Pharmacology Practice Assessment

A nurse is preparing to administer dextrose 5% in water (D5W) 400mL IV to infuse over 1 hour. 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?

100 gtt/min

A nurse is preparing to administer 0.9% sodium chloride (NaCl) 1,500 mL to infuse over 8 hr to a client who is postoperative. The nurse should set the IV pump to deliver how many ml/hr? (Round to the nearest whole number)

188

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?

300 mg

A nurse is preparing to administer to a client 0.9% sodium chloride 1,000 mL IV over 8 hours. 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?

31 gtt/min

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

A. Administer the medication outside the 5-cm (2-in) radius of the umbilicus. The nurse should administer the heparin by subcutaneous injection to the abdomen in an area that is above the iliac crest and at least 2 inches away from the umbilicus.

A nurse is precepting a newly licensed nurse who is caring for four clients. The nurse should complete an incident report for which of the following actions by the newly licensed nurse? A. Administers isosorbide mononitrate to a client who has a BP of 82/60 mmHg B. Administers digoxin to a client who has a heart rate of 92/min C. Administers regular insulin to a client who has a blood glucose of 250 mg/dL D. Administers heparin to a client who has an aPTT of 70 seconds

A. Administers isosorbide mononitrate to a client who has a BP of 82/60 mmHg Isosorbide mononitrate is a nitrate used for clients with angina. Taking isosorbide mononitrate leads to vasodilation, which can result in hypotension. The nurse should withhold the medication and notify the provider if the client's systolic blood pressure is below the expected reference range.

A nurse is caring for a client who is receiving haloperidol. The nurse should observe for which of the following findings as an adverse effect of the medication? A. Akathisia B. Paresthesia C. Excess tear production D. Anxiety

A. Akathisia A significant adverse effect associated with haloperidol is the development of extrapyramidal symptoms such as dystonia, pseudoparkinsonism, and akathisia.

A nurse is providing teaching for a client who has multiple sclerosis and a new prescription for methylprednisolone. Which of the following instructions should the nurse include? (SATA) A. Blood glucose levels will be monitored during therapy. B. Avoid contact with people who have known infections. C. Take the medication 1 hr before breakfast. D. Decrease dietary intake of foods containing potassium. E. Grapefruit juice can increase the effects of this medication.

A. Blood glucose levels will be monitored during therapy. The nurse should monitor the client for hyperglycemia while providing this medication to the client. Glucocorticoids, such as methylprednisolone, increase serum glucose levels and can require management with insulin or antihyperglycemics. B. Avoid contact with people who have known infections. The nurse should instruct the client to avoid exposure to infectious agents, such as contact with those who have active infections or illnesses. Glucocorticoids, such as methylprednisolone, depress the immune system, placing the client at an increased risk for developing an infection. E. Grapefruit juice can increase the effects of this medication. The nurse should instruct the client that grapefruit and grapefruit juice can increase the level of methylprednisolone in the body.

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? A. Carbamazepine B. Sumatriptan C. Atenolol D. Glipizide

A. Carbamazepine Carbamazepine causes an accelerated inactivation of oral contraceptives because of its action on hepatic medication-metabolizing enzymes.

A nurse is teaching a client who is starting to take ketorolac. Which of the following information should the nurse include in the teaching? A. Check for bruising while taking this medication. B. Take the medication on an empty stomach. C. The medication can cause anxiety. D. Increase iron intake with this medication.

A. Check for bruising while taking this medication. The nurse should instruct the client to check for bruising because ketorolac can increase the risk of bleeding by interfering with platelet aggregation.

A nurse is providing teaching to a client who is to start taking sumatriptan. Which of the following adverse effects should the nurse instruct the client to monitor for and report to the provider? A. Chest pressure B. White patches on the tongue C. Bruising D. Insomnia

A. Chest pressure Sumatriptan is an antimigraine agent which can cause coronary vasospasms, resulting in angina. The client should report chest pressure or heavy arms to the provider.

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 on a daily basis can minimize which of the following adverse effects of morphine? A. Constipation B. Drowsiness C. Facial flushing D. Itching

A. Constipation Constipation is a common adverse effect of morphine that will minimize when the client takes docusate sodium, a stool softener that promotes easier evacuation of stool by increasing water and fat in the intestine.

A nurse is teaching about neural tube defects to a client who is planning a pregnancy. Which of the following vitamins should the nurse instruct the client to start taking before becoming pregnant? A. Folic acid B. Thiamine C. Pyridoxine D. Riboflavin

A. Folic acid The nurse should instruct all female clients who could become pregnant to take at least 400 mcg of folic acid daily in addition to foods containing folic acid to prevent neural tube defects in the developing fetus. Enriched rice and breakfast cereals are good sources of folic acid but might not provide enough folic acid without supplements.

A nurse is caring for a client who has sickle cell anemia and is taking hydroxyurea. Which of the following findings should the nurse report to the provider? (SATA) A. Hemoglobin 7.0 B. Creatinine 1 C. RBC 4.7 million D. Platelets 75,000 E. Potassium 5.2

A. Hemoglobin 7.0 A hemoglobin level of 7.0 g/dL indicates hydroxyurea toxicity, and the nurse should report it to the provider. D. Platelets 75,000 A platelet level of 75,000/mm3 indicates hydroxyurea toxicity, and the nurse should report it to the provider. E. Potassium 5.2 A potassium level of 5.2 mEq/L indicates tumor lysis syndrome, and the nurse should report it to the provider.

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? A. Hot flashes B. Urinary retention C. Constipation D. Bradycardia

A. Hot flashes The estrogen receptor blocking action of tamoxifen commonly results in the adverse effect of hot flashes.

A nurse in a provider's office is assessing a client who has been taking aspirin daily for the past year. For which of the following findings should the nurse notify the provider immediately? A. Hyperventilation B. Heartburn C. Anorexia D. Swollen ankles

A. Hyperventilation When using the urgent vs. nonurgent approach to client care, the nurse should determine that the priority finding is hyperventilation. This indicates the client might have acute salicylate poisoning, which causes respiratory alkalosis in the early stages.

A nurse is reviewing the health history of a client who has diabetes mellitus and will begin taking insulin. Which of the following findings should the nurse identify as a factor that might cause the client to have difficulty safely self-administering insulin? A. Macular degeneration B. Right-sided heart failure C. Hyperlipidemia D. Stage II chronic kidney disease

A. Macular degeneration A client who has macular degeneration loses central vision, making it difficult to accurately draw up insulin for self-administration or dial the insulin pen to the appropriate dosage. The nurse should determine that adaptive equipment is necessary for the client who has macular degeneration.

