Pharmacology

A nurse is teaching a client who has a new prescription for enteric-coated aspirin as stroke prophylaxis. The client asks the nurse why the provider prescribed an enteric-coated medication. Which of the following responses should the nurse give?

"Enteric-coated medications cause less gastric irritation" Rationale: Enteric-coated medications do not dissolve until they reach the small intestine, which reduces the risk of gastric irritation

A nurse is preparing to administer Fosphenytoin 550 mg via IV bolus to a client who is having a seizure. Fosphenytoin 50 mg/1mL is available. How many mL should the nurse administer?

11 mL Rationale: 50mg/1mL = 550mg/xmL = 11mL

A nurse is preparing to administer Chlorothiazide 20mg/kg/day PO divided equally and administered twice daily for a toddler who weighs 28.6lb. The amount available is Chlorothiazide oral suspension 250mg/5mL. How many mL should the nurse administer per dose?

2.6mL Rationale: 2.2lb/1kg = 28.6lb/xkg = 13kg 20mg x 13kg = 260mg/day or 130mg every 12hrs 250mg/5mL = 130mg/xmL = 2.6mL

A nurse is preparing to administer Desmopressin 0.3 mcg/kg in 0.9% sodium chloride 50 mL IV over 30 min to a client who weights 154 lbs. How many mcg of medication should the client receive?

21 mcg Rationale: 2.2lb/1kg = 154lb/xkg = 70kg mcg x kg/dose = x 0.3mcg x 70kg = 21mcg

A nurse is preparing to administer Magnesium Hydroxide 1.5 oz PO to a client who has constipation. How many mL should the nurse administer?

45 mL Rationale: 1oz/30mL = 1.5oz/xmL = 45

A nurse is caring for a client who is experiencing an acute asthma exacerbation. Which of the following medications should the nurse identify as being contraindicated for this client?

Propranolol Rationale: The nurse should identify that a client who is experiencing an acute asthma exacerbation requires the use of a beta2-agonist to alleviate bronchospasm and relax the client's airway. Therefore, propranolol is contraindicated for this client. Propranolol is a beta-blocker that is used to treat cardiac conditions, including hypertension. Blocking the beta receptors prevents the action of beta2-agonists such as albuterol

A nurse is caring for a client who has a prescription for subdermal Etonogestrel. The nurse should alert the provider about which of the following findings in the client's medical history?

Take St. John's wort Rationale: St. John's wort can reduce the effects of subdermal Etonogestrel because it stimulates hepatic drug-metabolizing enzymes. Therefore, the nurse should alert the provider about the client's use of St. John's wort, and it should be discontinued

A nurse teaching a client who has a new prescription for Alosetron. Which of the following client statements indicates an understanding of the teaching?

"I should contact my provider immediately if I experience constipation" Rationale: The nurse should identify that constipation is an adverse effect of this medication and requires the provider to be notified. The provider may adjust the dose or withhold the medication and then instruct the client to resume taking it once the constipation has resolved

A nurse is teaching a client who has a new prescription for Sucralfate for a duodenal ulcer. Which of the following client statements indicates an understanding of the teaching?

"I should wait at least 30 minutes before taking this medication after I take an antacid" Rationale: The nurse should recognize that antacids can raise the gastric pH above 4, which can interfere with the effects of Sucralfate. To minimize these interactions, sucralfate should be taken at least 30 minutes apart from antacids

A nurse is providing teaching to a parent of a child who has asthma and a new prescription for a Cromolyn Sodium metered-dose inhaler. Which of the following statements by the parent indicates the need for further teaching?

"I will give my child a dose as soon as wheezing starts" Rationale: Cromolyn is a mast cell inhibitor that has a slow onset and is given for prophylactic treatment of asthma. It is not a rescue medication

A nurse is providing teaching to a client who has heart failure and is taking Spironolactone. Which of the following statements by the client indicates an understanding of the teaching?

