Pharmacology: Saunders

A client with epilepsy is taking the prescribed dose of phenytoin to control seizures. A phenytoin blood level is drawn, and the results reveal a level of 35 mcg/mL. Which symptom would be expected as a result of this laboratory result?

Slurred speech

A client informs the nurse that she has been taking acarbose as prescribed. The nurse determines that a therapeutic effect of the medication has occurred if which laboratory value is noted?

A 2-hour postprandial serum glucose of 120 mg/dL

A client reports to the clinic for follow-up after a 1-month treatment with acebutolol. The nurse determines that a therapeutic effect of the medication has occurred if which response is noted?

A blood pressure of 130/84 mm Hg

A client with benign prostatic hyperplasia is being administered finasteride. Which information should be included in the plan of care?

A pregnant caregiver should not be exposed to the crushed tablets of finasteride.

The nurse is caring for a client in the emergency department who has been diagnosed with Bell's palsy. The client has been taking acetaminophen, and acetaminophen overdose is suspected. Which antidote should the nurse prepare for administration if prescribed?

Acetylcysteine

A client with diabetes mellitus calls the clinic and tells the nurse that she has been nauseated during the night. The client asks the nurse if the morning insulin should be administered. Which is the appropriate nursing response?

Administer the full dose as prescribed.

The client has an as needed prescription for loperamide hydrochloride. For which condition should the nurse administer this medication?

An episode of diarrhea

The nurse is caring for a client receiving digoxin. The nurse monitors the client for which early manifestation of digoxin toxicity?

Anorexia

The nurse is preparing to administer digoxin to an adult client. The nurse checks which important item before administering the medication?

Apical pulse rate

Efavirenz, an antiviral medication, is prescribed for the client diagnosed with human immunodeficiency virus (HIV) infection. Which time should the nurse instruct the client to be best to take this medication?

At bedtime

A primary health care provider is planning to administer a skeletal muscle relaxant to a client with a spinal cord injury. The medication is going to be administered intrathecally. Which medication would the nurse expect to be prescribed and administered by this route?

Baclofen

The nurse is providing vaccine information to the second-day postpartum client who received a rubella vaccine. The nurse should instruct the client to avoid which action after receiving this vaccine?

Becoming pregnant for 2 to 3 months

The client diagnosed with portosystemic encephalopathy is receiving oral lactulose daily. The nurse should check which to determine medication effectiveness?

Blood ammonia level

The nurse reinforces instructions to a client who has been prescribed betaxolol eye drops for the treatment of glaucoma. The nurse instructs the client regarding the administration of the medication and about the importance of returning to the clinic for which assessment?

Blood pressure and apical pulse

A client is diagnosed with pulmonary embolism and is to be treated with thrombolytic therapy. The nurse should report which priority data collection finding to the registered nurse before initiating this therapy?

Blood pressure of 198/110 mm Hg

The nurse who is administering bethanechol chloride is monitoring for acute toxicity associated with the medication. The nurse should check the client for which sign of toxicity?

Bradycardia

A client has been started on long-term therapy with rifampin. Which information about this medication should the nurse provide to the client?

Causes red-orange discoloration of sweat, tears, urine, and feces

The nurse is reinforcing dietary instructions to a client who is taking spironolactone. The nurse instructs the client to avoid which food in the daily diet?

Citrus fruits

The client who has a cold is seen in the emergency department with an inability to void. Because the client has a history of benign prostatic hyperplasia, the nurse determines that the client should be questioned about the use of which class of medications?

Decongestants

A client is taking brompheniramine. The nurse reinforces instructions to the client to expect which side effect of this medication?

Drowsiness

A client with multiple sclerosis is receiving diazepam, a centrally acting skeletal muscle relaxant. Which data would indicate that the client is experiencing a side effect related to this medication?

Drowsiness

A client who recently began medication therapy with levodopa for Parkinson's disease complains of nausea. The nurse reminds the client to do which action to manage this problem?

Eat a snack before taking the medication.

The nurse is reinforcing dietary instructions to the client prescribed cyclosporine. Which priority food item should the nurse instruct the client to avoid?

Grapefruit juice

Amikacin is prescribed for a client with a diagnosed bacterial infection. The nurse instructs the client to contact the primary health care provider (PHCP) immediately if which occurs?

Hearing loss

A client who has begun taking fosinopril is very distressed, telling the nurse that he cannot taste food normally since beginning the medication 2 weeks ago. Which suggestion would provide the best support for the client?

Inform the client that impaired taste is expected and generally disappears in 2 to 3 months.

The nurse is caring for a client with glaucoma who is receiving acetazolamide daily. Which sign/symptom indicates to the nurse that the client is experiencing an adverse effect related to the medication?

Low back pain and dysuria

Atropine sulfate is prescribed for the client diagnosed with gastrointestinal hypermotility, and the nurse reviews the client's record before administering the medication. Which finding, if noted on the client's record, most indicates the need to contact the primary health care provider before administering the medication?

Narrow-angle glaucoma

A client taking buspirone hydrochloride for 1 month is scheduled for a follow-up appointment. The nurse gathers data from the client and interprets that the medication is effective if the client reports an absence of which sign/symptom?

Palpitations and anxiety

The nurse prepares to administer sodium polystyrene sulfonate to a client with chronic kidney disease for which laboratory abnormality?

Potassium level of 7.2 mEq/L

The hospitalized client with angina continues to have chest pain after the initial administration of a sublingual nitroglycerin tablet. The nurse should take which action?

Provide a second sublingual dose in 5 minutes.

A client is receiving acetylcysteine, 20% solution diluted in 0.9% normal saline by nebulizer. The nurse should have which item available for a possible adverse event after giving this medication?

Suction equipment

A client with angina pectoris who was given a first dose of newly prescribed nitroglycerin sublingual tablets complains of slight dizziness and headache. The nurse takes which action first?

Takes the client's blood pressure.

The client with a diagnosis of acquired immunodeficiency syndrome (AIDS) has a low T4 count. The nurse initiates prophylactic treatment as prescribed with aerosolized pentamidine isethionate and should monitor for which expected outcome?

The client has a respiratory rate and depth within normal limits for activity level.

A client diagnosed with hepatic encephalopathy is receiving lactulose. The nurse determines that the medication is effective if which finding is observed?

The client who was previously oriented to person only can now state name, year, and present location.

The nurse is scheduled to administer a dose of digoxin to a client with atrial fibrillation. The client has a potassium level of 4.6 mEq/L. Which would be the nurse's next action?

The dose should be administered as prescribed.

Vancomycin has been prescribed for the client. The nurse should plan to monitor which item associated with effectiveness of this medication?

Therapeutic serum levels

The nurse is reviewing the postoperative prescriptions for a client who has just returned from surgery and notes that the surgeon has prescribed lepirudin. Which is this medication prescribed to prevent?

Thromboembolic complications

The primary health care provider has prescribed butenafine for a client. The nurse recognizes that this has been prescribed to treat which disorder?

Tinea pedis

A client with cancer is receiving cisplatin. Which findings indicate that the client is experiencing an adverse effect of the medication? Select all that apply.

Tinnitus High-frequency hearing loss

A client has been prescribed cyclobenzaprine in the treatment of painful muscle spasms accompanying a herniated intervertebral disk. The nurse should withhold the medication and question the prescription if the client had which concurrent prescriptions to take?

Tranylcypromine

The client is receiving meperidine hydrochloride for pain. Which signs/symptoms are side and adverse effects of this medication? Select all that apply.

Tremors, Drowsiness, Hypotension

Isotretinoin is prescribed for a client with severe acne. Before the administration of this medication, the nurse anticipates that which laboratory test will be prescribed?

Triglyceride level

Bethanechol chloride is prescribed for a client. When should the nurse tell the client to take the medication?

Two hours after meals

The client with acute myelocytic leukemia is being treated with busulfan. Which laboratory value should the nurse specifically monitor during treatment with this medication?

Uric acid level

Which precautions should the nurse specifically take during the administration of ribavirin to a child with respiratory syncytial virus (RSV)?

Wearing goggles

The nurse employed in a primary health care provider's office is collecting data on a client who is taking ergotamine tartrate. The nurse evaluates the effectiveness of therapy by asking which question?

"Are the headaches relieved?"

The nurse notes that a client is taking lansoprazole. On data collection the nurse should ask the client which question to determine medication effectiveness?

"Are you experiencing any heartburn?"

The client plans to give his lispro insulin injection at 0800 right before eating breakfast. The nurse knows that the client understood the education provided when the client states which time presents the greatest risk for hypoglycemia?

