pharmacology study questions A med surg

Adverse Effect: Amitriptyline (antidepressant)

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

A nurse is teaching a client who is starting to take ketorolac. which of the following information should the nurse include in the teaching?

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

A nurse is planning discharge teaching for a client who has a prescription for furosemide. the nurse should plan to include which of the following statements in the teaching

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

A nurse is teaching a client who is to start taking ranitidine for peptic ulcer disease. which of the following client statements should the nurse identify as understanding of the teaching

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

A nurse is providing teaching to a client who has a new prescription for phenytoin. Which of the following statements by the client indicates an understanding of the teaching

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

A nurse is providing teaching to a client about the use of ethinyl estradiol/norelgestromin. the nurse should identify that which of the following statements by the client indicates an understanding of the teaching

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

A nurse is teaching about self-administration of transdermal medication with a male client who has a new prescription for nitroglycerin. the nurse should identify that which of the folloeing statements by the client indicates an understanding of the teaching

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

A nurse is providing discharge instruction to a client who is to self-administer insulin at home. Which of the following client statements should indicate to the nurse that the teaching is effective

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

A nurse is teaching a client about cyclobenzaprine. Which of the following client statemets should indicate to the nurse that the teaching is effective

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

A nurse is teaching about zolpidem with a client who has insomnia. the nurse should identify that which of the following client statements indicates an understanding of the teaching

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

Patient teaching: Guaifenesin for URI

(MUCINEX) Increase fluid intake to at least 2 liters each day while taking this medication. - The nurse should instruct the client to increase fluid intake to at least 2 L per day while taking guaifenesin. An increase in fluid intake facilitates the removal of secretions and helps to create a more productive cough.

A nurse is providing teaching for a client who has multiple sclerosis and a new prescription for methylprednisolone. which of the following instructions should the nurse include

- Blood glucose levels will be monitored during therapy. - Avoid contact with people who have known infections. - Grapefruit juice can increase the effects of the medication.

A nurse is preparing to administer a schedule antibiotic 0800 to a client and discovers the antibiotic is not present in the clients medication drawer. the nurse should identify that administration of the medication can occur at which of the following time periods without requiring an incident report

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

A nurse is caring for the mother of a newborn. The mother asks the nurse when her newborn should recieve his first diphtheria, tetanus, and pertussis vaccine (DTaP). The nurse should instruct the mother that her newborn should receive the immunization at which of the following ages

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

A nurse is caring for a client who has DM and is taking glyburide. the client reports feeling confused and anxious. which of the following actions should the nurse take first

A nurse is caring for a client who has DM and is taking glyburide. the client reports feeling confused and anxious. which of the following actions should the nurse take first -The greatest risk to this client is injury from hypoglycemia. Therefore, the nurse should perform a capillary blood glucose test to determine the client's blood glucose status. Manifestations of hypoglycemia include weakness, anxiety, confusion, sweating, and seizures.

A nurse is preparing to administer heparin subcut. to a client. Which of the following actions should the nurse plan to take

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

A nurse is caring for a client who is receiving long-term treatment for systemic lupus erythematosus with prednisone. The nurse should inform the client to expect to undergo which of the following diagnostic tests to monitor for longterm complications of prednisone

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

A nurse is administering baclofen for a client who has a spinal cor injury. WHich of the following should the nurse documentas a therapeutic outcome

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

A nurse is reviewing the medication list of a client who wants to begin taking oral contraceptives. the nurse should identify that which of the following client medications will interfere witht the effectiveness of oral contraceptives

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

A nurse is administering cefotetan via intermittent IV bolus to a client who suddenly develops dyspnea and widespread hives. WHich of the following actions should the nurse take first

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

A nurse is providing teaching about insulin glargine to a client who has type 1 DM. which of the following information should the nurse include in the instructions

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

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

Drink 8 to 10 glasses of water daily. - The nurse should instruct the client to increase water intake to 1,920 to 2,400 mL (64 to 80 oz) a day to decrease the chance of kidney damage from crystallization.

A nurse is caring for a client who has sickle cell anemia and is taking hydroxyurea. Which of the following findings should the nurse report to the provider

Hemoglobin 7.0 g/dl, Platelets 75,000/mm3, potassium 5.2 mEq/L - Hemoglobin 7.0 g/dL is correct. A hemoglobin level of 7.0 g/dL indicates hydroxyurea toxicity, and the nurse should report it to the provider. Creatinine 1 mg/dL is incorrect. A creatinine level of 1 mg/dL is within the expected reference range. RBC 4.7 million/mm3 is incorrect. A RBC 4.7 million/mm3 is within the expected reference range. Platelets 75,000/mm3 is correct. A platelet level of 75,000/mm3 indicates hydroxyurea toxicity, and the nurse should report it to the provider. Potassium 5.2 mEq/L is correct. A potassium level of 5.2 mEq/L indicates tumor lysis syndrome, and the nurse should report it to the provider.

Contraindication: Ciprofloxacin

I have tendonitis, so I haven't been able to exercise. - The nurse should identify tendonitis is a contraindication for taking ciprofloxacin due to the risk of tendon rupture.