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? A. Obtain the client's blood pressure. B. Contact the client's provider. C. Inform the charge nurse. D. Complete an incident report.

A. Obtain the client's blood pressure. The first action the nurse should take to prevent injury to the client when using the nursing process is to assess the client for adverse effects of atenolol, such as hypotension.

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? A. Oral candidiasis B. Headache C. Joint pain D. Adrenal suppression

A. Oral candidiasis The adverse effects of inhaled corticosteroids can include dysphonia and oral candidiasis. Using a spacer and rinsing the mouth after inhalation will minimize the amount of medication remaining in the oropharynx, preventing the development of these adverse effects.

A nurse is providing teaching to a client who has a prescription for a MAOI inhibitor. Which of the following foods should the nurse instruct the client to avoid while taking this medication? A. Smoked sausage. B. Cottage cheese. C. Green beans. D. Apple pie.

A. Smoked sausage. The nurse should instruct the client to avoid eating smoked sausage because it contains tyramine. Tyramine can interact with MAOIs and result in hypertensive crisis.

A nurse administers ceftazidime to a client who has a severe penicillin allergy. The nurse should identify which of the following client findings as an indication she should complete an incident report? A. The client reports shortness of breath. B. The client is also taking lisinopril. C. The client's pulse rate is 60/min D. The client's WBC count is 14,000

A. The client reports shortness of breath. A severe penicillin allergy is a contraindication for taking ceftazidime, a cephalosporin antibiotic, due to the potential for cross-sensitivity. Shortness of breath can indicate the client is developing anaphylaxis.

The 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? A. Tingling of fingers. B. Constipation. C. Weight gain. D. Oliguria.

A. Tingling of fingers. The nurse should instruct the client to report the adverse effect of paresthesia, a tingling sensation in the extremities, when taking acetazolamide.

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? A. Turn the client to a side-lying position. B. Disconnect the client's oxytocin from the maintenance IV. C. Apply oxygen to the client by face mask. D. Increase the client's maintenance IV infusion rate.

A. Turn the client to a side-lying position. The greatest risk to the fetus experiencing late decelerations is injury from uteroplacental insufficiency. Therefore, the priority intervention the nurse should take is to place the client in a lateral position.

A nurse is caring for the mother of a newborn. The mother asks the nurse when her newborn should receive his first DTaP vaccine. The nurse should instruct the mother that her newborn should receive the immunization at which of the following ages? A. Birth B. 2 months C. 6 months D. 15 months

B. 2 months The CDC recommends that newborns receive the first dose of the five-dose series of the DTaP immunization at 2 months of age.

A nurse is caring for a client who has acute acetaminophen toxicity. The nurse should anticipate administering which of the following medications? A. Vitamin K B. Acetylcysteine C. Benzotrophine D. Physostigmine

B. Acetylcysteine Acetylcysteine is a specific antidote for acetaminophen. It can prevent severe injury when given orally or by IV infusion within 8 to 10 hr of overdose.

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? A. Muscle weakness B. Sedation C. Tinnitus D. Peripheral edema

B. Sedation Metoclopramide has multiple effects on the CNS, including dizziness, fatigue, and sedation.

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 the medication? A. Tingling toes B. Sexual dysfunction C. Absence of dreams D. Pica

B. Sexual dysfunction Sexual dysfunction, including a decreased libido, impotence, and delayed orgasm, or anorgasmia, is a common adverse effect of fluoxetine and occurs in about 70% of clients who take this SSRI antidepressant.

A nurse is teaching a client who is to start taking diltiazem. The nurse should instruct the client to report which of the following findings as an adverse effect of the medication? A. Blurred vision B. Shortness of breath C. Muscle twitching D. Dry cough

B. Shortness of breath. The client who is taking diltiazem, a calcium channel blocker, can experience shortness of breath as an adverse effect and should report the finding to the provider immediately.

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 her instructions? A. Take one tablet three times a day before meals. B. Take one tablet at onset of migraine. C. Take up to eight tablets as needed within a 24-hour period. D. Take one tablet every 15 minutes until migraine subsides.

B. Take one tablet at onset of migraine. The client should take one tablet immediately after the onset of aura or headache.

A nurse is reviewing the medical record of a client who has schizophrenia and a prescription for clozapine. Which of the following laboratory tests should the nurse review before administering the medication? A. Troponin B. Total cholesterol C. Creatinine D. Thyroid stimulating hormone

B. Total cholesterol (can cause hyperlipidemia)

A nurse is providing teaching about adverse effects of clindamycin to a client. Which of the following findings should the nurse instruct the client to report to the provider? A. Orange urine B. Watery diarrhea C. Weight gain D. Headache

B. Watery diarrhea The client who takes clindamycin can have an adverse effect of watery diarrhea that can lead to Clostridium difficile-associated diarrhea or pseudomembranous colitis. The client should report these findings immediately to the provider.

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 an incident report? A. 1000 B. 0900 C. 0830 D. 1200

C. 0830 The nurse should identify that an antibiotic can be administered 30 min before or after the scheduled time to maintain therapeutic blood levels without requiring an incident report.

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

C. A transition in care requires the nurse to conduct medication reconciliation.

A nurse in the 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? A. Potassium iodide B. Glucagon C. Atropine D. Protamine

C. Atropine A cholinergic crisis is caused by an excess amount of cholinesterase inhibitor, such as neostigmine. The nurse should plan to administer atropine, an anticholinergic agent, to reverse cholinergic toxicity.

A nurse is assessing a client who has received atropine eye drops during an eye examination. Which of the following findings should the nurse expect as an adverse effect of the medication? A. Difficulty seeing in the dark. B. Pinpoint pupils. C. Blurred vision. D. Excessive tearing.

C. Blurred vision. Blurred vision is an expected finding following the administration of atropine eye drops. This is due to the cycloplegic effects of the medication, which cause distant objects to appear blurry to the client.

A nurse is providing teaching about insulin glargine to a client who has type 1 diabetes mellitus. Which of the following information should the nurse include in the instructions? A. Observe for hypoglycemia when the insulin peaks. B. Administer the insulin immediately before meals. C. Do not mix this medication in a syringe with other insulin. D. Rotate the bottle gently prior to drawing up the insulin.