0930

A client with trigeminal neuralgia tells the nurse that acetaminophen is taken on a frequent daily basis for relief of generalized discomfort. The nurse reviews the client's laboratory results and determines that which indicates toxicity associated with the medication?

A direct bilirubin level of 2 mg/dL

The nurse is monitoring a client receiving glipizide. Which outcome indicates an ineffective response from the medication?

A glycosylated hemoglobin level of 12%

The client with myasthenia gravis becomes increasingly weak. The primary health care provider (PHCP) prepares to identify whether the client is reacting to an overdose of the medication (cholinergic crisis) or increasing severity of the disease (myasthenic crisis). An injection of edrophonium is administered. Which change in condition indicates that the client is in cholinergic crisis?

A temporary worsening of the condition

Following kidney transplantation, cyclosporine is prescribed for a client. Which laboratory result would indicate an adverse effect from the use of this medication?

Blood urea nitrogen level of 25 mg/dL (8.8 mmol/L)

Tamoxifen is prescribed for the client with metastatic breast carcinoma. The nurse assists in planning care, knowing that which is the primary action of this medication?

Compete with estradiol for binding to estrogen in tissues containing high concentrations of receptors.

A client diagnosed with pleurisy is being started on medication therapy with ibuprofen. Which statement by the nurse accurately describes the purpose of the medication for the client?

Ibuprofen is a nonsteroidal anti-inflammatory medication to enhance coughing and deep breathing.

Carbidopa-levodopa is prescribed for a client with Parkinson's disease, and the nurse monitors the client for adverse effects of the medication. Which sign/symptom indicates the client is experiencing an adverse effect?

Impaired voluntary movements

The nurse is providing instructions to a client who is taking codeine sulfate for severe back pain. Which action does the nurse instruct the client to do?

Increase fluid intake.

An oral hypoglycemic medication, a sulfonylurea, is prescribed for a client with type 2 diabetes mellitus. The nurse is reviewing the medical record and needs to contact the primary health care provider if there is a history of which condition?

Liver disease

A client with tuberculosis is being started on antituberculosis therapy with isoniazid. Before giving the client the first dose, the nurse ensures that which baseline study has been completed?

Liver enzyme levels

The nurse admitting a client to the hospital is reviewing the client's history and medications taken at home. Which condition in the client's history is being treated with tamoxifen citrate?

Metastatic breast cancer

An oral powder form of nelfinavir is prescribed for the client diagnosed with human immunodeficiency virus (HIV). The nurse should reinforce instructions regarding the preparation of the medication and instruct the client to mix the powder with which substance?

Milk

A histamine (H2)-receptor antagonist will be prescribed for a client. The nurse understands that which medications are H2-receptor antagonists? Select all that apply.

Nizatidine Ranitidine Famotidine Cimetidine

Bethanechol is prescribed for the client with urinary retention, and an injectable form of bethanechol is available for use as prescribed. The nurse informs the client of the primary health care provider's prescription, knowing that the medication will be administered by which injectable route?

Subcutaneously

The nurse reviews the laboratory results of a client with trigeminal neuralgia who is being treated with carbamazepine 400 mg orally daily. The client's white blood cell (WBC) count is 3000 cells/mm3, blood urea nitrogen (BUN) is 15 mg/dL, sodium is 140 mEq/L, and uric acid is 5 ng/dL. Which laboratory result should the nurse report to the primary health care provider?

The WBC is low, indicating a blood dyscrasia.

Ketoconazole is prescribed for an assigned client. The nurse should prepare to administer the medication in which manner?

With food

A client is suspected of having myasthenia gravis, and the primary health care provider administers edrophonium to determine the diagnosis. After administration of this medication, which sign/symptom would indicate the presence of myasthenia gravis?

An increase in muscle strength

Allopurinol has been prescribed for a client with chronic tophaceous gout. The nurse explains to the client that what condition can occur during the first few months of treatment?

Acute gouty arthritis

A client who was started on anticonvulsant therapy with clonazepam tells the nurse of increasing clumsiness and unsteadiness since starting the medication. The client is visibly upset by these manifestations and asks the nurse what to do. How should the nurse respond to the client's concerns?

"Clumsiness and unsteadiness are worse during initial therapy and decrease or disappear with long-term use."

The nurse reviews the medication history of a client admitted to the hospital and notes that the client is taking leflunomide. During data collection, the nurse asks which question to determine if the medication is effective?

"Do you have any joint pain?"

The client who received a kidney transplant is taking azathioprine, and the nurse reinforces instructions about the medication. Which statement by the client indicates a need for further teaching?

"I need to discontinue the medication after 14 days of use."

The nurse is giving discharge instructions to the client concerning theophylline. Which client statement indicates a need for further teaching?

"I need to drink plenty of fluids, so I will drink more coffee and tea."

The nurse reinforces medication instructions to the client who had a kidney transplant about therapy with cyclosporine. Which statement by the client should indicate a need for further teaching?

"I need to obtain a yearly influenza vaccine."

Metoclopramide four times daily has been prescribed for a client with a diagnosis of reflux esophagitis. The nurse reinforces instructions to the client regarding administration of the medication. Which statement by the client indicates an understanding of the use of the medication?

"I need to take the medication 30 minutes before meals and at bedtime."

The nurse has reinforced discharge instructions to the mother of a child who is prescribed tetracycline to treat Rocky Mountain spotted fever (RMSF). Which statement by the mother indicates the best understanding regarding the administration of the medication?

"I need to use a straw when I give the medication."

The nurse has reinforced discharge instructions to a client with multiple sclerosis who is receiving baclofen. Which statement by the client indicates an understanding of the medication?

"I need to watch for urinary retention."

Moxifloxacin is prescribed for the client with a diagnosis of community-acquired pneumonia. The client needs to take the medication for 10 days, and the nurse reinforces instructions to the client about the medication. Which statement by the client best indicates an understanding of the medication instructions?

"I need to wear sunscreen and protective clothing when outdoors."

The client has been prescribed nifedipine. The nurse is instructing the client about nifedipine. Which client statement indicates a need for further teaching?

"If I see empty tab shells in my stool, I need to report it to my doctor."

Itraconazole is prescribed for the client diagnosed with a fungal infection of the hands. Which statement by the client best indicates an understanding of the medication?

"If my urine becomes very dark, I should contact my primary health care provider."

Nifedipine has been prescribed for a client with Raynaud's disease, and the nurse reinforces medication instructions with the client about the medication. Which statement by the client indicates a need for further teaching?

"Nausea and drowsiness are expected, and if they occur, I don't really need to worry about it."

A film-coated form of diflunisal has been prescribed for a client for the treatment of chronic rheumatoid arthritis. The client calls the clinic nurse because of difficulty swallowing the tablets. Which initial instruction should the nurse reinforce to the client?

"Swallow the tablets with large amounts of water or milk."

A client with aldosteronism has been instructed on spironolactone treatment. Which client statement indicates that the client needs further teaching about the medication?

"This medication will decrease my blood glucose."

A client with multiple sclerosis is receiving dantrolene for relief of muscle spasticity. When would this medication be discontinued if there is no relief of spasticity?

2 months

A client is taking Humulin NPH insulin daily every morning. The nurse reinforces instructions to the client and should tell the client that which is the most likely time for a hypoglycemic reaction to occur?

6 to 14 hours after administration

The nurse is asked to prefill syringes containing NPH and regular insulin for a diabetic client who lives at home alone and has difficulty with seeing and accurately preparing dosages. Considering the stability of insulin, which number of prefilled syringes should the nurse prepare for the client?

A 7-day supply

The nurse is monitoring a client receiving furosemide 40 mg orally daily. Which indicator should inform the nurse that a therapeutic effect has occurred?

A blood pressure of 128/80 mm Hg

A client has been prescribed acarbose for treatment of diabetes mellitus. Client teaching regarding this medication should include which instructions? Select all that apply.

Abdominal cramping is common. Side effects include excessive flatulence. The medication should be taken with each meal.

The client has been prescribed nitrofurantoin sodium. The nurse should determine the therapy is effective if which result is noted?

Absence of dysuria

A client is taking lansoprazole for the chronic management of Zollinger-Ellison syndrome. If prescribed, which medication would be appropriate for the client if needed for a headache?

Acetaminophen

The nurse prepares to administer digoxin to a 3-year-old with a diagnosis of heart failure and notes that the apical heart rate is 120 beats per minute. Which nursing action is appropriate?

