Quizzy

The nurse is caring for a patient in the clinic with asthma who was prescribed a long-term systemic steroid for the patient to better manage their asthma. The nurse is aware that which of the following diseases may cause serious adverse effects? A. Diabetes B. Polycystic Ovary Syndrome (PCOS) C. Parkinson's D. Hyperthyroid

A. Diabetes Rationale: Adverse effect of long term therapy is hyperglycemia. Watch with Adrenal suppression.

The nurse is providing education to a patient who has been prescribed both an antacid and sucralfate, a mucosal protectant. Which instruction should the nurse give the patient about taking the medications? A. "Take the antacid 1 hour after the sucralfate." B. "Take the antacid 30 minutes after the sucralfate." C. "The antacid and sucralfate should be taken at the same time for better effect." D. "Take the antacid 15 minutes before the sucralfate."

A. "Take the antacid 1 hour after the sucralfate." Rationale: The antacid should be taken at least one hour after the sucralfate so it does not interfere with absorption.

A client has a blood pressure of 80/35 mm HG after a blood transfusion. In an effort to support renal perfusion, the nurse administers dopamine (Inotropin) at 2 mcg/kg/min as prescribed. What is the priority outcome indicating effectiveness of the medication for this client? A. An increase in urinary output B. A decrease in core temperature C. An increase in level of consciousness. D. A decrease in blood pressure

A. An increase in urinary output Rationale: Dopamine is a Vasopressor. Dopamine works by improving the pumping strength of the heart and improved blood flow to the kidneys. Dopamine increases cardiac output, improves tissue perfusion and renal perfusion. In an effort to support renal perfusion, an expected outcome would be an increase in urinary output.

What should the nurse include in a teaching plan for a client taking calcium channel blockers such as Verapamil? Select all that apply. A. Change positions slowly. B. Reduce calcium intake. C. Avoid drinking grapefruit juice. D. Increase fluid, fruit, fiber to prevent constipation E. Expect temporary hair loss.

A. Change positions slowly. C. Avoid drinking grapefruit juice. D. Increase fluid, fruit, fiber to prevent constipation

A nurse concludes that the lovastatin (Mevacor) prescribed to a client is effective. A decrease in what clinical finding supports this conclusion? A. Cholesterol B. Heart rate C. Blood pressure D. INR

A. Cholesterol Rationale: Lipid lowering agent - HMG CoA Reductase Inhibitors - "stains" - Lovastatin. Most effective drugs for lowering LDL and total cholesterol. In addition, they can raise HDL cholesterol and lower triglycerides in some patients.

A client recently diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH) complains of headache, weight gain, and nausea. Which of the following is an appropriate nursing diagnosis for this client? A. Excess fluid volume related to increased water retention B. Risk for injury related to fluid volume loss C. Deficient fluid volume related to excessive fluid loss D. Deficient fluid volume related to decreased fluid intake

A. Excess fluid volume related to increased water retention Rationale: The client with SIADH exhibits signs of excess fluid volume. SIADH is the release of excess ADH by the pituitary gland which results in hypervolemic hyponatremia and clinical manifestations of headache, weight gain, and nausea.

The nurse provides instructions to a client who is taking levothyroxine. The nurse should tell the client to take the medication in which way? A. In the morning on an empty stomach B. At bedtime with a snack C. At lunchtime D. In the morning with breakfast

A. In the morning on an empty stomach Rationale: Levothyroxine should be taken on an empty stomach to enhance absorption. Dosing should be done in the morning on an empty stomach.