A nurse is preparing to administer medication to a client who has gout. the nurse discoveres that an error was made during the previous shift and the client received atenolol instead of allopurinol. which of the following actions should the nurse take first

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

A nurse is providing teaching for a client who has a new prescription for ferrous sulfate. The nurse should instruct the client to take the medication with which of the following to promote absorption

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

A nurse is monitoring for AE of hydrochlorothiazide after administering the medication to an older adult client who has heart failure. which of the following findings should the nurse identify as an AE of the medication

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

A circulating nurse is planning care for a client who is scheduled for surgery and has a latex allergy. Which of the following actions should the nurse include in the plan of care

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

A nurse is teaching a client who is to start taking temazepam. which of the following instructions should the nurse include

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

Patient Teaching: Simvastatin

Report muscle pain, avoid grapefruit juice, expect this med to be a lifelong therapy -Side effects: myopathy > rhabdomyolysis -Take in the evening

A nurse is providing teaching to a client who is to start treatment for asthma with beclomethasone and albuterol inhalers. which of the following instructions should the nurse include in the teaching

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

A nurse is teaching a client who is to start taking dilitiazem. the nurse should instruct the client to report which of the following findings as an adverse effect of the medication

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

A nurse is providing discharge teaching about handling medication to a client who is to continue taking oral transmucosal fentanyl raspberry-flavored lozenged on a stick. which of the following information should the nurs include in the teaching

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

A nurse is caring for a client who is receiving end-of-life care and has a prescription for fentanyl patches. WHich of the following information regarding the AE of fentanyl should the nurse plan to give to the client and family

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

A nurse is caring for a client who is taking atenolol. WHich of the following findings should indicate to the nurse that the medication is effective

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

A nurse administers ceftazidimie to a client who has a severe penicillin allergy. the nurse should identify which of the following client findings as an indication that h=she should complete an inicident report

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

A nurse is caring for a client who is in labor . the client is receiving oxytocin by continuous IV infusion with a maintenance IV solution. the external FHR monitor indicates late decelerations. which of the following actions should the nurse take first

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

A nurse is reviewing the medical record for a client who has hypertension. the nurse should identify which of the following findings as a contrindication to receiving propranolol

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

A nurse is caring for a client who is recovering from a deep vein thrombosis and is to start taking warfarin. for which of the following findings should the nurse monitor as an AE of warfarin

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

A nurse is assessing a client who has received atropine eye drops during an eye examination. which of the following findings should the nurse expect as an AE of the medication

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

A nurse is prviding teaching to a client who is to start taking sumatriptan. which of the following AE should the nurse instruct the client to monitor for and report to the provider

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

A nurse is caring for a client who has cancer and is taking oral morphine and docusate sodium. The nurse should instruct the client that taking the docusate sodium on a daily basis can minimize which of the following AE of morphine

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

A nurse is caring for a client who has pnuemonia. the client tells the nurse she is pregnant and that she has not told her provider yet. The nurse should identify that pregnancy is a contraindication to recieving which of the following medications

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

A nurse is providing teaching to a client who is start taking lisinopril. Which of the following findings is an AE that the nurse should instruct the client to monitor and report to the provider

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

A nurse in an emergency department is caring for a client whose family reports the client has taken large amounts of diazepam. which of the following medications should the nurse anticipate administering

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

A nurse in a providers office is assessing a client who has been taking aspirin daily for the past year. For which of the following findings should the nurse notify the provider immediately

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

patient has heart failure and is receiving an IV infusion of dopamine. Which finding indicates that the med is working?

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

A nurse is assessing a client who has myasthenia gravis and is taking neostigmine. which of the following findings should indicate to the nurse the client is experiencing an AE

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

A nurse is an emergency department is caring for a client who has heroin toxicity. the client is unresponsive with pinpoint pupils and a respiratory rate of 6/ min. which of the following medications should the nurse plan to administer

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

A nurse is caring for a client who reports lethargy and myalgia after taking clozapine for 6 months. which of the following actions should the nurse plan to take

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

Adverse Effect: Amphotericin B intermittent IV bolus for tx of histoplasmosis

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

A nurse is caring for a 20 yr old female who has a prescription for isotretinoin for severe nodulocystic acne vulgaris. before the client can obtain a refill, the nurse should advise the client that which of the following tests is required

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

A nurse is reviewing the prescriptions of a client who has tuberculosis. The nurse should identify that which of the following medications are used for tuberculosis

rifampin isoniazid Rifampin is correct. This medication is given to treat tuberculosis by inhibiting the production of mycobacteria. Mirtazapine is incorrect. This medication is given to treat depression. Temazepam is incorrect. This medication is given to treat insomnia. Infliximab is incorrect. This medication is given to treat moderate to severe Crohn's disease or arthritis. Isoniazid is correct. This medication is given to treat tuberculosis by inhibiting the production of mycobacteria.

A nurse is providing teaching to a client who has a prescription for a MAOI inhibitor. Which of the following foods should the nurse instruct the client to avoid while taking this medication

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

Adverse Effect: Acetazolamide for open-angle glaucoma

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

Lab Results Review: Clozapine for schizophrenia review first?

total cholesterol - The nurse should review the client's total cholesterol before administering clozapine, because this medication can cause hyperlipidemia.

A nurse is providing teaching about AE of clindamycin to a client. Which of the following findings should the nurse instruct the client to report to the provider

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

A nurse is preparing to teach a client who is to start a new prescription for extended release verapamil. which of the following instructions should the nurse plan to include

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