Administer the digoxin.

The nurse is caring for a client with chronic heart failure who is taking digoxin 0.125 mg daily. Before administering the medication, the nurse reviews the serum digoxin level that was drawn earlier in the day. The result is 1 ng/mL. Which action should the nurse take based on this laboratory result?

Administer the dose of the medication as scheduled

A client is at risk for pulmonary embolism and is on anticoagulant therapy with warfarin sodium. The nurse is told that the client's prothrombin time is 18 seconds with a control of 11 seconds. Which action should the nurse plan?

Administer the next dose of warfarin sodium.

The nurse is caring for a mental health client who has been prescribed a benzodiazepine called chlorazapate. Which are the principal indications for this medication? Select all that apply.

Anxiety Insomnia Seizure disorders Alcohol withdrawal

The nurse is caring for a client with a burn injury to the lower legs. Silver sulfadiazine is prescribed to be applied to the sites of injury. Which indicates the appropriate method to apply this medication?

Apply to cleansed, debrided wounds as prescribed.

The 15-year-old child is scheduled to receive a series of the hepatitis B vaccine. The child arrives at the clinic for the first dose. The nurse collects data on the child before administering the vaccine and should ask the child about a history of an allergy to which primary product?

Baker's yeast

A client with a history of hypertension has been prescribed triamterene. The nurse determines that the client understands the effect of this medication on the diet if the client states to avoid which fruit?

Bananas

The nurse is caring for a client who is receiving hydralazine. The nurse evaluates the effectiveness of the medication by monitoring which client parameters?

Blood pressure

A client who is on lithium carbonate will be discharged at the end of the week. In reinforcing a discharge teaching plan, the nurse should include which instructions?

Check with the psychiatrist before using any over-the-counter (OTC) medications or prescription medications.

A client has been taking indomethacin for gout and experiencing side/adverse effects. Which assessment should the nurse expect the primary health care provider to prescribe?

Checking for occult blood

An older client has recently been taking cimetidine. The nurse should monitor the client for which most frequent central nervous system side effect of this medication?

Confusion

A client with chronic kidney disease is receiving ferrous sulfate. The nurse should monitor the client for which common side effect associated with this medication?

Constipation

A primary health care provider has prescribed codeine sulfate for a client with a nonproductive cough to suppress the cough reflex. The nurse reinforces instructions given to the client about the medication and tells the client to monitor for which side effect?

Constipation

A client arrives at the health care clinic for follow-up care and evaluation of the effectiveness of prazosin. Which finding indicates a therapeutic effect related to the use of this medication?

Decrease in blood pressure

A licensed practical nurse (LPN) is assisting in the care of a client who is receiving oxytocin to induce labor. The LPN plans to notify the registered nurse immediately if which signs and symptoms are noted? Select all that apply.

Decreased blood pressure, increased pulse Contractions greater than 1 minute in duration

The nurse is collecting data from a client receiving pioglitazone 30 mg orally daily. Which finding indicates that the client is experiencing the expected result of the action of this medication?

Decreased fasting blood glucose and reduced hemoglobin A1c (HbA1c)

A client has been taking benzonatate as prescribed. The nurse determines that the medication is having the intended effect if the client experiences which response?

Decreased frequency and intensity of cough

The client diagnosed with acquired immunodeficiency syndrome (AIDS) has an opportunistic respiratory fungal infection and is prescribed intravenous amphotericin B. The nurse assisting in caring for the client should primarily monitor for which sign that indicates an adverse effect of the medication?

Decreased urine output

A client with severe preeclampsia is receiving magnesium sulfate by intravenous infusion. Which criteria indicate expected findings for this medication? Select all that apply.

Deep tendon reflexes at 2+ Magnesium level of 7 mg/dL Urine output of 30 mL per hour Feeling of warmth, flushing and diaphoresis

The nurse is collecting data from a client, and the client's spouse reports that the client is taking donepezil hydrochloride. Which disorder should the nurse suspect that this client may have based on the use of this medication?

Dementia

A client has taken his first dose of lisinopril about 2 hours ago and begins to develop fullness in his face and hoarseness. Which action should the nurse take first?

Determine the client's ability to breathe effectively.

Capecitabine is prescribed for a client with metastatic breast cancer. The nurse reinforces information to the client about the medication including what frequent side effect?

Diarrhea

Fludrocortisone is prescribed for a client with Addison's disease. The primary health care provider needs to be notified if the client experiences which conditions? Select all that apply.

Edema Chest pain Muscle cramps

Propantheline bromide is prescribed for a client with bladder spasms. Which disorder, noted in the client's record, alerts the nurse to question the prescription for this medication?

Glaucoma

The nurse notes that a client is being treated with nesiritide. The nurse should expect this client to be experiencing which disorder?

Heart failure

A client is scheduled to receive chemotherapy with a group of medications, one of which is asparaginase. The nurse anticipates that this medication should be removed from the regimen after noting which findings in the client's medical record? Select all that apply.

History of pancreatitis, Significantly elevated serum amylase

The nurse notes that the client is receiving lamivudine. The nurse should determine that this medication has been prescribed to most likely treat which condition?

Human immunodeficiency virus (HIV) infection

Indinavir is prescribed for the client with a diagnosis of human immunodeficiency virus (HIV). Which medication instruction should the nurse reinforce to the client?

Increase fluid intake to at least 1.5 L/day.

The nurse is analyzing the laboratory results of a client with leukemia who has received a regimen of chemotherapy. Which laboratory value should the nurse note as a result of the massive cell destruction that occurred from the chemotherapy?

Increased uric acid level

The nurse is monitoring a client receiving levothyroxine sodium for hypothyroidism. Which findings indicate the presence of a side effect associated with this medication? Select all that apply.

Insomnia Weight loss Mild heat intolerance

The clinic nurse is performing an admission assessment on a client and notes that the client is taking azelaic acid. The nurse determines that which client complaint may be associated with the use of this medication?

Itching

The nurse is caring for a client who has been taking acetazolamide for glaucoma. The nurse reviews the assessment data documented in the client's medical record and determines that an adverse effect of the medication may be occurring if which result is noted?

Jaundice

The nurse is reviewing medications with the client receiving colchicine for the treatment of gout. The nurse determines that the medication is effective if the client reports a decrease in which?

Joint inflammation

The nurse is reinforcing discharge instructions to a client receiving sulfisoxazole. Which should be included in the plan of care for instructions?

Maintain a high fluid intake.

A client is being discharged with a prescription for propranolol. When reinforcing instructions to the client about the medication, the nurse should include which information?

Medication should be withheld if the pulse rate drops below 60 beats per minute.

Potassium iodide is prescribed for a client. The client calls the nurse at the clinic and complains of a brassy taste and burning sensations in the mouth. How should the nurse respond?

Notify the primary health care provider.

A client is receiving a continuous heparin infusion for venous thromboembolism treatment. Which laboratory monitoring should the nurse plan to check during a continuous heparin infusion? Select all that apply.

Platelets Activated partial thromboplastin time (aPTT)

The nurse is preparing to administer eardrops to an infant. How should the nurse administer the eardrops?

Pull down and back on the ear, and direct the solution toward the wall of the canal.

The client diagnosed with acquired immunodeficiency syndrome (AIDS) is taking nevirapine. The nurse should monitor for which side/adverse effects of the medication? Select all that apply.

Rash Hepatotoxicity

The nurse is reinforcing instructions to a client regarding epoetin alfa that will be administered subcutaneously by the client at home. The nurse tells the client to do which action?

Refrigerate the medication.

A registered nurse has administered a dose of naloxone intravenously to a client with intravenous opioid overdose. The licensed practical nurse assigned to assist in monitoring the client ensures that which equipment is available in the immediate vicinity of the client?

Resuscitation equipment

A client with acute nonlymphocytic anemia receives treatment with cytarabine. The nurse reinforces medication instructions to the client and tells the client that it is important to report which adverse effect to the primary health care provider?

Sore throat

The nurse is reinforcing dietary instructions to a client who is currently prescribed probenecid. Which food should the nurse encourage the client to continue to eat?

Spinach

The nurse reinforces dietary instructions to a client who will be taking warfarin sodium. The nurse tells the client to avoid which food item?

Spinach

A client is newly diagnosed with hypothyroidism. Levothyroxine is prescribed. The nurse should reinforce to the client which instructions about the medication?

Take on an empty stomach.

The nurse reinforces instructions to a client who is taking levothyroxine. Which instruction should the nurse give the client?