"I will watch for increased breast tissue growth while taking this medication" Rationale: Spironolactone, which is derived from steroids, can cause adverse endocrine effects such as gynecomastia, impotence in men, and irregular menses and hirsutism in women. The nurse should instruct the client that these changes can occur

A nurse is teaching about adverse effects of Ergotamine with a client who has migraine headaches. Which of the following client statements should the indicate an understanding of the teaching?

"If I overuse this medication, I might become addicted to it" Rationale: The client should take the Ergotamine according to the prescribed dose and should only take the medication when needed to avoid developing a physical dependence

A nurse is preparing to administer Warfarin to a client who has a new onset of atrial fibrillation. The client asks the nurse, "What should this medication do?" Which of the following responses should the nurse make?

"It can reduce your risk of having a stroke" Rationale: The nurse should identify that atrial fibrillation increases the client's risk of having a stroke due to clot formation in the atrium. Warfarin can prevent clot formation when used long-term, which will reduce the client's risk of having a stroke

A nurse teaching a client who has persistent cancer pain about the adverse effects of opioids. Which of the following statements should the nurse include in the teaching?

"Physical dependence is not the same as addiction" Rationale: The nurse should explain that physical dependence can occur in all clients who take opioids, and the client may develop abstinence syndrome if the opioid is abruptly withdrawn. Physical dependence is not the same as addiction, but it can result in addiction. Addiction results when the opioid is continued despite physical or psychological harm

A nurse is providing teaching about Benzodiazepines to a client who is discontinuing long-term Alprazolam. Which of the following pieces of information should the nurse include in the teaching?

"Plan to taper the dose slowly over several months" Rationale: The nurse should instruct the client to plan to taper the Alprazolam dose slowly over several weeks or months to ease the physiological and psychological manifestations of withdrawal

A nurse is teaching a client who has diabetes mellitus about a new prescription for Pioglitazone. Which of the following statements should the nurse include in the teaching?

"This medication can be taken when using insulin" Rationale: The client can take Pioglitazone when using insulin because Pioglitazone increases the cellular response to insulin, and insulin is needed in order for the medication to be effective.

A nurse is preparing to administer Cefaclor 750 mg PO in 3 divided doses. Cefaclor 500 mg/tablet is available. How many tablets should the nurse administer with each dose?

0.5 tablet Rationale: 750mg/3 doses daily = 250mg 500mg/1tab = 250mg/xtab = 0.5tab

A nurse is planning care for a client who is receiving Gentamicin IM and has a new prescription to obtain Gentamicin peak and trough levels. At which of the following times should the nurse plan to obtain a blood sample to evaluate the Gentamicin peak?

1 hour after administering the IM injection Rationale: Timing is important when drawing blood samples for Aminoglycoside levels. The nurse should obtain blood samples for peak levels 1 hours after administering an IM injection or 30 minutes after completing an IV infusion

A nurse is planning care for a client who is postoperative and scheduled to ambulate. At which of the following times should the nurse plan to administer PO Morphine to the client for peak analgesic effect during the ambulation?

60 to 90 min prior to ambulation Rationale: The peak effect of PO Morphine takes 60 to 90 minutes to occur. Medicating the client 60 to 90 minutes prior to ambulation will provide the greatest analgesic effect

A nurse is preparing to administer iron dextran IV to a client. Which of the following actions should the nurse plan to take?

Administer a small test dose before giving the full dose Rationale: A serious adverse effect of iron dextran is anaphylaxis caused by hypersensitivity to the medication. A small test dose should be administered over 5 minutes before giving the full dose. The client should be monitored carefully for an allergic reaction during and for a period of time following the test dose

A nurse is caring for a client who has asthma and a prescription for Zileuton. Which of the following laboratory values should the nurse monitor while the client is taking this medication?

Alanine aminotransferase (ALT) Rationale: The nurse should identify that ALT is a lever function test. Zileuton is a leukotriene modifier that can affect the liver, causing increased ALT levels. The nurse should monitor this laboratory value closely while the client is taking the medication.

A nurse is caring for a client who has a new prescription for Tamoxifen. The nurse should recognize that Tamoxifen has which of the following therapeutic effects?