C. Do not mix this medication in a syringe with other insulin. The client should not mix insulin glargine with any other type of insulin in the same syringe, because this procedure can alter the medication's effects.

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? A. Diphenhydramine B. Albuterol inhaler C. Epinephrine D. Prednisone

C. Epinephrine According to evidence-based practice, the nurse should first administer epinephrine to induce vasoconstriction and bronchodilation during anaphylaxis.

A nurse is teaching a client who is taking allopurinol for the treatment of gout. Which of the following information should the nurse include in the teaching? A. Plan to increase the dosage each week by 200 mg increments. B. Prolonged use of this medication can cause glaucoma. C. Drink 2 L of water daily. D. A fine red rash is transient and can be treated with antihistamines.

C. Drink 2 L of water daily. The nurse should instruct the client to drink at least 2 L of water each day to prevent renal stone formation and kidney injury because allopurinol is eliminated through the kidneys.

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

C. I will taper off the medication before discontinuing it. The client should taper off cyclobenzaprine before discontinuing it to prevent the return of the musculoskeletal condition.

A nurse is caring for a client who has heart failure and is receiving an IV infusion of dopamine. Which of the following findings indicates that the medication is effective? A. Decreased blood pressure. B. Increased heart rate. C. Increased cardiac output. D. Decreased serum potassium.

C. Increased cardiac output. Dopamine is an adrenergic that causes a receptor specificity effect, which increases cardiac output and improves perfusion.

A nurse is providing teaching to a client who has a gastric ulcer and a new prescription for ranitidine. Which of the following instructions should the nurse include? A. Take the medication on an empty stomach for full effectiveness. B. You may discontinue this medication when stomach discomfort subsides. C. Report yellowing of the skin. D. Store the medication in the refrigerator.

C. Report yellowing of the skin. Ranitidine can be hepatotoxic and cause jaundice. The nurse should instruct the client to monitor for and report yellowing of the skin or eyes to the provider.

A nurse is caring for a client who is taking atenolol. Which of the following findings should indicate to the nurse that the medication is effective? A. The client has an increase in urinary output. B. The client reports an improvement in memory. C. The client has a decrease in blood pressure. D. The client reports having an increase in libido.

C. The client has a decrease in blood pressure. Atenolol, a beta-adrenergic blocking agent, lowers blood pressure by decreasing peripheral vascular resistance.

A nurse is teaching a client who is starting to take amitriptyline. Which of the following findings should the nurse include in the teaching as an adverse effect of the medication? A. Diarrhea B. Cough C. Urinary retention D. Increased libido

C. Urinary retention The nurse should instruct the client that amitriptyline causes the anticholinergic effect of urinary retention.

A nurse is preparing to administer a new prescription of amoxicillin/clavulanic to a client. The client tells the nurse that he is allergic to penicillin. Which of the following actions should the nurse take first? A. Update the client's medical record. B. Notify the provider. C. Withhold the medication. D. Inform the pharmacist of the client's allergy to penicillin.

C. Withhold the medication. When using the urgent vs nonurgent approach to client care, the nurse should determine that the priority action is to withhold the medication in order to prevent injury to the client.

A nurse is teaching a client who has tuberculosis about the adverse effects of isoniazid. The nurse should instruct the client to report to the provider which of the following findings as an adverse effect of the medication? A. Reddish-orange urine B. Photosensitivity C. Yellowish skin tones D. Headache

C. Yellowish skin tones Isoniazid is a hepatotoxic medication that can cause hepatitis. The nurse should instruct the client to monitor for and report signs of hepatitis, such as malaise, nausea, and yellowish skin tones, to the provider.

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? A. Weight loss B. Increased intraocular pressure C. Auditory hallucinations D. Bibasilar crackles

D. Bibasilar crackles Mannitol, an osmotic diuretic, can precipitate heart failure and pulmonary edema. Therefore, the nurse should recognize lung crackles as an indicator of a potential complication and stop the infusion.

A nurse is caring for a client who is recovering from a deep vein thrombosis and is to start taking warfarin. For which of the following findings should the nurse monitor as an adverse effect of warfarin? A. Hypertension B. Low INR C. Constipation D. Bleeding gums

D. Bleeding gums The nurse should monitor the client for bleeding gums, which is an adverse effect of warfarin, an anticoagulant.

A nurse is planning discharge teaching for a client who has a prescription for furosemide. The nurse should plan to include which of the following statements in the teaching? A. This medication increases your risk for hypertension. B. Avoid potassium-rich foods in your diet. C. Take each dose of medication in the evening before bed. D. Drink a glass of milk with each dose of medication.

D. Drink a glass of milk with each dose of medication. The client should take furosemide with food or milk to reduce gastric irritation.

A nurse is providing teaching to a client who has depression and has a new prescription for fluoxetine. Which of the following statements by the client indicates an understanding of the teaching? A. I should start to feel better within 24 hours of starting this medication. B. I will be sure to follow a strict diet to avoid foods with tyramine. C. I will continue to take St. John's Wort to increase the effects of the medication. D. I should take acetaminophen instead of ibuprofen for my headaches while taking this medication.

D. I should take acetaminophen instead of ibuprofen for my headaches while taking this medication. Fluoxetine suppresses platelet aggregation, which increases the risk of bleeding when used concurrently with NSAIDs and anticoagulants. Therefore, clients who are taking fluoxetine should take acetaminophen for headaches or pain, since acetaminophen does not suppress platelet aggregation.

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? A. Take beclomethasone to avoid an acute attack. B. Use beclomethasone 5 minutes before using albuterol. C. Limit your calcium and vitamin D intake when taking beclomethasone. D. Rinse your mouth after inhaling the beclomethasone.

D. Rinse your mouth after inhaling the beclomethasone. The client should rinse her mouth after using beclomethasone, a glucocorticoid inhaler, to prevent oropharyngeal candidiasis and hoarseness.

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? A. Chew on the medication stick to release the medication. B. Leave the medication stick in one location of the mouth until melted. C. Allow the medication 1 hr for analgesia effects to begin. D. Store unused medication sticks in a storage container.

D. Store unused medication sticks in a storage container. The nurse should instruct the client to store unused, used, or partially used medication sticks in the safe storage container that comes in the kit when the medication is initially prescribed.