Take the medication on an empty stomach.

Isosorbide mononitrate is prescribed for a client with angina pectoris. The client tells the nurse that the medication is causing a chronic headache. Which action should the nurse suggest to the client?

Take the medication with food.

The nurse is monitoring a client who is taking propranolol. Which data collection finding would indicate a potential serious complication associated with propranolol?

The development of audible expiratory wheezes

The nurse is caring for a client with a diagnosis of chronic kidney disease who is receiving dialysis. Epoetin alfa has been prescribed for the client. How should the nurse prepare to administer the medication?

The subcutaneous route

The nurse is reviewing the postoperative prescriptions for a client who has just returned from surgery and notes that the surgeon has prescribed lepirudin. Which is this medication prescribed to prevent? 1.Pain 2.Nausea 3.Respiratory complications 4.Thromboembolic complications

Thromboembolic complications

A client diagnosed with testicular cancer is prescribed cisplatin. The nurse should monitor for which toxic effect of this medication?

Tinnitus

A client is admitted to the hospital with complaints of back spasms. The client states, "I have been taking 2 or 3 aspirin every 4 hours for the past week, and it hasn't helped my back." Aspirin intoxication is suspected. Which complaint would indicate aspirin intoxication?

Tinnitus

The nursing student is asked about the medication latanoprost and how this medication helps glaucoma. The student responds correctly by identifying which as the medication's mechanism of action?

To facilitate the outflow of aqueous humor

A client who is taking hydrochlorothiazide has also been prescribed triamterene. The client asks the nurse why both medications are required. Which response is the most accurate to give to the client?

Triamterene is a potassium-retaining (sparing) diuretic, whereas hydrochlorothiazide is a potassium-excreting diuretic.

The nurse is assisting in preparing a plan of care for a client with renal colic receiving meperidine hydrochloride for pain. The nurse includes in the plan of care to monitor for which side effect of this medication?

Urinary retention

Entacapone is prescribed for a client with a diagnosis of Parkinson's disease. The nurse reinforces medication instructions to the client and instructs on which frequent side effect?

Urine discoloration to dark yellow or orange

Disulfiram is prescribed for a client and the nurse is collecting data on the client and is reinforcing instructions regarding the use of this medication. Which is most important for the nurse to determine before administration of this medication?

When the last alcoholic drink was consumed

A hospitalized client is taking clozapine for the treatment of a schizophrenic disorder. Which laboratory study prescribed for the client should the nurse specifically review to monitor for an adverse effect associated with the use of this medication?

White blood cell count

The nurse is reading the laboratory results for a client being treated with carbamazepine for prophylaxis of complex-partial seizures. The nurse interprets that which value is consistent with an adverse effect to this medication?

White blood cell count 3200 mm3

The client with recurrent constipation has begun using psyllium. The nurse should instruct the client that this medication should be taken in which manner?

With a full glass of liquid, followed by a second glass of liquid

The nurse is reinforcing teaching for a client regarding how to mix regular insulin and NPH insulin in the same syringe. Which action performed by the client indicates the need for further teaching?

Withdraws the NPH insulin first

A client in renal failure is receiving epoetin alfa. The nurse should monitor the client for which adverse effect of this medication?

Hypertension

The nurse is caring for a client with a diagnosis of metastatic breast carcinoma. Tamoxifen citrate 10 mg orally twice daily is prescribed for the client, and the nurse is reinforcing instructions to the client regarding the medication. Which statement by the client would indicate an understanding of the medication?

"If I have difficulty seeing, I need to call the primary health care provider."

Zidovudine is prescribed for an adult client diagnosed with human immunodeficiency virus (HIV). Which statement by the nurse should provide the best instruction to the client about the medication?

"Space the medication doses evenly around the clock."

The nurse is caring for a child receiving carbamazepine who has a carbamazepine level drawn. Which result indicates a therapeutic level?

6 mcg/mL

A client with myasthenia gravis verbalizes complaints of feeling much weaker than normal. The primary health care provider plans to implement a diagnostic test to determine if the client is experiencing a myasthenic crisis and administers edrophonium. Which data would indicate that the client is experiencing a myasthenic crisis?

A temporary improvement in the condition

Atenolol hydrochloride is prescribed for a hospitalized client. The nurse should perform which as a priority action before administering the medication?

Check the client's blood pressure.

A client has begun therapy with theophylline. The nurse tells the client to limit the intake of which while taking this medication?

Coffee, cola, and chocolate

A long-term care nurse is caring for an older client taking cimetidine. The nurse should observe this client frequently for which most common central nervous system (CNS) side effect of this medication?

Confusion

The client with a diagnosis of gastric ulcer has a prescription for oral sucralfate four times daily. The nurse reinforces instructions to the client about which adverse or side effect that can occur while taking this medication?

Constipation

Mycophenolate mofetil is prescribed for the client as prophylaxis for organ rejection following an allogeneic renal transplant. Which instruction should the nurse most reinforce regarding administration of this medication?

Contact the primary health care provider (PHCP) if a sore throat occurs.

The nurse employed in a neighborhood health care clinic notes that the primary health care provider has prescribed oseltamivir. The nurse should reinforce teaching the client specific home care measures after determining this medication was prescribed for which condition?

Influenza virus

The nurse is teaching a client, newly diagnosed with diabetes mellitus, to mix 24 units NPH and 12 units regular insulin in the same syringe. Which instructions should the nurse give to the client to take after wiping the vials with an alcohol wipe?

Inject 24 units of air into the NPH insulin vial.

The nurse is assigned to care for the client with a diagnosis of hepatic encephalopathy. Which prescribed medication should the nurse most anticipate administering?

Lactulose syrup

A client with tuberculosis is being started on antitubercular therapy with isoniazid. The nurse reviews the client's health care record to be sure that which baseline studies have been completed before giving the client the first dose?

Liver enzymes

The nurse reinforces instructions to the client prescribed to take cyclosporine oral solution. Which instruction should the nurse primarily include?

Mix the concentration with chocolate milk.

A client receiving an anxiolytic medication complains that he feels very "faint" when he tries to get out of bed in the morning. The nurse explains to the client that which side effect is associated with this type of medication?

Postural hypotension

The client with peptic ulcer disease has been prescribed to take cimetidine. The nurse determines that which is the primary action of this medication?

Protects the gastric mucosa

The nurse is caring for a client on the mental health unit who has been declared incompetent through a formal legal proceeding. A guardian has been appointed. The nurse knows that guardians are typically selected from among family members. From the list of family members, what is the order of selection of a guardian for this client? List in descending order of importance from the first to the last choice. All options must be used.

Spouse Adult children or grandchildren Parents Adult siblings Adult nieces and nephews

A postoperative client has received a dose of naloxone hydrochloride for respiratory depression shortly after transfer to the nursing unit from the postanesthesia care unit. After administration of the medication, the nurse should check the client for which sign/symptom?

Sudden increase in pain

A client who takes a diuretic every evening expresses frustration with the medication and wants to stop therapy. When the nurse explores the reasoning, the client says, "It keeps me up all night. I feel as though I should bring my pillow into the bathroom!" Which action can the nurse suggest to assist the client in successfully adapting to this therapy?

Switching to a morning administration of the medication

A client is taking a monoamine oxidase (MAO) inhibitor. The nurse plans care, knowing which information?

Symptomatology of MAO toxicity includes headache, hypertension, and nausea and vomiting.

A client has a new prescription to take guaifenesin every 4 hours as needed. Which medication instructions should the nurse reinforce?

Take the tablet with a full glass of water.

The nurse is assisting in caring for a pregnant client who is receiving intravenous magnesium sulfate for the management of preeclampsia and notes that the client's deep tendon reflexes are absent. On the basis of this data, the nurse reports the finding and makes which determination?

The client is experiencing magnesium toxicity.

A client has been started on cyclobenzaprine for the management of muscle spasms in the cervical spine. The client is experiencing drowsiness, dizziness, and dry mouth. The nurse interprets these signs/symptoms as which response?

These are the common side effects of this medication.

A client is seen in the clinic for complaints of thirst, frequent urination, and headaches. Following diagnostic studies, diabetes insipidus is diagnosed. Desmopressin acetate is prescribed for the client. What would the nurse explain to the client as the purpose of the medication?

To increase water reabsorption

A client has received atropine sulfate intravenously during a surgical procedure. The nurse monitors the client for which side effect of the atropine sulfate in the postoperative period?

Urinary retention

The nurse has reinforced instructions to a client with Parkinson's disease who is taking carbidopa/levodopa. Which statement by a client indicates the need for further teaching?