Anti-estrogenic Rationale: Tamoxifen is an anti-estrogen medication used to treat cancer of the breast in both premenopausal and postmenopausal women. It is also used to prevent breast cancer in women who are at an increased risk

A nurse is caring for a client who is taking an agonist medication. The nurse should expect which of the following actions from this type of medication?

Binds to receptors and mimics regulatory molecules Rationale: Full agonist medications act by binding to receptors and mimicking the actions of the body's regulatory molecules. Agonists activate receptors to produce the expected effects. hormones are an example of agonists

A nurse in a provider's office is assessing a client who reports taking a dietary supplement to reduce hot flashes related to menopause. Which of the following supplements should the nurse expect the client to report taking?

Black cohosh Rationale: Black cohosh is a herb that is used for the treatment of menopausal symptoms such as hot flashes, vaginal dryness, irritability, and sleep disturbances

A nurse is planning discharge teaching for a client who has major depressive disorder and a new prescription for Phenelzine. Which of the following foods should the nurse include in the plan as safe for the client to consume while taking Phenelzine?

Broiled beef steak Rationale: Phenelzine, an MAOI, is an antidepressant. This medication interacts with a variety of foods to produce a hypertensive crisis. Beef steak and other meats that are fresh do not interact with Phenelzine and are safe to consume

A nurse is caring for a client who has a new diagnosis of rheumatoid arthritis. The nurse should anticipate a prescription from the provider for which of the following medications for daily management of this condition?

Celecoxib Rationale: The nurse should anticipate that the provider will prescribe Celecoxib, which is an NSAID. This medication or another NSAID should be initiated for a client who has a new diagnosis of rheumatoid arthritic

A nurse is providing teaching to a client who has hypothyroidism and is taking Levothyroxine. The nurse should instruct the client that which of the following findings is an indication of thyrotoxicosis?

Chest pain Rationale: Thyrotoxicosis can result if a client takes too much Levothyroxine. Manifestations include chest paint, tachycardia, insomnia, tremors, hyperthermia, heat intolerance, and diaphoresis. The client should notify the provider if any of these manifestations are present

A nurse is preparing to administer an Epinephrine IV bolus to a client. Which of the following should the nurse verify before initiating the IV medication?

Concentration of the formulation Rationale: The nurse should verify the concentration of the formulation of the medication prior to administration. Epinephrine can be injected through several routes, and a solution prepared for use by a certain route can differ in concentration from others. Solutions intended for subcutaneous administration are generally concentrated, whereas solutions intended for intravenous use are dilute. If a solution prepared for subcutaneous administration is administered intravenously, the result could be fatal because intravenous administration of concentrated Epinephrine can overstimulate the heart and blood vessels, causing severe hypertension, cerebral hemorrhage, stroke, and death

A nurse is reviewing the laboratory results of a client who is taking tobramycin and notes that the medication's peak level is 7mcg/mL. Which of the following actions should the nurse take?

Continue to administer the medication as prescribed Rationale: The nurse should identify that a peak level of 7mcg/mL for Tobramycin is within the expected reference range of 5 to 10mcg/mL. Therefore, the nurse should continue to administer the scheduled medication as prescribed

A nurse is caring for a client who has been taking Metformin for 6 months. Which of the following findings should the nurse identify as an expected therapeutic effect of the medication?

Decreased blood glucose level Rationale: A client who has taken Metformin for 6 months should experience the expected therapeutic effect of decreased blood glucose levels. Metformin is a non-insulin medication for clients who have type 2 diabetes mellitus

A nurse is caring for a female client who has been taking Clomiphene to treat infertility. Which of the following findings should indicate to the nurse that the medication has been effective?

Follicular enlargement and conversion to corpus luteum after ovulation Rationale: The nurse should identify that Clomiphene is a medication that promotes follicular maturation and is used in the treatment of infertility. Successful treatment reveal progressive follicular enlargement, followed by conversion of the follicle to a corpus luteum after ovulation occurs

A nurse is caring for a client who has hyperlipidemia and is receiving Simvastatin 40mg PO daily. Which of the following items should the nurse remove from the client's breakfast tray before it is delivered to the room?