A nurse is caring for a client who is receiving end-of-life care and has a prescription for fentanyl patches. Which of the following information regarding adverse effects of fentanyl should the nurse plan to give the client and family? A. The provider will prescribe naloxone at home for respiratory depression. B. Remove the patch to reverse the adverse effects immediately. C. Expect an increase in urinary output. D. Take a stool softener on a daily basis.

D. Take a stool softener on a daily basis. Constipation is an adverse effect of opioid use and stool softeners can decrease the severity of this adverse effect.

A nurse is providing teaching for 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) A. Blood glucose levels will need to be monitored during therapy. B. Avoid contact with persons who have known infections. C. Take the medication 1 hour before a meal. D. Decrease intake of foods containing potassium. E. Grapefruit juice can increase the blood levels of the medication.

A. Blood glucose levels will need to be monitored during therapy. B. Avoid contact with persons who have known infections. E. Grapefruit juice can increase the blood levels of the medication.

A nurse is caring for a client who is taking atorvastatin for hyperlipidemia. Which of the following client laboratory values should the nurse monitor? A. Creatinine kinase B. Erythrocyte sedimentation rate C. International normalized ratio D. Potassium

A. Creatinine kinase The client can develop an adverse effect called rhabdomyolysis, which causes muscle weakness or pain and can progress to myositis. Creatinine kinase (CK) levels rise in response to enzymes released with muscle injury.

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? A. The client's vital signs are within normal limits. B. The client has not requested additional medication. C. The client is resting comfortably with eyes closed. D. The client rates the pain at a 3 on a scale from 0 to 10.

D. The client rates the pain at a 3 on a scale from 0 to 10. The client's description of the pain is the most accurate assessment of pain.

A nurse in a clinic is caring for a client who is taking aspirin for the treatment of arthritis. The nurse should identify which of the following findings as an indication that the client is beginning to exhibit salicylism? A. Gastric distress. B. Oliguria. C. Excessive bruising. D. Tinnitus.

D. Tinnitus. Tinnitus is a manifestation of aspirin toxicity, also called salicylism. Other manifestations include sweating, headache, and dizziness.

A nurse is providing teaching to a client who is to start therapy with digoxin. For which of the following adverse effects should the nurse instruct the client to monitor and report to the provider? A. Dry cough B. Pedal edema C. Bruising D. Yellow- tinged vision

D. Yellow-tinged vision The nurse should instruct the client to monitor for and report yellow-tinged vision, which is a sign of digoxin toxicity and should be reported to the provider. Other manifestations of digoxin toxicity include nausea, vomiting, loss of appetite, and fatigue. As the digoxin levels increase, the client can experience cardiac dysrhythmias.

A nurse is preparing to administer amoxicillin 250 mg PO to a school-age child. The amount available is amoxicillin oral suspension 200 mg/5 mL. How many mL should the nurse administer per dose? (Round the answer to the nearest tenth.)

6.3 mL

A nurse is planning to teach about inhalant medications to a client who has a new diagnosis of exercise-induced asthma. Which of the following medications should the nurse plan to instruct the client to use prior to physical activity? A. Cromolyn B. Beclomethasone C. Budesonide D. Tiotropium

A. Cromolyn Cromolyn sodium stabilizes mast cells, which inhibit the release of histamine and other inflammatory mediators. The client should use cromolyn 10 to 15 min before planning to exercise to prevent bronchospasms.

A nurse is teaching a client who has a new prescription for docusate sodium about the medication's mechanism of action. Which of the following information should the nurse include in the teaching? A. Docusate sodium reduces the surface tension of the stools to change their consistency. B. Docusate sodium causes rectal contractions. C. Docusate sodium acts as a fiber agent, increasing bulk in the intestines. D. Docusate sodium stimulates the motility of the intestines.

A. Docusate sodium reduces the surface tension of the stools to change their consistency. Docusate sodium is a surfactant that softens stool by reducing surface tension, allowing water to penetrate more easily into the stool.

A nurse is providing teaching to a client who is to begin taking oxybutynin for urinary incontinence. The nurse should instruct the client to report which of the following findings as an adverse effect of the medication? (Select all that apply) A. Dry mouth B. Tinnitus C. Blurred vision D. Bradycardia E. Dry eyes

A. Dry mouth Oxybutynin is an anticholinergic agent that can cause dry mouth. C. Blurred vision Oxybutynin is an anticholinergic agent that can cause blurred vision due to an increase in intraocular pressure. E. Dry eyes Oxybutynin is an anticholinergic agent that can cause dry eyes and mydriasis, or pupil dilation.

A nurse at an urgent care clinic is collecting a history from a female client who has a UTI. 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? A. I have tendonitis, so I haven't been able to exercise. B. I take a stool softener for chronic constipation. C. I take medicine for my thyroid. D. I am allergic to sulfa.

A. I have tendonitis, so I haven't been able to exercise. (risk of tendon rupture)

A nurse is caring for a patient who is receiving oprelvekin. Which of the following findings should the nurse document to indicate the effectiveness of the therapy? A. Increased platelet count. B. Increased RBC count C. Decreased prothrombin time D. Decreased triglycerides

A. Increased platelet count. Oprelvekin stimulates the bone marrow to produce platelets. For clients receiving chemotherapy, thrombocytopenia is minimized so these clients will require fewer platelet transfusions.

A nurse is caring for a client who has diabetes mellitus and is taking glyburide. The client reports feeling confused and anxious. Which of the following actions should the nurse take first? A. Perform a capillary blood glucose test. B. Provide the client with a protein-rich snack. C. Give the client 120 mL (4 oz) of orange juice. D. Schedule an early meal tray.

A. Perform a capillary blood glucose test. The greatest risk to this client is injury from hypoglycemia. Therefore, the nurse should perform a capillary blood glucose test to determine the client's blood glucose status. Manifestations of hypoglycemia include weakness, anxiety, confusion, sweating, and seizures.

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? (SATA) A. Report muscle pain to the provider. B. Avoid taking the medication with grapefruit juice. C. Take the medication in the early morning. D. Expect a flushing of the skin as a reaction to the medication. E. Expect therapy with this medication to be lifelong.

A. Report muscle pain to the provider.(Myopathy is an adverse effect of simvastatin that can lead to rhabdomyolysis, so it should be reported to the provider.) B. Avoid taking the medication with grapefruit juice. ( When taken with grapefruit juice, simvastatin increases the risk of muscle injury from elevations in creatine kinase.) E. Expect therapy with this medication to be lifelong. ( If medication therapy is discontinued, cholesterol levels will return to their pretreatment range within several weeks to months.)