"I will eat lots of foods high in vitamin B6."

The nurse is providing instructions to a client with a diagnosis of scabies regarding the administration of crotamiton. Which statement by the client indicates an understanding regarding the application of this medication?

"I will massage the medication into the skin from my chin downward and apply a second application in 24 hours, followed by a cleansing bath 48 hours after the second application."

Cortisone acetate is prescribed for a client with adrenal insufficiency, and the nurse reinforces instructions to the client regarding the medication. Which statement by the client would indicate a need for further teaching?

"I will stop the medication when I feel better."

The nurse is reinforcing instructions to the client about the use of ceftriaxone, an antibiotic, for treating cervical gonorrhea. The nurse should determine a need for further teaching if the client makes which statement?

"I will take the pills for 20 full days."

A client with heart failure is being discharged to home and will be taking furosemide. The nurse determines that teaching has been effective if the client makes which statement?

"I will weigh myself every day."

The nurse is reinforcing instructions to the family of a client with Alzheimer's disease regarding tacrine. Which statement by the family would indicate an understanding of the side/adverse effects related to this medication?

"Increased urination may be an indication of an adverse effect."

The client is prescribed trimethoprim-sulfamethoxazole for a recurrent urinary tract infection (UTI). The nurse should reinforce which most appropriate instructions to the client regarding this medication?

"Take each dose with 8 oz of water, and drink extra water each day."

A client with myasthenia gravis is being discharged on pyridostigmine bromide. The nurse reinforces medication instructions with the client and makes which statement to the client?

"Take the medication before activities such as eating."

Thyroid replacement therapy is prescribed for a client diagnosed with hypothyroidism. The client asks the nurse when the medication will no longer be needed. Which response by the nurse would be accurate?

"The medication will need to be continued for life."

A client has self-administered his first injection of regular insulin at 7:30 am, before breakfast. This client should be instructed to closely monitor for signs of hypoglycemia at which time?

11:00 am

The nurse is admitting the client to the nursing unit who is scheduled for several diagnostic tests. When obtaining a medication history, the nurse discovers that the client is prescribed tacrolimus daily. On further data collection, which should the nurse expect to note in the client history?

Allogenic liver transplant

The nurse is reinforcing dietary instructions to a client who is taking triamterene. The nurse instructs the client that it is acceptable to consume which food item daily?

Apple

The nurse is concerned that a client may experience systemic effects from a beta-blocker ophthalmic solution. The nurse realizes the client is able to self-administer the medication if the client instills the drops in which manner?

Applies digital pressure to the lacrimal sac for 1 to 2 minutes after instillation

A client who has developed atrial fibrillation that is not responding to medication therapy has begun taking warfarin. The nurse is reinforcing dietary discharge teaching with the client. The nurse should plan to teach the client to avoid which food while taking this medication?

Broccoli

A client being seen in the clinic is taking phenytoin. The client's phenytoin blood level is within therapeutic range, and the client's seizures are controlled. Which data collected by the nurse would require primary health care provider notification and possible discontinuation of the medication?

Diffuse body rash

Desmopressin acetate is prescribed for the treatment of diabetes insipidus. The nurse monitors the client after medication administration for which therapeutic response?

Decreased urinary output

The nurse is caring for a client who has been prescribed citalopram and checks the client for which signs/symptoms of serotonin syndrome? Select all that apply.

Diarrhea, Abdominal pain, Increased blood pressure

The nurse is preparing to administer an injection of regular insulin. The vial of the regular insulin has been refrigerated. On inspection of the vial, the nurse finds that the medication is frozen. Which action should the nurse take?

Discard the insulin and obtain another vial.

A client complaining of not feeling well is seen in a clinic. The client is taking several medications for the control of heart disease and hypertension. These medications include a beta blocker, digoxin, and a diuretic. A tentative diagnosis of digoxin toxicity is made. Which assessment data supports this diagnosis?

Double vision, loss of appetite, and nausea

A client with diabetes mellitus who has been controlled with daily insulin has been placed on atenolol for the control of angina pectoris. Because of the effects of atenolol, the nurse determines that which is the most reliable indicator of hypoglycemia?

Low blood glucose level

The nurse caring for a client taking tamsulosin determines that which finding indicates the need for follow-up?

Pulse rate of 120 beats per minute

A client receiving long-term therapy with lithium carbonate has a toxic serum lithium level of 1.5 and 2 mEq/L. Which organ functions are the major long-term risk factors? Select all that apply.

Renal function, Thyroid function

Oxybutynin chloride is prescribed for a client with neurogenic bladder. Which sign would indicate a possible toxic effect related to this medication?

Restlessness

Salicylic acid is prescribed for a client with a diagnosis of psoriasis. The nurse monitors the client, knowing that which finding indicates the presence of systemic toxicity from this medication?

Tinnitus

The nurse is reinforcing medication instructions to the client with a diagnosis of human immunodeficiency virus (HIV) who is prescribed saquinavir. Which instruction should the nurse most appropriately provide the client in regard to taking this medication?

Within 2 hours after a full meal

During the monitoring of a client's response to disease-modifying antirheumatic drugs (DMARDs), which findings should the nurse interpret as acceptable responses? Select all that apply.

-Symptom control during periods of emotional stress -Normal white blood cell, platelet, and neutrophil counts -Radiological findings that show nonprogression of joint degeneration -An increased range of motion in the affected joints 3 months into therapy

Isotretinoin is prescribed for a client to treat severe cystic acne. The nurse tells the client that the length of the usual prescribed course of treatment is which?

15 to 20 weeks

The client diagnosed with acquired immunodeficiency syndrome (AIDS) is prescribed intravenous (IV) pentamidine isethionate. The nurse assigned to care for the client should primarily monitor for signs of which toxic effect related to the administration of this medication?

Hypoglycemia

The nurse is reviewing the laboratory results for the client receiving tacrolimus. Which laboratory result should indicate to the nurse that the client is experiencing an adverse effect of the medication?

Blood glucose of 200 mg/dL

A client is taking nicotinic acid for hyperlipidemia, and the nurse reinforces instructions to the client about the medication. Which statement by the client indicates an understanding of the instructions?

"Ibuprofen taken 30 minutes before the nicotinic acid should decrease the flushing."

The nurse is assigned to care for a client with a leg ulcer. Sutilains treatments are prescribed. The nurse should avoid which action when performing the treatment?

Applying the sutilains immediately followed by a dry sterile dressing

The nurse is reinforcing medication discharge instructions for a client who has just begun taking isocarboxazid for depression and knows that the client needs further teaching after stating that which foods are safe to eat? Select all that apply.

Avocado, Bolonga

The nurse performs an admission assessment on a client who visits a health care clinic for the first time. The client tells the nurse that propylthiouracil is taken daily. The nurse continues to collect data from the client, suspecting that the client has a history of which disorder?

Graves' disease

The nurse is taking a health history on the client seen in the health care clinic for the first time. When the nurse asks the client about current prescribed medications, the client tells the nurse that amprenavir is prescribed twice daily. Based on this finding, the nurse should elicit data from the client regarding the presence of which condition?

Human immunodeficiency virus (HIV)

The nurse is caring for a hospitalized child with a history of seizures who is receiving oral phenytoin sodium. Which should be included in the plan of care for this child?

Providing oral hygiene, especially care of the gums

A hospitalized client is having the dosage of clonazepam adjusted. The nurse should plan to implement which action?

Instituting seizure precautions

The nurse is monitoring a client receiving baclofen for side effects related to the medication. Which should indicate that the client is experiencing a side effect?

Drowsiness

A client with Parkinson's disease has been prescribed benztropine. The nurse monitors for which gastrointestinal (GI) side effect of this medication?

Dry mouth

The nurse in the preoperative holding unit administers a dose of scopolamine to a client. The nurse monitors the client for which common side effect of the medication?

Dry mouth

The nurse is reinforcing medication instructions to a client who has been prescribed simvastatin. Which is the action of simvastatin?

It inhibits hepatic synthesis of cholesterol.

A client with breast cancer has been given a prescription for cyclophosphamide. The nurse determines that the client understands the proper use of the medication if the client makes which statements? Select all that apply.

"I will increase fluid intake to 2 to 3 L/day." "I will observe my urine carefully for signs of bleeding."

The nurse is collecting data from a client who is taking pantoprazole. The nurse determines that the medication is most effective if the client states relief of which symptom?