Grapefruit juice Rationale: Grapefruit juice is contraindicated for a client who is taking Simvastatin because it raises blood levels of the medication significantly by inactivating a liver enzyme that is responsible for metabolism

A nurse is preparing to administer Digoxin to a client. Which of the following findings should the nurse identify as a contraindication to the client receiving this medication?

Heart rate 51/min Rationale: The nurse should identify that if the client's heart rate is less than 60/min, the medication should be withheld, and the provider should be notified

A nurse is preparing to administer Dantrolene to a client who has muscle spasticity. Which of the following findings from the client's medical history should the nurse identify as a contraindication to the administration of this medication?

History of cirrhosis Rationale: The nurse should identify that Dantrolene is contraindicated for clients who have active liver disease because it is hepatotoxic and can cause liver failure. Liver function tests are monitored for clients throughout treatment with this medication

A nurse is teaching a client who has chemotherapy-induced anemia and a prescription for Epoetin Alfa. The nurse should instruct the client to report which of the following findings as an adverse effect of Epoetin Alpha?

Hypertension Rationale: The nurse should instruct the client to report hypertension, which is an adverse effect of Epoetin Alfa. Other adverse effects can include headaches, seizures, heart failure, and thromboembolic events related to increased hemoglobin levels

A nurse is caring for a client who is taking Fludrocortisone. Which of the following findings indicates to the nurse that the client is experiencing an adverse effect to the medication?

Hypokalemia Rationale: The nurse should identify that hypokalemia is an adverse effect of Fludrocortisone due to excessive sodium and water retention, resulting in the loss of excessive amounts of potassium

A nurse is caring for a client who has a prescription for an oral contraceptive to prevent pregnancy. The nurse should identify that which of the following actions is the purpose of this medication?

Inhibition of ovulation Rationale: The nurse should identify that this medication inhibits ovulation to prevent pregnancy

A nurse is preparing to administer Meperidine to a client who is postoperative and reports a pain level of 8 on a scale of 0 to 10. Which of the following routes of administration will deliver the medication with the shortest time of onset?

Intravenous Rationale: The nurse should identify that Meperidine given intravenously has no barriers to absorption because it is deposited directly into the circulatory system, An instantaneous time of onset and absorption gives the client immediate relief.

A nurse is reviewing laboratory values for a client who reports fatigue and cold intolerance. The client has an increased thyroid-stimulating hormone (TSH) level and a decreased total T3 and T4 level. The nurse should anticipate a prescription for which of the following medications?

Levothyroxine Rationale: Levothyroxine replaces thyroid hormone for a client who has hypothyroidism. Laboratory values for hypothyroidism include an increased TSH level and decreased total T3 and T4 levels. Clinical manifestations of hypothyroidism include fatigue, cold intolerance, and a decreased body temperature and pulse

A nurse is caring for a client who is at 28 weeks gestation and is experiencing preterm labor. Which of the following medications should the nurse plan to administer?

Nifedipine Rationale: Nifedipine is a tocolytic medication that is administered to stop preterm labor

A nurse is teaching a client who has ADHD and is starting therapy with an Amphetamine/Dextroamphetamine mixture. Which of the following manifestations should the nurse instruct the client to identify as an adverse effect and report to the provider?

Palpitations Rationale: The nurse should instruct the client that palpitations can be a sign of a cardiovascular adverse reaction and requires immediate attention. The nurse should instruct the client to contact the provider if palpitations develop

A nurse is teaching a client who has type 1 diabetes mellitus about a new subcutaneous insulin infusion pump. Which of the following pieces of information should the nurse include in the teaching?

