RN Pharmacology Online Practice 2019 B

A nurse is reviewing the medical record of a client who has hypertension. The nurse should identify which of the following findings as a contraindication for receiving propranolol? Cholelithiasis Asthma Angina pectoris Tachycardia

Asthma Asthma is a contraindication for 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 planning to teach about inhalant medications to a client who has a new diagnosis of exercise-induced asthma. Which of the following medications should the nurse plan to instruct the client to use prior to physical activity? Cromolyn Beclomethasone Budesonide Tiotropium

Cromolyn Cromolyn sodium stabilizes mast cells, which inhibit the release of histamine and other inflammatory mediators. The client should use cromolyn 10 to 15 min before planning to exercise to prevent bronchospasms.

A nurse is reviewing laboratory results for a client who is to receive a dose of ceftazidime via intermittent IV bolus. Which of the following laboratory findings is the priority for the nurse to report to the provider before administering the medication? Total bilirubin 0.4 mg/dL Alanine aminotransferase 26 units/L Platelet count 360,000/mm3 Creatinine 2.6 mg/dL

Creatinine 2.6 mg/dL Rationale: Ceftazidime is excreted primarily by the renal system. A serum creatinine level above 1.3 mg/dL can indicate a kidney disorder requiring a reduction in the dose administered. The nurse should notify the provider, who is likely to prescribe a lowered dose of medication.

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? Administer epinephrine 0.5 mL via IV bolus. Discontinue the medication IV infusion. Elevate the client's legs above the level of the heart. Collect a blood specimen for ABGs.

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 teaching a client who has a new prescription for docusate sodium about the medication's mechanism of action. Which of the following information should the nurse include in the teaching? Docusate sodium reduces the surface tension of the stools to change their consistency. Docusate sodium causes rectal contractions. Docusate sodium acts as a fiber agent, increasing bulk in the intestines. Docusate sodium stimulates the motility of the intestines.

Docusate sodium reduces the surface tension of the stools to change their consistency. Docusate sodium is a surfactant that softens stool by reducing surface tension, allowing water to penetrate more easily into the stool.

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? (Select all that apply.) Hemoglobin 7.0 g/dL Creatinine 1 mg/dL RBC 4.7 million/mm3 Platelets 75,000/mm3 Potassium 5.2 mEq/L

Hemoglobin 7.0 g/dL Platelets 75000/mm3 Potassium 5.2 mEq/L Rationale: A hemoglobin level of 7.0 g/dL indicates hydroxyurea toxicity, and the nurse should report it to the provider. A platelet level of 75,000/mm3 indicates hydroxyurea toxicity, and the nurse should report it to the provider. A potassium level of 5.2 mEq/L indicates tumor lysis syndrome, and the nurse should report it to the provider.

A nurse in a provider's 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 Heartburn Anorexia Swollen ankles

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

A nurse is caring for a client who has heart failure and is receiving an IV infusion of dopamine. Which of the following findings indicates that the medication is effective? Decreased blood pressure Increased heart rate Increased cardiac output Decreased serum potassium

Increased cardiac output. Rationale: Dopamine is an adrenergic that causes a receptor specificity effect, which increases cardiac output and improves perfusion.

A nurse is providing teaching to 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? Vitamin E Orange juice Milk Antacids

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 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? Schedule the client for the last surgery of the day. Place monitoring cords and tubes in a stockinet. Choose rubber injection ports for fluid administration. Ensure phenytoin IV is readily available.

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

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 adverse effects of fentanyl should the nurse plan to give to the client and family? The provider will prescribe naloxone at home for respiratory depression. Remove the patch to reverse the adverse effects immediately. Expect an increase in urinary output. Take a stool softener on a daily basis.

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

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? Take the medication on an empty stomach. ​Avoid crowds. ​Discontinue the medication if palpitations occur. ​Change positions slowly.

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

A nurse is preparing to administer 0.9% sodium chloride 1,000 mL IV over 8 hr to a client. The drop factor of the manual IV tubing is 15 gtt/mL. The nurse should set the manual IV infusion to deliver how many gtt/min? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

31 gtt/min

A nurse administers ceftazidime to a client who has a severe penicillin allergy. The nurse should identify which of the following client findings as an indication she should complete an incident report? The client reports shortness of breath. The client is also taking lisinopril. The client's pulse rate is 60/min The client's WBC count is 14,000

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 receiving haloperidol. The nurse should identify which of the following findings as an adverse effect of the medication? Akathisia Paresthesia Excess tear production Anxiety

Akathisia An adverse effect associated with haloperidol is the development of extrapyramidal manifestations such as dystonia, pseudoparkinsonism, and akathisia.

A nurse is providing teaching to a client who is to start taking sumatriptan. Which of the following adverse effects should the nurse instruct the client to monitor for and report to the provider? Chest pressure White patches on the tongue Bruising ​Insomnia

Chest pressure Rationale: 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 is taking atorvastatin for hyperlipidemia. Which of the following client laboratory values should the nurse monitor? Creatinine kinase Erythrocyte sedimentation rate International normalized ratio Potassium

Creatinine kinase rationale: the client who is taking atorvastatin can develop an adverse effect called rhabdomyolysis, which can cause muscle weakness or pain and can progress to myositis. Creatinine kinase levels rise in response to enzymes released with muscle injury.