Heartburn

Ibuprofen is prescribed for a client. Which instruction should the nurse give the client about taking this medication?

Take with 8 oz of milk.

The nurse is caring for a child with heart failure and provides instructions to the mother regarding the procedure for administration of the prescribed digoxin. Which statement by the mother indicates a need for further teaching?

"I can mix the medication with food."

The home care nurse visits a client at home who has been prescribed prednisone 5 mg orally daily. The nurse reinforces teaching for the client about the medication. Which statement made by the client indicates a need for further teaching?

"I can take aspirin or my antihistamine if I need it."

Psyllium is prescribed for the client diagnosed with a cardiac disorder to facilitate defecation and prevent straining with bowel movements. The nurse reinforces instructions to the client regarding administration of the medication. Which statement by the client indicates an understanding of the use of the medication?

"I should mix the medication with a full glass of water."

A client with Parkinson's disease is beginning treatment with carbidopa/levodopa. Which statement made by the client indicates the need for further teaching?

"I should take my medication after a full meal."

Amantadine hydrochloride 100 mg orally twice daily has been prescribed for a client with Parkinson's disease, and the nurse teaches the client about the medication. Which statement by the client indicates a need for further teaching?

"I'll take this medication early in the morning and just before I go to bed."

A client taking carbamazepine asks the nurse what to do if he misses one dose. Which response should the nurse give?

"Take the medication as long as it is not immediately before the next dose."

The client who is scheduled for an intravenous pyelogram has been instructed to take liquid magnesium citrate on the day before the scheduled procedure. The client asks the nurse about the administration procedure for this medication. Which instruction should the nurse provide to the client?

"Take the medication on ice."

Which instruction should the nurse reinforce to the client with diabetes mellitus receiving acarbose? Select all that apply.

"Take the medication with each meal." "Side effects include abdominal bloating and flatus." "Take some form of glucose if hypoglycemia occurs." "Report symptoms such as shortness of breath or tiredness."

A client with tuberculosis (TB) will be treated with isoniazid and rifampin. The nurse is reinforcing instructions for the client regarding these medications. Which statement should the nurse plan to provide to the client?

"The entire prescribed course of the medication needs to be completed."

The nurse is caring for a client with kidney failure. The serum phosphate level is reported as 7 mg/dL. Which medication should the nurse plan to administer as prescribed to the client?

Aluminum hydroxide gel

Prednisone is prescribed for a client with diabetes mellitus who is taking Humulin neutral protamine Hagedorn (NPH) insulin daily. Which prescription change does the nurse anticipate during therapy with the prednisone?

An increased amount of daily Humulin NPH insulin

The nurse is planning to administer amlodipine to a client. The nurse should plan to check which before giving the medication?

Blood pressure and heart rate

The nurse is assigned to care for the client diagnosed with herpes simplex virus (HSV) prescribed acyclovir. The nurse is monitoring for adverse effects of the medication. Which laboratory result should the nurse primarily monitor to identify an adverse effect associated with the use of this medication?

Blood urea nitrogen (BUN)

Which finding indicates a side effect associated with the use of latanoprost eye drops?

Brown pigmentation of the iris

A client on the nursing unit has a prescription for a central nervous (CNS) stimulant orally daily. The nurse collaborates with the dietitian to limit the amount of which item on the client's dietary trays?

Caffeine

A client returning to the medical nursing unit following cardiac catheterization has a stat prescription to receive a dose of procainamide. The licensed practical nurse assisting in caring for the client obtains which piece of equipment to adequately determine the client's response to this medication?

Cardiac monitor

A client receiving nitrofurantoin calls the primary health care provider's office complaining of side effects related to the medication. Which side effect indicates the need to stop treatment with this medication?

Chest pain

A client taking an aldosterone antagonist known as eplerenone for hypertension asks about side effects of this medication. The nurse tells the client that which sign/symptom is a side effect?

Elevated potassium level

The nurse is assisting in preparing a plan of care for a client with a diagnosis of cancer who is receiving morphine sulfate in an extended format by mouth. The nurse should include which priority nursing action in the plan of care for this client?

Encourage the client to cough and deep breathe.

A client has a prescription for valproic acid orally once daily. How should the nurse plan to administer the medication?

Ensure that the medication is administered at the same time each day.

Letrozole is prescribed for a postmenopausal client with advanced breast cancer. Which side effect of this medication should the nurse reinforce in the instructions to the client?

Leg pain

A client is being discharged to home with a prescription for eye drops to be given in the left eye. The nurse has shown the client how to self-administer the drops. The nurse determines that the client needs further teaching if the client performs which actions during a return demonstration?

Lies supine, pulls up on the upper lid, and puts the drop in the upper lid

The nurse has reinforced instructions to a client regarding the method for instilling eye drops into the left eye. The nurse determines that the client needs further teaching if the client does which during a return demonstration?

Lies supine, pulls up on the upper lid, and puts the drop in the upper lid

The client diagnosed as human immunodeficiency virus (HIV) seropositive has been prescribed zalcitabine as a component of treatment. The nurse should instruct the client that which laboratory test will need to be monitored while taking this medication?

Liver function studies

Lispro insulin is prescribed for a child with type 1 diabetes mellitus. The nurse is reinforcing a teaching session with the child and mother about the onset, peak, and duration times of the insulin. The nurse provides which information about this type of insulin?

Onset of 15 to 30 minutes from injection time, peak of 2 to 4 hours later, and duration time of 4 to 8 hours

The nurse in the delivery room is caring for a newborn delivered 10 minutes ago. The nurse assists in preparing which medications that will be prescribed to be given within the first hour of life? Select all that apply.

Phytonadione Erythromycin eye drops

The nurse is assisting in developing a plan of care for a client receiving warfarin sodium. The nurse selects which problem as the priority in caring for this client?

Potential for injury

The client diagnosed as human immunodeficiency virus (HIV) seropositive is prescribed stavudine. Which measure should the nurse assess most closely while the client is taking this medication?

Presence of paresthesias

A client is receiving heparin sodium by continuous intravenous (IV) infusion. The licensed practical nurse (LPN) is concerned that the client received a bolus of medication when the tubing was removed from the IV pump during a gown change. The LPN immediately notifies the registered nurse or health care provider and then checks to see whether which medication is available in the medication supply area in case it is prescribed?

Protamine sulfate

A client arrives at the health care clinic and tells the nurse that they have been doubling their daily dosage of bupropion hydrochloride to help them get better faster. The nurse understands that the client is now at risk for which problem?

Seizure activity

An adult client with severe muscle spasticity is receiving intrathecal baclofen (ITB). The nurse knows that what adverse effects may occur if the medication is suddenly withdrawn. Select all that apply.

Seizures Hallucinations

The nurse is assigned to care for the client diagnosed with cytomegalovirus retinitis and acquired immunodeficiency syndrome (AIDS) who is receiving foscarnet. The nurse should monitor the results of which laboratory study while the client is taking this medication?

Serum creatinine level

The nurse is assisting in caring for the client diagnosed with a respiratory tract infection who is prescribed intravenous tobramycin sulfate. The nurse is instructed to monitor for adverse effects of the medication. The nurse should determine that which finding is most indicative of an adverse effect of this medication?

Vertigo

The nurse is reinforcing medication instructions to a client with breast cancer who is receiving cyclophosphamide. Which instruction should the nurse provide to the client?

Increase fluid intake to 2000 to 3000 mL daily.

The client prescribed infliximab via intravenous (IV) injection is complaining of difficulty swallowing. Which should be the initial nursing action?

Notify the registered nurse (RN).

The client with diagnosed peptic ulcer disease has been prescribed misoprostol and sucralfate. The nurse reinforces teaching the client that these two medications will work primarily for which reason?

The medications protect the gastric mucosa.

The client has a new prescription for metoclopramide. On review of the chart, the nurse identifies that this medication can be safely administered with which condition?

Vomiting following cancer chemotherapy

The nurse realizes that the client taking metformin needs further teaching when the client makes which statement?

"I should treat hypoglycemic episodes due to metformin with glucose tablets only."

A client is being treated for moderate hypertension and has been taking diltiazem for several months. The client is seen by the health care provider, and Prinzmetal's angina is diagnosed. The nurse is instructing the client about diltiazem. Which client statement indicates a need for further teaching?

"I have to limit my coffee, but I can drink all the fruit juice I want."

A client with dermatitis has been prescribed a topical corticosteroid for use on the affected areas, and the nurse has reinforced instructions about the use of this medication. Which statement by the client indicates a need for further teaching?