A nurse is caring for a client who recently began taking oral amoxicillin/clavulanate and reports urticaria. Which of the following actions should the nurse take? A. Request a change in the type of antibiotic. B. Ask for a change in the route of administration. C. Check for pitting edema. D. Check the client's WBC count.

A. Request a change in the type of antibiotic. Manifestations of urticaria after taking a penicillin-based medication indicate a mild allergic reaction. Therefore, it is appropriate for the nurse to request a change in the type of antibiotic.

A nurse is providing care for a client who is postoperative following an open cholecystectomy with the placement of a closed suction drain and is receiving morphine via patient-controlled analgesia for pain. Which of the following assessments is the nurse's priority? A. Respiratory rate B. Bowel sounds C. Drainage amounts D. Wound appearance

A. Respiratory rate When using the airway, breathing, circulation approach to client care, the nurse should determine that the priority assessment is the client's respiratory rate due to the risk of respiratory depression. Morphine and other opioid medication can cause respiratory depression, constipation, and urinary retention.

A nurse is reviewing the prescriptions of a client who has tuberculosis. The nurse should identify that which of the following medications are used to treat tuberculosis? (SATA) A. Rifampin B. Mirtazapine C. Temazepam D. Infliximab E. Isoniazid

A. Rifampin This medication is given to treat tuberculosis by inhibiting the production of mycobacteria. E. Isoniazid This medication is given to treat tuberculosis by inhibiting the production of mycobacteria.

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

B. Aspirin will increase the risk of bleeding. Aspirin inhibits platelet aggregation and can potentiate the action of the anticoagulant warfarin. Therefore, it increases the risk for bleeding, so the client should avoid taking aspirin.

A nurse is reviewing the medical record of a client who has hypertension. The nurse should identify which of the following findings as a contraindication to receiving propranolol? A. Cholelithiasis B. Asthma C. Angina pectoris D. Tachycardia

B. Asthma Asthma is a contraindication to receiving propranolol. Propranolol is an adrenergic antagonist which blocks the beta2 receptors in the lungs, causing bronchoconstriction and leading to serious airway resistance and possibly respiratory arrest.

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

B. Blood in the urine The nurse should report blood in the urine to the provider because this can be a manifestation of heparin overdose. Other manifestations can include bruising, hematomas, hypotension, and tachycardia.

A nurse is administering baclofen for a client who has a spinal cord injury. Which of the following should the nurse document as a therapeutic outcome? A. Increase in seizure threshold. B. Decrease in flexor and extensor spasticity. C. Increase in cognitive function. D. Decrease in paralysis of the extremities.

B. Decrease in flexor and extensor spasticity. The client who has a spinal cord injury and takes baclofen can experience a decrease in the frequency and severity of muscle spasms and in flexor and extensor spasticity.

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? A. Weigh the client weekly. B. Determine apical pulse prior to administering. C. Administer the medication 30 minutes prior to breakfast. D. Monitor the client for jaundice

B. Determine apical pulse prior to administering. An adverse effect for this client is life-threatening bradycardia. Therefore, the nurse should assess the client's apical pulse prior to administering the medication. If the pulse rate is less than 60/min, the nurse should withhold the medication and notify the provider.

A nurse is administering cefotetan via intermittent IV bolus to a client who suddenly develops dyspnea and widespread hives. Which of the following actions should the nurse take first? A. Administer epinephrine 0.5 mL via IV bolus B. Discontinue the medication IV infusion C. Elevate the client's legs above the level of the heart. D. Collect a blood specimen for ABGs.

B. Discontinue the medication IV infusion The greatest risk to the client is respiratory arrest from anaphylaxis. Therefore, the first action the nurse should take is to discontinue the medication IV infusion to prevent the client from receiving more medication. However, the nurse should not remove the IV catheter. Instead, the nurse should change the tubing and administer 0.9% sodium chloride by continuous IV infusion.

A nurse is caring for a client who has heart failure and is prescribed enalapril. The nurse should monitor the client for which of the following findings as an adverse effect of the medication? A. Bradycardia B. Hyperkalemia C. Loss of smell D. Hypoglycemia

B. Hyperkalemia Enalapril improves cardiac functioning in clients who have heart failure and can cause hyperkalemia due to potassium retention by the kidneys.

A nurse is teaching a client who is to start taking ranitidine for peptic ulcer disease. Which of the following client statements should the nurse identify as understanding of the teaching? A. I will stop taking ranitidine when my stomach pain is gone. B. I know smoking makes ranitidine less effective. C. I will take ranitidine anytime my stomach hurts. D. I know that ranitidine will turn my stools black.

B. I know smoking makes ranitidine less effective. The nurse should instruct the client that smoking decreases the effectiveness of ranitidine by exacerbating the ulcer manifestations.

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? A. I should apply a patch every 5 minutes if I develop chest pain. B. I will take the patch off right after my evening meal. C. I will leave the patch off at least 1 day each week. D. I should discard the used patch by flushing it down the toilet.

B. I will take the patch off right after my evening meal. Clients should remove the patch each evening for a medication free time of 12 to 14 hr before applying a new patch to avoid developing a tolerance to the medication's effects.

A nurse is teaching about zolpidem with a client who has insomnia. The nurse should identify that which of the following client statements indicates an understanding of the teaching? A. I will need to get laboratory testing prior to a refill of this medication. B. I will use this medication for a short period of time. C. I will need to take this medication for 1 week before results are seen. D. I will need to change the medications to prevent building up a tolerance.

B. I will use this medication for a short period of time. Zolpidem is used for short-term treatment of insomnia. Therefore, the provider should reassess the client before refilling the prescription.

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? A. Aspirin B. Ibuprofen C. Ranitidine D. Bisacodyl

B. Ibuprofen Most NSAIDs can significantly increase lithium levels. Therefore, the client should not take ibuprofen and lithium concurrently.

A nurse is providing discharge teaching to a client who has a new prescription for furosemide twice daily. The nurse should include which of the following instructions in the teaching? (Select all that apply) A. Take the second dose at bedtime B. Increase intake of potassium-rich foods. C. Obtain your weight weekly. D. Monitor for muscle weakness. E. Dangle your legs from the side of the bed before standing.