Plan to use a type of short-duration insulin in the infusion pump Rationale: The client should plan to use short-duration insulin such as regular, Lispro, Aspart, or Glulisine Insulin in the infusion pump to deliver a baseline infusion of insulin. The client should also administer bolus doses of insulin before each meal

A nurse is assigned to care for several clients who are postoperative. The client taking which of the following medications is at risk of delated would healing?

Prednisone to treat persistent arthritis exacerbations Rationale: Prednisone is a corticosteroid that is associated with delated would healing. Clients who have arthritis often require high doses of prednisone to help resolve exacerbations

A nurse is caring for a client who has rheumatoid arthritis and a new prescription for Etanercept. Which of the following values should the nurse review prior to the administration of the medication?

Results of last purified protein derivative (PPD) test Rationale: The nurse should identify that a client who is taking Etanercept is at risk for infections such as tuberculosis (TB). To reduce this risk, the client should be tested for latent TB; if the test is positive, the client should undergo TB treatment before receiving Etanercept. During the treatment with Etanercept, the client should be monitored closely for the development of TB

A nurse is caring for a client who has asthma and is prescribed a short-acting beta2-agonist. Which of the following should the nurse identify as the expected outcome of this medication?

Reverses bronchospasm Rationale: The nurse should identify that the expected outcome of a short-acting beta2-agonist is a reversal of bronchospasm. Short-acting beta2-agonists bind to beta2-adrenergic receptors in the lungs, resulting in relaxation of bronchial smooth muscles

A nurse is caring for a client who has cystic fibrosis (CF) and has a prescription for high-dose Ibuprofen daily. The nurse should identify that which of the following is an expected outcome for the client receiving this medication?

Slowed progression of pulmonary damage Rationale: The nurse should identify that clients who have cystic fibrosis (CF) are prescribed high-dose Ibuprofen, which is an NSAID, to slow the progression of pulmonary damage by suppressing the inflammatory response that cause pulmonary damage. CF is a genetic disorder that primarily affects the lungs, pancreas, and sweat glands

A nurse providing teaching to a client who has a new prescription for Sertraline. The client asks the nurse if he should continue to take St. John's wort for depression. Which of the following instructions should the nurse give the client?

Stop taking the herbal supplement while taking the medication Rationale: Taking the antidepressant Sertaline and the herpal supplement St. John's wort increases the client's risk of serotonin syndrome

A nurse suspects that a client is having an allergic reaction to a medication. Which of the following factors should the nurse identify as increasing the likelihood of an allergic reaction to the medication?

The client has had previous exposure to the medication Rationale: Once the immune system has developed sensitization to a medication, subsequent exposure to that same medication can result in an allergic response. The more exposure the client has to the medication, the more intense the reaction will likely be.

A nurse is caring for a client who is experiencing acute pain and is receiving Morphine. Which of the following findings should indicate to the nurse the need to withhold the client's next dose of Morphine?

The client's respiratory rate is 10/min Rationale: The nurse should identify the Morphine can cause respiratory depression. Therefore, if the client's respiratory rate is less than 12/min, the nurse should withhold the next dose of Morphine and notify the provider

A nurse is providing teaching to a client who has a new prescription of Lisinopril. Which of the following should the nurse include in the teaching as an adverse effect of Lisinopril?

Tongue swelling Rationale: Angioedema is a fatal response that occurs in about 1% of clients who use ACE inhibitors such as Lisinopril. Manifestations of angioedema include swelling of the tongue, lips, or pharynx

A nurse is assessing a client who has hypothyroidism and take Levothyroxine. Which of the following findings indicates that the client is experiencing acute Levothyroxine overdose?

Tremor Rationale: Tremors and anxiety are expected findings in acute Levothyroxine overdose. These findings are similar to those seen in hyperthyroidism

A nurse is teaching a client who has a prescription for Chenodiol for the treatment of gallstones. Which of the following client statements indicates an understanding of the teaching/

"Liver function tests are required while taking this medication" Rationale: The nurse should identify that Chenodiol is hepatotoxic and can injure the liver. Periodic liver function tests are required during treatment. This medication is contraindicated in clients who have a preexisting liver condition

A nurse is providing teaching to a client with a seizure disorder who has a new prescription for Carbamazepine. Which of the following statements should the nurse include in the teaching?