"I will apply a bandage over the site after applying the medication."

Thrombolytic therapy was administered to a client following an acute inferior myocardial infarction. The nurse giving discharge instructions to the client evaluates a need for further teaching when the client makes which statement?

"I will apply pressure for 10 minutes for minor bleeding."

The nurse is reinforcing instructions to the client about insulin glargine. The nurse determines that the client understands the action of the medication if the client makes which statement?

"I will give myself this medication subcutaneously once each night before bed."

Saquinavir is prescribed for the client diagnosed as human immunodeficiency virus (HIV) seropositive. The nurse should reinforce medication instructions and determine that the client needs further teaching if the client makes which statement?

"I will take the medication on an empty stomach."

The home health care nurse is visiting a client with elevated triglyceride levels and a serum cholesterol level of 398 mg/dL (9.95 mmol/L). The client is taking cholestyramine. Which statement made by the client indicates the need for further teaching?

"I'll continue my nicotinic acid from the health food store."

The nurse is assisting in the care of a client with Parkinson's disease who is receiving carbidopa/levodopa. The nurse plans to monitor the client for which adverse effect, which could appear with elevated serum levels of this medication?

Impaired voluntary movements

The nurse is caring for a client who is receiving lithium carbonate for the treatment of bipolar disorder and monitors the client for signs/symptoms of lithium toxicity. Which sign/symptom should alert the nurse to the potential for toxicity?

Vomiting

The health care provider has prescribed morphine sulfate intravenous push for a client with pulmonary edema. Which therapeutic effects should the nurse expect in this client? Select all that apply.

Relief of anxiety Reduction of oxygen consumption Improvement in efficacy of breathing

A client is to begin a 6-month course of therapy with isoniazid. The nurse should plan to provide which information to the client?

Report yellow eyes or skin immediately.

A licensed practical nurse (LPN) is reviewing the medical record of a newly assigned client and notes that the client is receiving cyclobenzaprine hydrochloride for the treatment of muscle spasms. The LPN questions the prescription if which disorder is noted in the admission history?

Angle-closure glaucoma

A client receiving a tricyclic antidepressant arrives at the mental health clinic. Which observation indicates that the client is correctly following the medication plan?

Arrives at the clinic neat and appropriate in appearance

A primary health care provider has written a prescription for ranitidine 300 mg once daily on the client's discharge medication list. The nurse determines to instruct the client to take the medication at which time?

At bedtime

A client taking phenytoin has a serum phenytoin level of 30 mcg/mL. The nurse would expect to note which signs and symptoms on data collection of the client? Select all that apply.

Ataxia Nausea Diplopia Nystagmus

The nurse is reviewing the health care provider's prescription sheet for the preoperative client, which states that the client must be on nothing by mouth (NPO) status after midnight. The nurse should clarify whether which medication should be given to the client rather than withheld?

Atenolol

A client recently began medication therapy with propranolol. The nurse should be most concerned after noting the presence of which effect in this client?

Audible expiratory wheezes

The nurse is reinforcing discharge instructions to a client receiving baclofen. Which should the nurse include in the instructions?

Avoid the use of alcohol.

A client has been given a prescription for gemfibrozil. The nurse plans to instruct the client to limit intake of which food while taking this medication?

Beef

Rho(D) immune globulin is prescribed for a client after delivery and the nurse provides information to the client about the purpose of the medication. The nurse determines that the woman understands the purpose if the woman states that it will protect her next baby from which condition?

Being affected by Rh incompatibility

Methylergonovine is prescribed for a client with postpartum hemorrhage caused by uterine atony. Before administering the medication the nurse checks which important client parameter?

Blood pressure

The nurse is caring for a postrenal transplantation client with prescription for cyclosporine. If the nurse notes an increase in one of the client's vital signs and the client is complaining of a headache, which vital sign is most likely increased?

Blood pressure

A client is being treated for heart failure and is receiving digoxin. The client's vital signs are blood pressure 85/50 mm Hg, pulse 96 beats per minute, and respirations 26 breaths per minute. To evaluate therapeutic effectiveness of this medication, the nurse should expect which change in the client's vital signs?

Blood pressure 98/60 mm Hg, pulse 80 beats per minute, respirations 24 breaths per minute

The client diagnosed with acquired immunodeficiency syndrome (AIDS) has begun therapy with zidovudine. The nurse should monitor which laboratory result during treatment with this medication?

Complete blood count

Which report best indicates to the nurse that the client is experiencing a toxicity-related reaction to kanamycin sulfate?

Difficulty hearing

The nurse is preparing to reinforce instructions to the client who has been given a prescription for diphenoxylate with atropine. Which instructions should the nurse include?

Do not exceed the recommended dose because it can be habit forming.

The client has been given a prescription for trimethoprim. The nurse should determine the client understands how to use the medication properly if the client states an intention to perform which action?

Drink extra fluids while taking the medication.

The client with ovarian cancer is being treated with vincristine. The nurse monitors the client, knowing that which adverse effect is specific to this medication?

Extremity numbness

A 16-year-old child is brought to the emergency department by his mother with a complaint that the child just experienced a tonic-clonic seizure. On arrival in the emergency department no apparent seizures were occurring. The mother states that her son is taking medication for the seizure disorder. The nurse plans care, knowing that which medications are used for long-term control of tonic-clonic seizures? Select all that apply.

Gabapentin Ethosuximide Carbamazepine

The nurse is performing a follow-up teaching session with a client discharged 1 month ago who is taking fluoxetine. Which information should be important for the nurse to gather regarding the adverse effects related to the medication?

Gastrointestinal dysfunctions

A client is being treated for depression with amitriptyline hydrochloride. During the initial phases of treatment, which is the most important nursing intervention?

Getting baseline postural blood pressures before administering the medication and each time the medication is administered

Cyclobenzaprine is prescribed for a client for muscle spasms and the nurse is reviewing the client's record. Which disorder, if noted in the record, should indicate a need to contact the health care provider about the administration of this medication?

Glaucoma

A client has been given a prescription for chloral hydrate for short-term use. The nurse includes which nursing intervention in caring for this client?

Instruct the client to call for help to get out of bed.

The nurse prepares to reinforce instructions to a client who is taking allopurinol. The nurse should include which instruction in the plan?

Instruct the client to drink 3000 mL of fluid per day.

The client prescribed metronidazole calls the clinic nurse to report dark discoloration of the urine. The nurse should interpret that the client's report warrants which nursing action at this time?

Instruct the client to increase oral fluid intake.

The nurse is reinforcing instructions to a client regarding the administration of lypressin. The nurse instructs the client that the medication will be taken by which routes?

Intranasal

A client receiving morphine by the epidural route complains of itching. The nurse should anticipate which prescription to relieve the itching?

Low dose infusion of naloxone

Morphine sulfate is being administered to a client with cancer. The nurse is monitoring the client for signs of overdose related to this medication therapy. Which finding noted in the client should require the need to notify the registered nurse?

Respirations of 10 breaths per minute

A licensed practical nurse (LPN) is assisting in the care of a pregnant teenaged client with preeclampsia receiving magnesium sulfate. The LPN plans to notify the registered nurse immediately if which sign of magnesium toxicity is noted?

Respiratory rate of 10 breaths per minute

A client diagnosed with rheumatoid arthritis (RA) has been started on medication therapy with hydroxychloroquine. The nurse reinforces teaching with this client regarding the most serious adverse effect of this medication?

Retinal damage

The client with a diagnosis of urinary tract infection is beginning medication therapy with nitrofurantoin. The nurse should realize the need for further teaching if the client states which item will need to be avoided?

Rhubarb

The client diagnosed with an infected leg wound that is draining purulent material has a prescription for sodium hypochlorite to be used in the care of the wound. The nurse should perform which priority action while using this solution?

Rinse off the solution immediately following irrigation.

A 1-year-old child has been prescribed digoxin to treat heart failure (HF). When should the nurse plan on withholding the prescribed dose of the medication?

The child's pulse is less than 80 beats per minute.

The client newly diagnosed with gout has been prescribed allopurinol. The nurse should question the primary health care provider if the dose for which medication already prescribed has not changed?

Warfarin sodium

The nurse notes that a client in a long-term care facility is receiving a daily dose of furosemide. The nurse writes in the care plan to monitor which parameter on a daily basis?

Weight

The nurse has completed client teaching about heart failure and prescribed medications that include digoxin and furosemide. The nurse documents that the teaching goals have been met if the client states knowing to report which symptom?

