this. 3. Auditory hallucinations Rationale: This is not an adverse effect of mannitol. 4. Bibasilar crackles.

A nurse is developing a teaching plan for a client who has a new prescription for simvastatin. Which of the following instructions should the nurse include in the teaching plan? (Select all that apply.) 1. Report muscle pain to the provider. 2. Avoid taking the medication with grapefruit juice. 3. Take the medication in the early morning. 4. Expect a flushing of the skin as a reaction to the medication. 5. Expect therapy with this medication to be lifelong.

Answer: 1, 2, 5 1. Report muscle pain to the provider. 2. Avoid taking the medication with grapefruit juice. 3. Take the medication in the early morning. Rationale: Medication should be taken in the evening. 4. Expect a flushing of the skin as a reaction to the medication. Rationale: Flushing of the skin is an adverse effect of niacin, not simvastatin. 5. Expect therapy with this medication to be lifelong.

A nurse is preparing to administer dextrose 5% in water (D5W) 400 mL IV to infuse over 1 hr. The drop factor of the manual IV tubing is 15 gtt/mL. The nurse should set the manual IV infusion to deliver how many gtt/min? (Round to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.) _____________gtt/min

Answer: 100gtt/min 400 * 15 = 6000gtt 6000 / 60 = 100gtt/min

A nurse is preparing to administer ciprofloxacin 15 mg/kg PO every 12 hr to a child who weighs 44 lb. How many mg should the nurse administer per dose? (Round the answer to the nearest whole number. Using a leading zero if it applies. Do not use a trailing zero.) _________ mg

Answer: 300 mg 44 / 2.2 = 20kg 15 * 20 = 300mg ***12 hr is an unnecessary number for this math problem***