A client is prescribed omeprazole (Prilosec). The nurse determines that the medication is therapeutic if which of the following is stated by the client? A. Relief of gastroesophageal reflux disease [GERD] B. Reduced diarrheal episodes C. Relief of nausea and vomiting D. Relief of constipation

A. Relief of gastroesophageal reflux disease [GERD] Rationale: Omeprazole is a PPI used to treat symptoms of gastroesophageal reflux disease (GERD) and other conditions caused by excess stomach acid. It is also used to promote healing of erosive esophagitis (damage to your esophagus caused by stomach acid). The other are not related to this medication

The nurse is caring for a client with cardiac dysrhythmia, which laboratory value is a priority for the nurse to monitor? A. Serum potassium B. Serum creatinine C. PT and INR D. Hemoglobin and hematocrit

A. Serum potassium Rationale: Dysrhythmias - monitor Potassium level because hypokalemia and hyperkalemia can worsen dysrhythmias. Hypokalemia can lead to flattened T waves and hyperkalemia can lead to tall and tented T waves.

What should the nurse expect the health care provider to prescribe if the client exhibits clinical indicators of warfarin [coumadin] overdose? A. Vitamin K B. Protamine sulfate C. Iron dextran D. Heparin

A. Vitamin K Rationale: Vitamin K is an antidote for Warfarin.

The nurse recognizes that the most serious side effect of methimazole is: A. Skin rash B. Agranulocytosis C. Hepatitis D. Diarrhea

B. Agranulocytosis Rationale: Agranulocytosis is a potentially life threatening adverse reaction of methimazole therapy. Patients should be instructed to immediately report to their HCP any symptoms suggestive of agranulocytosis such as fever or sore throat.

The nurse is planning to administer hydrochlorothiazide to a client. The nurse should monitor for what adverse effects related to the administration of this medication? A. Hyperkalemia, hypoglycemia, check for penicillin allergy B. Hypokalemia, hyperglycemia, check for sulfa allergy C. Hyponatremia, hyperkalemia, check for penicillin allergy D. Hyperchloremia, hyperglycemia, check for sulfa allergy

B. Hypokalemia, hyperglycemia, check for sulfa allergy Rationale: Thiazide diuretics are sulfa based medication and a client with a sulfa allergy is at risk for an allergic reaction. Also at risk for hypokalemia, hyperglycemia, hypercalcemia, hyperuricemia, hypochloremia and hyponatremia.

A nurse is caring for a client with type 1 diabetes, and the health care provider prescribes one tube of glucose gel. What is the primary reason for the administration of glucose gel to this client? A. Diabetic ketoacidosis B. Insulin-induced hypoglycemia C. Hyper insulin secretion D. Idiosyncratic reactions to insulin

B. Insulin-induced hypoglycemia Rationale: Glucose gel delivers a measured amount of simple sugars to provide glucose to the blood for rapid action. Acidosis occurs when there is an increased serum glucose level; therefore glucose gel is not indicated. Diabetes Mellitus involves decreased insulin production. Glucose gel is not indicated in an idiosyncratic reaction to insulin (examples of this include rashes, jaundice, anemia.

A client develops hypothyroidism after a thyroidectomy. Which medication does the nurse anticipate the health care provider will prescribe? A. Potassium iodide (SSKI) B. Levothyroxine (Synthroid) C. Propylthiouracil (PTU) D. Vasopressin (Pitressin)

B. Levothyroxine (Synthroid) Rationale: Levothyroxine is a thyroid hormone that may be administered for this client. Vasopressin is a pituitary hormone. PTI interferes with the production of thyroid hormone and is used with hyperthyroidism. Potassium is not indicated for this client.

The nurse is reviewing the medications that have been ordered for a patient for whom Furosemide [lasix], a loop diuretic, has been newly prescribed. The loop diuretic may have possible interactions with which of the following medications? Select All That Apply A. Warfarin B. Lithium C. Digoxin D. Vitamin C

B. Lithium C. Digoxin Rationale: Furosemide and Lithium - watch for hyponatremia - may lead to Lithium toxicity; Furosemide and Digoxin - watch for hypokalemia- may lead to Digoxin toxicity; When loop diuretics and NSAIDs are taken concurrently, they can decrease the diuretic effect because these two drug classes have opposite effects on renal prostaglandin activity. Loop diuretics activate renal prostaglandins which result in dilation of blood vessels reducing renal, pulmonary, and systemic vascular resistance. NSAIDS inhibit prostaglandin activity.