B. Increase intake of potassium-rich foods. Loop diuretics, such as furosemide, act at the loop of Henle by blocking the resorption of sodium, water, and potassium. An adverse effect of the medication is the development of electrolyte imbalances such as hyponatremia, hypochloremia, and hypokalemia. To prevent hypokalemia, the client should increase intake of potassium-rich foods, such as potatoes, spinach, dried fruit, and nuts. D. Monitor for muscle weakness. Furosemide, a loop diuretic, causes a loss of potassium which can result in manifestations of hypokalemia such as difficulty concentrating, shallow respirations, hyporeflexia, and muscle weakness. The nurse should instruct the client to monitor for these manifestations and report them to the provider. E. Dangle your legs from the side of the bed before standing. Loop diuretics, such as furosemide, reduce vascular tone and increase fluid excretion. These effects decrease blood return to the heart and can manifest as dizziness and lightheadedness when going from a lying to a standing positon. The client should change positions slowly to minimize orthostatic hypotension.

A nurse is teaching a client who has an upper respiratory infection about guaifenesin. Which of the following statements should the nurse include in the teaching? A. Constipation is an expected adverse effect of this medication. B. Increase your fluid intake to at least 2 liters each day while taking this medication. C. Store your medication in the refrigerator. D. You can expect to experience insomnia while taking this medication.

B. Increase your fluid intake to at least 2 liters each day while taking this medication. (Aids in removal of secretions and helps create more productive cough)

A nurse is assessing a client who is receiving epoetin alfa to treat anemia. Which of the following findings should the nurse monitor? A. Paresthesia B. Increased blood pressure C. Fever D. Respiratory depression

B. Increased blood pressure The therapeutic effect of epoetin alfa is an increase in hematocrit levels, which can result in an increase in a client's blood pressure. If the client's hematocrit level rises too rapidly, hypertension and seizures can result. The nurse should monitor the client's blood pressure and ensure hypertension is controlled prior to administering the medication.

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? A. Methadone B. Naloxone C. Diazepam D. Bupropion

B. Naloxone The nurse should administer naloxone, an opioid antagonist, to a client who has heroin toxicity to reverse the respiratory depressive effects of the heroin. However, the nurse should not administer naloxone too quickly because naloxone can cause hypertension, tachycardia, nausea, vomiting, and might cause the client to enter a state of opioid withdrawal.

A nurse is monitoring a client who is receiving amphotericin B intermittent IV bolus for the treatment of histoplasmosis. Which of the following findings should the nurse identify as an adverse reaction to the medication? A. Tachycardia B. Oliguria C. Hyperkalemia D. Weight gain

B. Oliguria Oliguria can indicate renal compromise in a client who is taking amphotericin B. The nurse should report this finding to the provider.

A nurse is providing teaching for a client who has a new prescription for ferrous sulfate. The nurse should instruct the client to take the medication with which of the following to promote absorption? A. Vitamin E B. Orange juice C. Milk D. Antacids

B. Orange juice The absorption of ferrous sulfate is enhanced by a vitamin C source, such as orange juice. However, increasing the dosage of ferrous sulfate can provide the same benefit to increase the amount of iron uptake.

A nurse is monitoring for adverse effects of hydrochlorothiazide after administering the medication to an older adult client who has heart failure. Which of the following findings should the nurse identify as an adverse effect of the medication? A. Hypoglycemia B. Orthostatic hypotension C. Bradycardia D. Xanthopsia

B. Orthostatic hypotension The nurse should identify that hydrochlorothiazide is an antihypertensive thiazide diuretic medication, which can cause orthostatic hypotension and light headedness in clients who are taking the medication. Therefore, the nurse should instruct the client to rise slowly when moving from a recumbent to a standing position.

A circulating nurse is planning care for a client who is scheduled for surgery and has a latex allergy. Which of the following actions should the nurse include in the plan of care? A. Schedule the client for the last surgery of the day. B. Place monitoring cords and tubes in a stockinet. C. Choose rubber injection ports for fluid administration. D. Ensure phenytoin IV is readily available.

B. Place monitoring cords and tubes in a stockinet The circulating nurse should place monitoring devices in a stockinet to prevent direct contact with the client's skin.

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? A. Serum calcium B. Pregnancy test C. 24 hour urine collection for protein D. Aspartate aminotransferase level

B. Pregnancy test The client who is pregnant or might become pregnant must not take isotretinoin because this medication has teratogenic effects. Pregnancy testing is mandatory before the initial prescription (two tests) and before monthly refills (one test).

A nurse has administered 2 doses of betamethasone to a client in preterm labor. After delivery of the newborn, the nurse understands the medication was effective when she observes which of the following? A. The newborn is free of infection. B. The newborn has normal respiratory patterns. C. Mother's blood pressure is within the expected reference range. D. Mother's postpartum bleeding is minimal.

B. The newborn has normal respiratory patterns. The newborn having a normal respiratory pattern is an indication that the administration of betamethasone was effective. This medication stimulates surfactant production, which improves oxygenation and lung compliance in neonates.

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? A. Constipation B. Tinnitus C. Hypoglycemia D. Joint pain

B. Tinnitus Aminoglycosides, such as gentamicin, are ototoxic, which can manifest as tinnitus and deafness. The nurse should monitor the client for high pitched ringing in the ears and headaches and should notify the provider if these occur.

A nurse is providing teaching to a client who has a prescription for trimethoprim/sulfamethoxazole. Which of the following instructions should the nurse include in the teaching? A. Take the medication with food. B. Expect a fine, red rash as a transient effect. C. Drink 8-10 glasses of water daily. D. Store the medication in the refrigerator.

C. Drink 8-10 glasses of water daily. (1,920 to 2,400 a day to decrease the chance of kidney damage from crystallization)

A nurse is assessing a client who is taking amitriptyline for depression. Which of the following findings should the nurse identify as an adverse effect of the medication? A. Tinnitus B. Urinary frequency C. Dry mouth D. Diarrhea

C. Dry mouth The nurse should expect the client to have a dry mouth due to the blocking of acetylcholine receptors that cause anticholinergic responses.

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? A. Ondansetron B. Magnesium sulfate C. Flumazenil D. Protamine sulfate

C. Flumazenil Flumazenil is an antidote and the nurse should administer the medication to reverse benzodiazepines, such as diazepam.

