Pharmacology Pre-Assessment ATI
A nurse have provided education to a client regarding prescribed levothyroxene sodium (Synthroid). What of the following client statements demonstrates understanding of medication administration?
"I should take the medication in the morning to prevent insomnia."
Warfarin (Coumadin)
Lab Value to monitor - PT and INR
A nurse is preparing to administer enoxaparin (Lovenox) to a client. Which of the following actions should the nurse take when administering this medication?
Do not expel the air bubble from the prefilled syringe. The nurse should not expel the air bubble from the prefilled syringe. The air bubble should follow the medication to ensure the client receives the full dose of medication in the syringe.
A nurse is caring for a client receiving patient-controlled analgesia (PCA). Which of the following interventions should the nurse take while caring for this client?
Encourage the client to use the PCA before dressing changes.
Heparin
Lab Value to monitor - aPTT
A nurse is caring for a client prescribed ferrous sulfate (Feosol) for the treatment of anemia. Which of the following instructions should be included in client teaching about this medication?
Take the medication on an empty stomach to maximize absorption. The nurse should instruct the clients to take iron on an empty stomach, such as 1 hr before meals to maximize absorption. Stomach acid increases absorption. If GI adverse effects occur, the client can take with food to increase adherence to therapy even though absorption is also decreased.
A client is prescribed Heparin 6,000 units subcutaneously every 12 hours for DVT prophylaxis. The pharmacy dispenses a vial containing 10,000 units per 1mL. How many milliliters of heparin should the nurse administer?
0.6 mL
amiodarone (Cordorone)
Drug Class - Antidysrhythmic agent
ondansetron (Zofran)
Drug Class - Antiemetic, Serotonin antagonist
atenolol (Tenormin)
Drug Class - Beta Adrenergic Blocker
clonidine (Catapres)
Drug Class - Centrally acting alpha-2 agonist
ciprofloxacin (Cipro)
Drug Class - Fluroquinolone
prednisone (Deltasone)
Drug Class - Glucocorticoid
glipizide (Glucotrol)
Drug Class - Oral hypoglycemic, Sulfonylurea
A nurse is caring for a client prescribed digoxin (Lanoxin). Which the following should alert the nurse to possible digitalis toxicity?
Anorexia and weakness. Bradycardia is commonly noted in digitalis toxicity. GI effects of digitalis toxicity include anorexia, nausea, vomiting and abdominal pain. CNS effects include fatigue, weakness, vision changes (diplopia, blurred vision, yellow-green or white halos around objects).
Warfarin (Coumadin)
Antidote - Vitamin K (Mephyton)
A client is prescribed Propranolol (Inderal). Which of the following client history findings would require the nurse to clarify this medication prescription?
Asthma - Clients with asthma should avoid Beta2 Blockade agents such as propranolol. Bronchoconstriction can occur. Clients with asthma should be administered a beta1selective agent.
terazosin (Hytrin)
Drug Class - Alpha-Adrenergic blocker
Potassium-sparing diuretics
Mechanism of Action - Block the action of aldosterone (sodium and water retention) which result in potassium retention and the secretion of sodium and water
A client has been prescribed lisinopril (Prinivil). Which of the following medication interactions should the nurse instruct this client about?
Potassium supplements
A nurse has just administered a wrong medication to a client. Which of the following actions should the nurse take next?
Report error to the provider.
A client diagnosed with Parkinson's disease is prescribed levodopa (Dopar). The nurse should instruct the client not to take over the counter pyridoxine (vitamin B6) supplements while taking this medication.
TRUE. Pyridoxine (vitamin B6) decreases the effects of levodopa. Clients should not take over the counter supplements without consulting their provider.
A nurse is preparing to administer a measles, mumps, and rubella vaccine (MMR) to an adult client. Which of the following is a contraindication to this vaccine?
The possibility of pregnancy within 4 weeks.
Which of the following are contraindications to aspirin therapy?
Third trimester pregnancy , Thrombocytopenia , Adolescents with chickenpox
A client has been prescribed isosorbide mononitrate (Imdur). Which of the following should the nurse include in this client's education related to this medication?
This medication is prescribed for long-term prophylaxis against anginal attacks.
A client has been prescribed vasopressin (Pitressin) for the treatment of diabetes insipidus. What is the expected pharmacological action of this medication?
To increase reabsorption of water in renal tubules.
A nurse is caring for a client newly prescribed doxazosin mesylate (Cardura). Which of the following instructions should the nurse include in client education regarding taking the first dose of this medication?
Change positions slowly and lie down if dizziness occurs. First-dose orthostatic hypotension can occur with Cardura. The nurse should instruct clients to change positions slowly and to lie down if feeling dizzy, lightheaded or faint.
captopril (Capoten)
Drug Class - Angiotensin converting enzyme (ACE) inhibitor
A nurse is caring for a client prescribed the HMG CoA reductase inhibitor, atorvastatin (Lipitor). Which of the following should be monitored while this medication is prescribed?
Liver function tests. Statins (HMG CoA reductase inhibitors) like atorvastatin (Lipitor) can cause hepatotoxicity. Prior to initiating therapy the client's baseline liver function should be determined then liver function tests should be checked after 12 weeks of therapy and then every 6 months. The nurse should advise the client to observe for symptoms of liver dysfunction (anorexia, vomiting, nausea, jaundice) and to notify the provider if these occur.
A nurse is caring for a client prescribed montelukast (Singulair). Which of the following should the nurse include in teaching related to this medication?
Advise client to take the medication once daily at bedtime.
Heparin
Antidote - Protamine Sulfate
A nurse is to instill ear drops to a 2 year-old child. To straighten the ear canal, the nurse should pull the auricle of the ear:
Down and backward
Osmotic diuretics
Mechanism of Action - Reduce intracranial pressure and intraocular pressure by raising serum osmolality and drawing fluid back into the vascular and extravascular space
Thiazide diuretics
Mechanism of Action - Work in the early distal convoluted tubule to block the reabsorption of sodium and chloride and prevent the reabsorption of water that this site
Loop diuretics
Mechanism of Action - Work on the ascending limb of the loop of Henle to block reabsorption of sodium and chloride and to prevent reabsorption of water
A nurse is caring for a client prescribed hydromorphone (Dilaudid) for severe pain. The client's respiratory rate has decreased from 16 breaths per minute to 6. Which if the following medications should the nurse prepare to administer?
Naloxone (Narcan)
A client has been prescribed metoclopramide (Reglan). Which of the following should the nurse include in client education regarding this medication?
Notify your provider if you experience restlessness or spasms of the face or neck.
epoetin alfa (Epogen, Procrit)
Pharmacological Action - Erythropoietic growth factor that acts on the bone marrow to increase production of red blood cells
sargramostim (Leukine)
Pharmacological Action - Granulocyte macrophage colony stimulator that acts on the bone marrow to increase production of white blood cells (neutrophils, monocytes, macrophages, eosinophils).
filgrastim (Neupogen)
Pharmacological Action - Leukopoietic growth factor that stimulates the bone marrow to increase production of neutrophils
oprelvekin (Interleukin-11, Neumega)
Pharmacological Action - Thrombopoietic growth factor that increase the production of platelets
A nurse is caring for a client receiving a dopamine (Intropin) infusion via a peripheral IV. Which of the following actions should the nurse take if the IV site appears infiltrated?
Stop the infusion. If infiltration is suspected, the infusion should be stopped. Necrosis can occur from extravasation of high doses of dopamine. Extravasation can be treated with local injection of an alpha-adrenergic blocking agent, such as phentolamine.