"This medication will decrease the effectiveness of oral contraceptives"

A nurse is teaching a client who has a prescription for Doxycycline for the treatment of a Helicobacter Pylori infection. Which of the following instructions should the nurse include in the teaching?

"Wear protective clothing while in the sun" Rationale: The nurse should include in the teaching that all Tetracycline medications increase the sensitivity of the skin to ultraviolet light and sunlight. Therefore, clients are encouraged to avoid prolonged exposure to the sun and to wear protective clothing while outside and exposed to the sun

A nurse is teaching a client who has a prescription for a combination oral contraceptive (OC) that uses a 28-day cycle. Which of the following instructions should the nurse include in the teaching?

"You can miss up to 7 pills with little risk in getting pregnant as long as you have taken the pills regularly for the previous 3 weeks" Rationale: The nurse should instruct this client that up to 7 days can be missed with little or no increase in the chance of getting pregnant, provided that the client took the pills continuously for the previous 3 weeks

A nurse is providing discharge teaching for a client who has a new prescription for Metoprolol. Which of the following instructions should the nurse include? (SELECT ALL THAT APPLY)

- "Do not stop taking this medication abruptly" - "Count your radial pulse daily" - "Change positions slowly" Rationale: Clients who stop taking Metoprolol abruptly increase their risk of angina, hypertension, and myocardial infarction. They should reduce the dosage gradually over 1 to 2 weeks. Clients should count the radial pulse daily and report a heart rate slower than 60/min. Metoprolol can cause orthostatic hypotension; to prevent injury, the client should move slowly from lying down or sitting to standing

A nurse is completing the admission history for a client who reports drinking 1 pint of whiskey everyday for 6 years. The client's last drink was 10hrs ago. Which of the following medications should the nurse plan to administer upon admission?

Chlordiazepoxide Rationale: The nurse should anticipate the client will experience manifestations of alcohol withdrawal. Benzodiazepines are the most effective medications used to facilitate alcohol withdrawal, and Chlordiazepoxide is preferred because it has a longer half-life than other benzodiazepines. Benzodiazepines are safe and can stabilize vital signs, reduce the intensity of symptoms, and decrease the risk of seizures and delirium tremens

A nurse is planning to administer Diltiasema via IV bolus to a client who has atrial fibrillation. When assessing the client, the nurse should recognize that which of the following findings is a contraindication to administration of Diltiazem?

Hypotension Rationale: Diltiazem can be a treatment option for essential hypertension. This medication will lower blood pressure and is contraindicated for a client to self-monitor blood pressure and keep a record of the readings

A nurse is teaching a group of nurses about the effects of a client receiving spinal anesthesia. Which of the following pieces of information should the nurse include in the teaching?

Hypotension is an adverse effect of spinal anesthesia Rationale: The local anesthetic can cause the client's blood pressure to decrease due to venous dilation secondary to a sympathetic nervous system response. If hypotension occurs, the nurse should lower the head of the client's bed, increase fluids if applicable, and administer vasoconstrictive medication as indicated by the provider

A nurse is caring for a client who is taking Warfarin. Which of the following laboratory values should the nurse recognize as an effective response to the medication?

INR 3.0 Rationale: Warfarin is an anticoagulant that prevents thrombus formation in susceptible clients. The INR measures its effectiveness. For most clients taking Warfarin, an INR of 3.0 indicates effective therapy

A nurse is reviewing the laboratory reports of a client who has been taking Warfarin for atrial fibrillation. Which of the following results should the nurse report to the provider immediately?

INR 5.5 Rationale: When using the urgent vs nonurgent approach to client care, the nurse should determine that the priority laboratory result is an INR of 5.5. A client who is taking Warfarin for the treatment of atrial fibrillation is expected to have an INR in the range of 2 to 3. A level of 5.5 is considered a critical value and places the client at risk of bleeding; therefore, the nurse should report this result to the provider immediately

A nurse is preparing to administer Oxytocin to a client who is at 41 weeks gestation and is experiencing ineffective labor. Which of the following actions should the nurse plan to take?