A nurse is providing teaching to a client who has a 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? A. Decreases stomach acid secretion. B. Neutralizes acids in the stomach. C. Forms a protective barrier over ulcers. D. Treats ulcers by eradicating H. pylori.

C. Forms a protective barrier over ulcers. Secretions by the parietal and chief cells, hydrochloric acid and pepsin, can further irritate the ulcerated areas. Sucralfate, a mucosal protectant, forms a gel-like substance that coats the ulcer, creating a barrier to hydrochloric acid and pepsin.

A nurse is providing teaching to a client who has a new prescription for phenytoin. Which of the following statements by the client indicates an understanding of the teaching? A. I should take my medication with antacids to minimize gastric upset. B. This type of medication does not require blood monitoring. C. I should let my dentist know I'm taking this medication. D. I should expect to experience some unusual eye movement when taking this medication.

C. I should let my dentist know I'm taking this medication. Phenytoin commonly causes gingival hyperplasia. As a result, the client should notify his dentist.

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? A. I should take the medication with food. B. I should take naproxen if I develop joint pain. C. I should tell my provider if I develop a sore throat. D. I should expect the medication to cause my urine to look orange.

C. I should tell my provider if I develop a sore throat. The client should report a sore throat to the provider because this can indicate neutropenia, a serious adverse effect of captopril. Neutropenia can be reversed if it is recognized early and the medication is promptly discontinued.

A nurse is providing teaching to a client about the use of ethinyl estradiol/norelgestromin. The nurse should identify that which of the following statements by the client indicates an understanding of the teaching? A. I will apply the patch once a week for 2 weeks. B. I will leave the existing patch on for 4 hours after applying the new patch. C. I will fold the sticky sides of the old patch together before disposing of it. D. I will apply the patch within 14 days of menses.

C. I will fold the sticky sides of the old patch together before disposing of it. The client should fold the sticky sides of the old patch together and then place it in a childproof container to ensure safe disposal of the patch.

A nurse is teaching about self-administration of transdermal medication with a male client who has a new prescription for nitroglycerin. The nurse should identify that which of the following statements by the client indicates an understanding of the teaching? A. I can apply the patch to a chest area that has hair. B. I can take this medication if using an erectile dysfunction product. C. I will remove the patch after 14 hours. D. I need to apply a new patch to the same area every day.

C. I will remove the patch after 14 hours. The client should remove the patch after 12 to 14 hr to prevent tolerance of the medication.

A nurse is teaching about a new prescription for ciprofloxacin to an older adult client who has a urinary tract infection. The nurse should identify which of the following statements as an indication that the client understands the teaching? A. I will take this medication with an antacid to prevent gastrointestinal upset. B. I will stop taking this medication when I no longer have pain upon urination. C. I will report any signs of tendon pain or swelling. D. I will take this medication with milk.

C. I will report any signs of tendon pain or swelling. Ciprofloxacin, a fluoroquinolone, is associated with a risk of tendon rupture. This risk is increased in older adult clients, so the client should notify the provider at the onset of tendon pain or swelling.

A nurse is providing discharge instruction to a client who is to self-administer insulin at home. Which of the following client statements should indicate to the nurse that the teaching is effective? A. I should avoid getting rid of the air bubble in the syringe. B. I should inject the insulin into my thigh for the fastest absorption. C. I will store my unopened bottles of insulin in the refrigerator. D. I need to shake the insulin before using it to make sure it is well mixed.

C. I will store my unopened bottles of insulin in the refrigerator. The client should store unopened vials of insulin in the refrigerator to maintain medication viability. Once opened, the insulin may remain at room temperature for up to 1 month.

A nurse is caring for a client who reports lethargy and myalgia after taking clozapine for 6 months. Which of the following actions should the nurse plan to take? A. Infuse 0.9% sodium chloride 1,000 mL IV bolus B. Schedule the client for an electroencephalogram C. Obtain WBC with absolute neutrophil count. D. Place the client on a tyramine-free diet.

C. Obtain WBC with absolute neutrophil count. The client who takes clozapine can develop lethargy and myalgia caused by the adverse effect of agranulocytopenia. Therefore, monitoring the WBC with absolute neutrophil count weekly for the first 6 months of treatment is recommended. After 6 months, monitoring can be changed to occur every 2 weeks up to 1 year.

A nurse is providing follow-up care to a client who is taking lisinopril. Which of the following manifestations should the nurse instruct the client to report as an adverse effect of lisinopril? A. Drowsiness B. Hallucinations C. Persistent cough D. Weight gain

C. Persistent cough Lisinopril is an ACE inhibitor that can cause a persistent, dry, irritating, nonproductive cough from an excessive buildup of bradykinin. The client should report this adverse effect to the provider.

A nurse is caring for a client who is receiving long-term treatment for systemic lupus erythematosus with prednisone. The nurse should inform the client to expect to undergo which of the following diagnostic tests to monitor for long-term complications of prednisone? A. Pulmonary function tests B. Electrocardiograms C. Liver function studies D. Bone density scans

D. Bone density scans The client who is taking prednisone, which is a glucocorticoid, should have regularly scheduled bone density scans to monitor for the adverse effects of osteoporosis.

A nurse is preparing to teach a client who is to start a new prescription for extended-release verapamil. Which of the following instructions should the nurse plan to include? A. Take the medication on an empty stomach. B. Avoid crowds. C. Discontinue the medication if palpitations occur. D. Change positions slowly.

D. Change positions slowly. The nurse should instruct the client to change positions gradually to prevent orthostatic hypotension and syncope.

A nurse is reviewing laboratory results for a client who is to receive a dose of ceftazadime via intermittent IV bolus. Which of the following laboratory findings is the priority for the nurse to report to the provider before administering the medication? A. Total bilirubin 0.4 B. Alanine aminotransferase 26 C. Platelet count 360,000 D. Creatinine 2.6

D. Creatinine 2.6 mg/dL Ceftazadime is excreted primarily by the renal system. A serum creatinine level above 1.3 mg/dL can indicate a kidney disorder requiring a reduction in the dosage administered. The nurse should notify the provider, who is likely to prescribe a lowered dose of medication.

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? A. The medication should be taken 1 hour prior to eating. B. It takes 48 hours for therapeutic effects to occur. C. Tablets should not be crushed or chewed. D. Decreased respirations might occur.