To avoid the first-dose phenomenon, the nurse understands that the initial doses of Terazosin [hytrin] should be: A. The usual dosage and given before breakfast. B. Low and given at bedtime. C. Increased and given at bedtime. D. Doubled and given before breakfast.

B. Low and given at bedtime. Rationale: Alpha adrenergic blocker - significant dizziness and syncope are common with the first dose (known as first dose effect). Low dose and give at bedtime.

The nurse recognized that which drug requires the nurse to monitor the client for signs of hyperkalemia? A. Hydrochlorothiazide (Hydrodiuril) B. Spironolactone (Aldactone) C. Furosemide (Lasix) D. Metolazone (Zaroxolyn)

B. Spironolactone (Aldactone) Rationale: Spironolactone is a potassium sparing diuretic; hyperkalemia is an adverse effect.

A patient comes to the clinic complaining of dizziness. During the initial evaluation, the nurse discovers that the dizziness started after beginning Prazosin for hypertension. What should the nurse recommend to the patient? A. "The dizziness is an unavoidable adverse effect of Prazosin and will persist while taking the medication." B. "Dizziness is not normally associated with Prazosin. Please contact your physician immediately." C. "The dizziness can be alleviated by being sure to rise slowly after sitting or lying down." D. "The dizziness should go away after you have been on the medication for two weeks."

C. "The dizziness can be alleviated by being sure to rise slowly after sitting or lying down." Rationale: Orthostatic hypotension - rise slowly after sitting or lying down.

Dopamine is prescribed for a client. The nurse recognizes all of the following as adverse effects except? A. Tachycardia B. Angina Pectoris C. Bradycardia D. Dysrhythmias

C. Bradycardia Rationale: Dopamine Indication - shock. Activates beta 1 receptors in the heart increasing cardiac output and improving tissue perfusion. Adverse Effects: tachycardia, dysrhythmias, angina pain.

A nurse administers desmopressin acetate [DDAVP] to a client with diabetes insipidus. What should the nurse monitor to evaluate the effectiveness of this drug? A. Fasting serum glucose B. Pulse and respiratory rates C. Intake and output D. Arterial blood pH

C. Intake and output Rationale: Desmopressin is a structural analog of natural antidiuretic hormone (ADH). Desmopressin is an agent of choice because it has a long duration of action, is easy to administer, and lacks significant side effects, especially vasoconstriction. The response to treatment is rapid, and urine volume quickly drops to normal therefore the nurse should monitor Intake and Output.

The client asks how Metoprolol [Lopressor] helps angina. The response provided by the nurse is based on what concept? This medication A. Increases the heart rate and diminishes contractility. B. Blocks sodium channels and elevates depolarization. C. Slows the heart rate and reduces contractility. D. Decreases blood pressure and blocks alpha-2 receptors.

C. Slows the heart rate and reduces contractility. Rationale: Mechanism of action - Slows the heart rate and reduces contractility.

A client who has just had an adrenalectomy is told about a death in the family and becomes very upset. What concern about the client requires the nurse to notify the health care provider? A. Feelings of exhaustion and lethargy may result from the emotional stress. B. Analgesia and mild sedation will be required to ensure rest. C. Steroid replacement medication therapy will need to be increased. D. Steroid replacement medication therapy will need to be reduced.

C. Steroid replacement medication therapy will need to be increased. Rationale: Clients with adrenocortical insufficiency who are receiving steroid therapy require increased amounts of medication during periods of stress because they are unable to produce the increased level of glucocorticoids needed by the body at this time. Although sedation may be prescribed, the major concern is the regulation of glucocorticoids in the presence of emotional and physiologic stress. Increased stress requires increased steroids.