Increase the dose of Oxytocin to obtain uterine contractions that occur every 2 to 3 min Rationale: Effective uterine contractions should occur every 2 to 3 minutes

A nurse is administering a prescription for Nifedipine to a client who is pregnant. Which of the following pieces of information related to Nifedipine should the nurse monitor and document?

Number of uterine contractions Rationale: A client who is going into preterm labor can have a prescription for Nifedipine, which is a calcium channel blocker that inhibits the entry of calcium into myometrial cells, which can delay labor

A nurse is preparing a discharge teaching plan for a client who is scheduled to begin long-term oral Prednisone for asthma. Which of the following instructions should the nurse include in the plan?

Schedule the medication on alternate days to decrease adverse effects Rationale: Some of the adverse effects caused by long-term glucocorticoid therapy can be avoided by using alternate-day therapy

A home health nurse is visiting an older adult client who has Alzheimer's disease. His caregiver tells the nurse she has been administering prescribed Lorazepam, 1 mg 3 times per day, to the client for restlessness and anxiety over the past few days. For which of the following adverse effects should the nurse assess the client?

Sedation Rationale: Lorazepam is a benzodiazepine with anti-anxiety and sedative effects. Older adult clients are especially at risk for central nervous system depression, even with low doses of benzodiazepines. Clients who are 50 years or older can have a more profound and prolonged sedation than younger clients

A nurse is assessing a client who reports using several herbal and vitamin supplements daily, including saw palmetto. The nurse should recognize that saw palmetto is a supplement used by clients to elicit which of the following therapeutic effects?

Urinary health promotion Rationale: Saw palmetto is used primarily for manifestations related to prostatic conditions such as benign prostatic hypertrophy (BPH). However, its effectiveness has not been scientifically verified. The nurse should instruct the client to check with the provider about interactions between saw palmetto and other medications

A nurse is caring for a client who was recently diagnosed with rheumatoid arthritis. The nurse should expect the provider to prescribe Methotrexate at which of the following times?

Within 3 months of the initial diagnosis Rationale: The nurse should identify that current guidelines recommend starting a disease-modifying anti-rheumatic (DMARD) such as Methotrexate within 3 months of a diagnosis of rheumatoid arthritis to prevent or delay joint degeneration

A nurse is providing teaching to a client about a new prescription for Captopril to treat hypertension. Which following client statements indicates an understanding of the teaching?

"I might feel dizzy at times while taking this medication" Rationale: Hypotension and dizziness are potential adverse effects of this medication. The nurse should monitor the client's blood pressure and instruct the client to change positions slowly

A nurse is caring for a client who is taking Streptomycin. Which of the following medications increases the client's risks of developing ototoxicity when taken with streptomycin?

Furosemide Rationale: Furosemide, a high-ceiling (loop) diuretic, increases the risk of developing ototoxicity when taken with streptomycin, an aminoglycoside

A nurse assessing a child who has acute lymphocytic leukemia and is receiving vincristine sulfate. Which of the following findings is the nurse's priority?

Paresthesia Rationale: The nurse should apply the safety and risk-reduction priority-setting framework, which assigns priority to the factor or situation posing the greatest safety risk to the client. When there are several risks to client safety, the one posing the greatest threat is the highest priority. The nurse should use Maslow's hierarchy of needs, the ABS priority-setting framework, and/or nursing knowledge to identify which risk poses the greatest threat to the client. The greatest risk to this client is neurotoxicity. Vincristine, a cell-cycle specific chemotherapy agent, interrupts cellular reproduction at mitosis and can cause neurotoxicity. An early finding with neurotoxicity is PARESTHESIA (numbing) of the peripheral extremities. As neurotoxicity progresses, the client can develop autonomic and central nervous system dysfunction. The nurse should report paresthesia immediately, as the provider might change the dosage or type of therapy