D. Decreased respirations might occur. The nurse should instruct the client that hydrocodone with acetaminophen might cause respiratory depression, which is an adverse effect of the medication. The client should avoid taking over-the-counter medications or newly prescribed medications without consulting her provider to avoid increased respiratory depression.

A nurse is caring for a client who has pneumonia. The client tells the nurse she is pregnant and that she has not told her provider yet. The nurse should identify that pregnancy is a contraindication to receiving which of the following medications? A. Acetaminophen B. Ipratropium C. Benzonatate D. Doxycycline

D. Doxycycline Doxycycline is a tetracycline antibiotic and is contraindicated for a client who is pregnant because the medication is a category D medication of the FDA pregnancy risk categories, which indicates the medication has fetal risks that can cause fetal damage. The client should only take doxycycline for a life-threatening condition.

A nurse is providing teaching to a client who is to start taking lisinopril. Which of the following findings is an adverse effect that the nurse should instruct the client to monitor and report to the provider? A. Hair loss B. Ringing in the ears C. Facial flushing D. Dry cough

D. Dry cough A buildup of bradykinin from taking lisinopril can cause a client to have a dry cough and lead to life-threatening consequences. The client should report the finding to the provider.

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? A. Dyspepsia B. Diarrhea C. Dizziness D. Dyspnea

D. Dyspnea The first action the nurse should take when using the airway, breathing, circulation approach to client care is to report the adverse effect of dyspnea, caused by bronchoconstriction, to the provider. Bronchoconstriction, dyspepsia, diarrhea, and dizziness are caused by the increase in acetylcholine levels, which is a primary effect of donepezil.

A nurse is caring for a client in the emergency department following a diazepam overdose. Which of the following medications should the nurse anticipate administering to the client? A. Naloxone B. Leucovorin C. Neostigmine D. Flumazenil

D. Flumazenil Flumazenil is a benzodiazepine receptor antagonist that can decrease the sedative effects of benzodiazepines, such as diazepam. The nurse should administer the medication via IV bolus, titrating doses as needed, for a maximum of 3 mg. However, the medication can precipitate seizures and might not reverse respiratory depression, so airway support may be necessary.

A nurse is caring for a client who is receiving cefazolin IV. The nurse should identify that which of the following medications can potentiate nephrotoxicity if administered concurrently? A. Famotidine B. Levofloxacin C. Metoclopramide D. Gentamicin

D. Gentamicin Gentamicin, an aminoglycoside antibiotic, can damage renal function. When combined with a penicillin or cephalosporin, such as cefazolin, the client is at increased risk for nephrotoxicity.

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? A. I will drink a glass of milk when I take the risedronate. B. I will take the risedronate 15 minutes after my evening meal. C. I should take an antacid with the risedronate to avoid nausea. D. I should sit up for 30 minutes after taking the risedronate.

D. I should sit up for 30 minutes after taking the risedronate. Sitting upright for at least 30 min after taking risedronate will reduce the adverse gastrointestinal effects of esophagitis and dyspepsia. Risedronate is contraindicated for a client who cannot sit or stand upright for this length of time.

A nurse is teaching a client who is starting to take diltiazem. Which of the following statements should the nurse identify as an indication that the client understands the teaching? A. I will stop taking the medication if I get dizzy. B. I should not drink orange juice while taking this medication. C. I should expect to gain weight while taking this medication. D. I will check my heart rate before I take the medication.

D. I will check my heart rate before I take the medication. Diltiazem, a calcium channel blocker, has cardio-suppressant effects at the SA and AV nodes, which can lead to bradycardia. The client should check her heart rate before taking the medication and notify the provider if it falls below the expected reference range.

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? A. Decrease in WBC count B. Decrease in amount of time sleeping. C. Increase in appetite D. Increase in ability to focus

D. Increase in ability to focus A client who has Graves' disease can experience psychological manifestations such as difficulty focusing, restlessness, and manic-type behaviors. Propylthiouracil is a thyroid hormone antagonist that decreases the circulating T4 hormone, reducing the manifestations of hyperthyroidism. An increased ability to focus indicates that the medication is effective.

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? A. Cough B. Joint pain C. Alopecia D. Insomnia

D. Insomnia Bupropion, an atypical antidepressant, has stimulant properties, which can result in agitation, tremors, mania, and insomnia.

A nurse is assessing a client who has myasthenia gravis and is taking neostigmine. Which of the following findings should indicate to the nurse the client is experiencing an adverse effect? A. Tachycardia B. Oliguria C. Xerostomia D. Miosis

D. Miosis Miosis, which is pupillary constriction, is a common adverse effect of neostigmine due to the excessive muscarinic stimulation that causes difficulty with visual accommodation.

A nurse is teaching a client who is to start taking temazepam. Which of the following instructions should the nurse include? A. Limit continuous use to 7 to 10 weeks. B. Schedule doses for early morning before breakfast. C. Expect that it will take 4 nights before benefits are noticed. D. Plan to withdraw from the medication gradually.

D. Plan to withdraw from the medication gradually. The nurse should include in the teaching to have the client plan to withdraw from taking temazepam gradually to avoid mild withdrawal syndrome.

A nurse is reviewing laboratory results for a client who is receiving heparin via continuous IV infusion for DVT. The nurse should discontinue the medication infusion for which of the following client findings? A. Potassium 5.0 B. aPTT 2x the control C. Hemoglobin 15 D. Platelets 96,000

D. Platelets 96,000 A platelet count less than 100,000/mm3 while receiving heparin can indicate heparin-induced thrombocytopenia, a potentially fatal condition, which requires stopping the infusion.

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? A. Minimize diaphoresis B. Maintain abstinence C. Lessen craving D. Prevent delirium tremens

D. Prevent delirium tremens The client should take chlordiazepoxide to prevent delirium tremens during acute alcohol withdrawal.

A nurse is preparing to mix and administer dantrolene via IV bolus to a client who has developed malignant hyperthermia during surgery. Which of the following actions should the nurse take? A. Administer the reconstituted medication slowly over 5 minutes. B. Store the reconstituted medication in the refrigerator. C. Use the reconstituted medication within 12 hours. D. Reconstitute the initial dose with 60 mL of sterile water without a bacteriostatic agent.

D. Reconstitute the initial dose with 60 mL of sterile water without a bacteriostatic agent. The nurse should dilute the medication with 60 mL of sterile water without a bacteriostatic agent and inject rapidly.