A nurse is administering baclofen for a client who has a spinal cord injury. Which of the following findings should the nurse document as a therapeutic outcome? Increase in seizure threshold Decrease in flexor and extensor spasticity Increase in cognitive function Decrease in paralysis of the extremities

Decrease in flexor and extensor spasticity A 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 caring for a client who has developed hypomagnesemia due to long-term therapy with lansoprazole. The nurse should monitor the client for which of the following manifestations? Bradycardia Hypotension Muscle weakness Disorientation

Disorientation rationale: the nurse should monitor the client for disorientation and confusion as manifestations of hypomagnesemia. The nurse should also assess the client for a positive Chvostek's and Trousseau's signs.

A nurse is caring for a client who has pneumonia. 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 for receiving which of the following medications? Acetaminophen Ipratropium Benzonatate Doxycycline

Doxycycline Rationale: 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 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. Rationale: The nurse should instruct the client to increase water intake to 1,920 to 2,400 mL (65 to 81 oz) a day to decrease the chance of kidney damage from crystallization.

A nurse is assessing a client who is taking amitriptyline for depression. Which of the following findings should the nurse identify as an adverse effect of the medication? Tinnitus Urinary frequency Dry mouth Exopthalmos

Dry mouth The nurse should expect the client to have a dry mouth due to the blocking of acetylcholine receptors that cause anticholinergic responses.

A nurse is administering diazepam to a client who is having a colonoscopy. Which of the following actions should the nurse take? Ensure flumazenil is available to administer for toxicity management. Monitor the client for an increase in blood pressure. Expect the client to become unconscious within 30 seconds. Measure the capnography level every hour until the client is awake and oriented.

Ensure flumazenil is available to administer for toxicity management. The nurse should monitor the client for manifestations of diazepam toxicity, such as respiratory depression and hypotension. The nurse should be prepared to administer flumazenil to reverse the effects of diazepam.

A nurse contacts a client's provider on the telephone to obtain a prescription for pain medication. Which of the following actions should the nurse take? Write the order on a prescription pad designated for the client's provider. Have the provider spell out the unfamiliar medication names. Read the prescription back to the provider using abbreviations. Consult with a second nurse for any questions regarding dosage.

Have the provider spell out the unfamiliar medication names. The nurse should ask the provider to spell out the name of the medication if the stated name is one the nurse is not familiar with.

A nurse is caring for a client who has heart failure and a prescription for enalapril. The nurse should monitor the client for which of the following findings as an adverse effect of the medication? Bradycardia Hyperkalemia Loss of smell Hypoglycemia

Hyperkalemia Enalapril improves cardiac functioning in clients who have heart failure and can cause hyperkalemia due to potassium retention by the kidneys.

A nurse is assessing a client who is receiving epoetin alfa to treat anemia. Which of the following findings should the nurse monitor? Paresthesia Increased blood pressure Fever Respiratory depression

Increased blood pressure The therapeutic effect of epoetin alfa is an increase in hematocrit levels, which can result in an increase in a client's blood pressure. If the client's hematocrit level rises too rapidly, hypertension and seizures can result. The nurse should monitor the client's blood pressure and ensure hypertension is controlled prior to administering the medication.

A nurse is caring for a client who is to receive treatment for opioid use disorder. Which of the following medications should the nurse expect to administer? Bupropion Disulfiram Methadone Modafinil

Methadone Rationale: The nurse should expect to administer methadone for treatment of opioid use disorder. Methadone can be administered for withdrawal and to assist with maintenance and suppressive therapy.

A nurse administered digoxin immune Fab to a client who received the incorrect dose of digoxin over a period of 3 days. The nurse should identify that which of the following findings indicates the antidote was effective? Normal sinus rhythm Digoxin level of 2.5 ng/mL Decrease in blood pressure Potassium level of 3.2 mEq/L

Normal sinus rhythm Dysrhythmias are a life-threatening adverse effect of digoxin toxicity. The return of the heart to normal sinus rhythm indicates a therapeutic response to the antidote. Digoxin immune Fab is administered to a client who is experiencing severe digoxin toxicity. It binds with digoxin and works to reduce the client's blood digoxin level.

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? Infuse 0.9% sodium chloride 1,000 mL IV fluid bolus. Schedule the client for an electroencephalogram. Obtain WBC with absolute neutrophil count. Place the client on a tyramine-free diet.

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

A nurse is preparing to administer hydrochlorothiazide (HCTZ) to a client. Which of the following actions should the nurse take prior to administering the medication? Ask the client to drink 8 oz of water. Review the client's most recent Hgb level. Obtain the client's blood pressure. Determine if the client is allergic to NSAIDs.

Obtain the client's blood pressure. Rationale: HCTZ is a thiazide diuretic administered to promote urine output and reduce blood pressure and edema. The nurse should obtain the client's blood pressure prior to administration of the medication.