Weight gain of 2 to 3 pounds in a few days

A health care provider (HCP) writes a prescription for digoxin, 0.25 mg daily. The nurse teaches the client about the medication and tells the client that it is important to do which?

Withhold the medication and call the HCP if the pulse is less than 60 beats per minute.

A hospitalized client is started on phenelzine sulfate for the treatment of depression. At lunchtime, a tray is delivered to the client. Which food item on the tray should the nurse remove?

Yogurt

Iron dextran is prescribed to be administered intramuscularly to a client. The nurse prepares the medication and determines that the appropriate method of administration is which?

Using the Z-track technique

A client with cancer is receiving daunorubicin intravenously. The nurse assigned to assist in caring for the client monitors for which commonly expected side effect?

Nausea and vomiting

Cycloserine is added to the medication regimen for a client with tuberculosis. Which instruction should the nurse reinforce in the client-teaching plan regarding this medication?

To return to the clinic weekly for serum drug-level testing

The client with Cushing's syndrome had bilateral adrenalectomies and is now on corticosteroid therapy. The client also has a history of seizures. The nurse giving discharge instructions concerning corticosteroid therapy realizes there is a need for further teaching when the client makes which statement?

"I know my doctor can now decrease my dosage of phenytoin."

Exemestane 25 mg orally daily is prescribed for a client with advanced breast cancer. When reinforcing instructions to the client about the medication, which time does the nurse tell the client to take the medication?

After a meal

The client has been taking medication for rheumatoid arthritis for 3 weeks. During the administration of etanercept, it is most important for the nurse to collect which data?

The white blood cell and platelet counts

The nurse is caring for a client who is taking phenytoin for control of seizures. During the assessment, the nurse notes that the client is taking birth control pills. Which information should the nurse include in the teaching plan?

There is the potential of decreased effectiveness of birth control pills while taking phenytoin.

Lamivudine is prescribed for the client diagnosed with human immunodeficiency virus (HIV) who is prescribed zidovudine. Which should the nurse reinforce in the medication instructions to the client?

To report vomiting or abdominal pain to the primary health care provider

Meperidine has been prescribed for a client to treat pain. Which side and adverse effects should the nurse monitor for? Select all that apply.

Tremors Drowsiness Hypotension

A client is receiving anticonvulsant therapy with phenytoin. The nurse plans to monitor the results of which laboratory tests closely? Select all that apply.

Urinalysis Serum calcium Alkaline phosphatase Complete blood cell count

Ribavirin is prescribed for the hospitalized child with respiratory syncytial virus (RSV). The nurse prepares to administer this medication via which route?

Via face mask

The nurse is providing instructions to a client taking ethambutol about the medication. The nurse instructs the client to contact the primary health care provider immediately if which occurs?

Visual disturbances

The nurse has given medication instructions to a client beginning therapy with carisoprodol. The nurse determines that the client understands the effects of the medication if the client makes which statement?

"I need to avoid alcohol while taking this medication."

Coal tar has been prescribed for a client with a diagnosis of psoriasis, and the nurse reinforces instructions to the client about the medication. Which statement by the client indicates a need for further teaching?

"The medication can cause systemic effects."

A client taking an angiotensin-converting enzyme (ACE) inhibitor reviewed the medication information sheet and notes that the medication is used to treat hypertension. He states, "I have heart failure. Why am I taking this medicine?" The nurse responds by making which statement?

"The medication causes relaxation in your arteries and veins and decreases the heart's work."

The nurse reinforces medication instructions to a client with peptic ulcer disease. Which statement by the client indicates the best understanding of the medication therapy?

"The nizatidine will cause me to produce less stomach acid."

The nurse notes that zidovudine (AZT) has recently been prescribed for the client. The client states, "I've been getting a little nauseated, and I've had a couple of headaches since I was prescribed the AZT. Does this mean I can't take the medicine?" The nurse should make which response to the client?

"These symptoms may become more tolerable as you adjust to ongoing therapy."

The nurse has reinforced instructions to the client who has been prescribed cholestyramine. Which statement by the client indicates a need for further teaching?

"This medication should only be taken with water."

The nurse has provided discharge instructions to a client being placed on long-term anticoagulant therapy with warfarin sodium. The nurse reminds the client to do which?

Avoid taking products containing acetylsalicylic acid.

The nursing student is caring for a client scheduled for cataract surgery. The student reviews the preoperative prescriptions with the nursing instructor and notes that cyclopentolate eye drops are prescribed to be administered preoperatively. The unit nurse performed an admission health assessment on the client before surgery. Which condition contraindicates using cyclopentolate?

Glaucoma

The nurse is caring for a client receiving chemotherapy and determines that the client has developed myelosuppression. Which laboratory value would support the client's diagnosis of myelosuppression?

Hemoglobin 9.4 g/dL, hematocrit 26%

The primary health care provider has prescribed a bacteriostatic agent effective against both gram-positive and gram-negative organisms for application to a burn wound. The nurse determines that which medication has been prescribed?

Mafenide acetate

The nurse is providing care for a client with a diagnosis of germ cell cancer of the testes who has been prescribed ifosfamide. The nurse anticipates that the client will also be prescribed which additional antineoplastic medication?

Mesna

The nurse is preparing to administer ribavirin to the child with a diagnosis of respiratory syncytial virus (RSV). The pharmacy dispenses the medication as a powder. Which action should the nurse perform in preparation to administer the medication?

Mixing the medication as prescribed and administering by inhalation

The nurse is caring for a client with severe back pain, and codeine sulfate has been prescribed for the client. Which should the nurse include in the plan of care while the client is taking this medication?

Monitor bowel activity.

A client is diagnosed with an acute myocardial infarction and is receiving tissue plasminogen activator, alteplase. Which action is a priority nursing intervention?

Monitor for signs of bleeding.

A client is being treated for acute heart failure with intravenously administered bumetanide. The vital signs are as follows: blood pressure, 100/60 mm Hg; pulse, 96 beats per minute; and respirations, 24 breaths per minute. After the initial dose, which is the priority assessment?

Monitoring blood pressure

A tricyclic antidepressant is administered to a client daily. The nurse plans to alleviate the common side effects of the medication and includes which in the plan of care?

Offer hard candy or gum periodically.

The client with a gastric ulcer has a prescription for sucralfate 1 g by mouth four times daily. The nurse should schedule the medication to be administered at which times?

One hour before meals and at bedtime

The homecare nurse visits a client recently diagnosed with diabetes mellitus who is taking Humulin NPH insulin daily. The client asks the nurse how to store the unopened vials of insulin. The nurse should provide which information?

Refrigerate the insulin.

A client with a history of seizures is taking phenytoin for seizure control. The client arrives at the health care clinic, and a serum phenytoin drug level is drawn. The laboratory calls the nurse and reports a result of 10 mcg/mL. Which interpretation should the nurse make of this value?

The laboratory value is at the low end of therapeutic range.

The parent of a client taking atomoxetine asks how the medication works to control attention deficit hyperactivity disorder (ADHD). The nurse's correct explanation is based on which fact?

The medication inhibits norepinephrine (NE) transport and reuptake.

A client who exhibits fatigue, lack of energy, constipation, and depression is diagnosed with hypothyroidism. The primary health care provider prescribes levothyroxine. To increase the likelihood of medication compliance in the early course of treatment, the nurse plans to reinforce which information?

The full therapeutic effect may take 1 to 3 weeks.

A client who will undergo thyroidectomy at a later date has been started on medication therapy with potassium iodide As the licensed practical nurse (LPN) prepares to administer a scheduled dose, the client states that there is a burning sensation and a brassy taste in the mouth. Which action should the LPN take?

Withhold the medication and notify the RN.

The nurse has a routine prescription to instill erythromycin ointment into the eyes of the newborn. The nurse should explain to the parents that this medication is used for which primary purpose?

To protect the newborn from contracting an eye infection from the birth process

The home care nurse is visiting a client who was recently diagnosed with type 2 diabetes mellitus. The client, prescribed repaglinide and metformin, asks the nurse to explain these medications. The nurse should reinforce which instructions to the client? Select all that apply.

Diarrhea can occur secondary to metformin. The repaglinide is not taken if a meal is skipped. The repaglinide is taken 30 minutes before eating. Candy or another simple sugar is carried and used to treat mild hypoglycemia episodes.

The nurse is caring for a client who has been prescribed furosemide and is monitoring for adverse effects associated with this medication. Which should the nurse recognize as potential adverse effects? Select all that apply.

Tinnitus, Hypotension, Hypokalemia