A client is being treated for heart failure and is administered furosemide (Lasix) intravenously. The nurse understands that which outcome indicates the medication has achieved the expected effect? A. Patient's weight increased from 152 pounds to 154 pounds. B. The serum potassium level changes from 3.1 to 3.5 mEq/L C. Urine output increases from 10 mL/hour to greater than 50 mL/hourly D. Cough becomes productive of frothy pink sputum

C. Urine output increases from 10 mL/hour to greater than 50 mL/hourly Rationale: Furosemide is a diuretic and expected outcomes include increased urine output, decreased crackles, and decreased weight. The serum potassium level would drop and the patient would become hypokalemic.

A patient has been taking bismuth subsalicylate (Pepto-Bismol) three to four times daily for five days. The patient complains of stomach pain and has not had a bowel movement in 4 days. What nursing action is a priority? A. Ask the patient to drink a full glass of water B. Give a dose of Colace C. Request an order for a bisacodyl (dulcolax) suppository D. Auscultate for bowel sounds

D. Auscultate for bowel sounds

What should the nurse include in a teaching plan to help reduce the side effects associated with the calcium channel blocker, verapamil? A. Lie down after meals. B. Take the drug with an antacid. C. Avoid dairy products in the diet. D. Change positions slowly

D. Change positions slowly Rationale: Changing positions slowly will help prevent the adverse effects of orthostatic hypotension, dizziness. Don't lie down after meals - can relax the esophagus and lead to acid reflux. Avoiding dairy and taking the drug with an antacid are unnecessary.

The nurse is providing education to a patient who has been prescribed both an antacid and sucralfate, a mucosal protectant. Which instruction should the nurse give the patient about taking the medications? A. Regular insulin B. Insulin degludec C. Insulin glargine D. Insulin lispro

D. Insulin lispro Rationale: Insulin lispro has an onset of 0.25 hours, a peak action of 0.5 to 1.5 hours, and a duration of 3-4 hours. It is short duration and rapid acting. Regular insulin short duration, short action onset 0.5 hours. Glargine is long duration. Degludec is ultra long

A patient is taking bismuth subsalicylate [Pepto-Bismol] for mild diarrhea. The nurse performing an assessment notes that the patient's tongue is black. What nursing action is appropriate? A. Request an order for liver function tests to evaluate for hepatotoxicity. B. Assess further for signs of gastrointestinal (GI) bleeding. C. Withhold the drug, because this is a sign of bismuth overdose. D. Reassure the patient that this is an expected side effect of this drug.

D. Reassure the patient that this is an expected side effect of this drug. Rationale: Black tongue is an expected side effect of bismuth subsalicylate. Reassure the patient that this is an expected side effect.

In evaluating the effects of loperamide (Imodium), which outcome would indicate that the drug is performing as intended? A. An increase in urine output. B. Two or three soft stools per day. C. Watery, diarrhea stools. D. Slow the passage of stools through the intestines.

D. Slow the passage of stools through the intestines. Rationale: Loperamide treats diarrhea. Suppresses bowel motility and fluid secretion into the intestinal lumen, slowing the passage of stools. Docusate Sodium [Colace] is a stool softener.

The nurse is monitoring a client who is taking metoprolol. Which assessment finding indicates a potential adverse complication associated with this medication? A. A baseline blood pressure of 150/80 mm Hg followed by a blood pressure of 138/72 mm Hg after 2 doses of the medication B. A baseline resting heart rate of 88 beats/minute followed by a resting heart rate of 72 beats/minute after 2 doses of the medication C. The development of complaints of insomnia D. The development of audible expiratory wheezes

D. The development of audible expiratory wheezes Rationale: Beta Blocker - Beta 1 and Beta 2 - watch for bronchospasm. The drop in BP and HR is expected. The patient complains of lethargy.

Cimetidine (Tagamet) is prescribed for a client with a gastric ulcer. The client asks the nurse what this medication does. The nurse responds, "It: A. neutralizes gastric acidity." B. facilitates histamine release." C. increases gastric motility." D. reduces secretion of gastric acid."

D. reduces secretion of gastric acid." Rationale: H2 Blocker reduces secretion of gastric acid. First-choice drugs for treating gastric and duodenal ulcers. Promote healing by suppressing secretion of gastric acid