A nurse is monitoring for adverse effects 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 adverse effect of the medication? Hypoglycemia Orthostatic hypotension Bradycardia Conjunctivitis

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

A nurse in a clinic is caring for a client who is taking aspirin for the treatment of arthritis. The nurse should identify which of the following findings as an indication that the client is beginning to exhibit salicylism? Gastric distress Oliguria Excessive bruising Tinnitus

Tinnitus Rationale: Tinnitus is a manifestation of aspirin toxicity, also called salicylism. Other manifestations include sweating, headache, and dizziness.

A nurse is reviewing the medical record of a client who has schizophrenia and a prescription for clozapine. Which of the following laboratory tests should the nurse review before administering the medication? Troponin Total cholesterol Creatinine Thyroid stimulating hormone

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

A nurse is teaching a client who is starting to take amitriptyline. Which of the following findings should the nurse include in the teaching as an adverse effect of the medication? Muscle twitching Cough Urinary retention Increased libido

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

A nurse is preparing to mix and administer dantrolene via IV bolus to a client who has developed malignant hyperthermia during surgery. Which of the following actions should the nurse take? Administer the reconstituted medication slowly over 5 min. Store the reconstituted medication in the refrigerator. Use the reconstituted medication within 12 hr. Reconstitute the initial dose with 60 mL of sterile water without a bacteriostatic agent.

Reconstitute the initial dose with 60 mL of sterile water without a bacteriostatic agent. The nurse should store the reconstituted medication at room temperature and protect it from the light until used.The nurse should use the reconstituted medication within 6 hr.

A nurse is providing discharge teaching to a client who has a new prescription for furosemide twice daily. The nurse should include which of the following instructions in the teaching? (Select all that apply.) "Take the second dose at bedtime." "Increase intake of potassium-rich foods." "Obtain your weight weekly." "Monitor for muscle weakness." "Dangle your legs from the side of the bed before standing."

"Increase intake of potassium-rich foods" is correct. Loop diuretics, such as furosemide, act at the loop of Henle by blocking the resorption of sodium, water, and potassium. An adverse effect of the medication is the development of electrolyte imbalances such as hyponatremia, hypochloremia, and hypokalemia. To prevent hypokalemia, the client should increase intake of potassium-rich foods, such as potatoes, spinach, dried fruit, and nuts. "Monitor for muscle weakness" is correct. Furosemide, a loop diuretic, causes a loss of potassium, which can result in manifestations of hypokalemia such as difficulty concentrating, shallow respirations, hyporeflexia, and muscle weakness. The nurse should instruct the client to monitor for these manifestations and report them to the provider. "Dangle your legs from the side of the bed before standing" is correct. Loop diuretics, such as furosemide, reduce vascular tone and increase fluid excretion. These effects decrease blood return to the heart and can manifest as dizziness and lightheadedness when going from a lying to a standing position. The client should change positions slowly to minimize orthostatic hypotension.

A nurse is caring for a client who is recovering from deep-vein thrombosis and is to start taking warfarin. For which of the following findings should the nurse monitor as an adverse effect of warfarin? Hypertension Low INR Constipation Bleeding gums

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 effect of the medication? Difficulty seeing in the dark Pinpoint pupils Blurred vision Excessive tearing

Blurred vision Rationale: 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 near objects to appear blurry to the client.

A nurse is caring for a client who is refusing to take their scheduled morning furosemide. Which of the following statements should the nurse make? "By not taking your furosemide, you might retain fluid and develop swelling." "You can double your dose of furosemide this evening if that would be better for you." "If you do not take your furosemide, we might get in trouble." "I'll go ahead and mix the furosemide into your breakfast cereal."

By not taking your furosemide, you might retain fluid and develop swelling. The nurse should respect the client's right to refuse the medication and inform the client of the risks of not taking the medication, notify the provider, and document the refusal. Furosemide is a loop diuretic given to reduce edema.

A nurse is teaching a client who is taking allopurinol for the treatment of gout. Which of the following information should the nurse include in the teaching? Plan to increase the dosage each week by 200 mg increments. Prolonged use of the medication can cause glaucoma. Drink 2 L of water daily. A fine red rash is transient and can be treated with antihistamines.

Drink 2 L of water daily. Rationale: The nurse should instruct the client to drink at least 2 L of water each day to prevent renal stone formation and kidney injury, because allopurinol is eliminated through the kidneys.

A nurse is caring for a client who has diabetes mellitus and is taking glyburide. The client reports feeling confused and anxious. Which of the following actions should the nurse take first? Perform a capillary blood glucose test. Provide the client with a protein-rich snack. Give the client 120 mL (4 oz) of orange juice. Schedule an early meal tray.

Preform a capillary blood glucose test. Rationale: 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 reviewing the laboratory results of a client who is taking carbamazepine for a seizure disorder. Which of the following findings should the nurse report to the provider? Potassium 4.1 mEq/L 24-hour urine glucose 300 mg/day Carbamazepine level 7 mcg/mL WBC 3,500/mm3

WBC 3500/mm3 A WBC count of 3,500/mm3 is below the expected reference range of 5,000 to 10,000/mm3. Leukopenia is an adverse effect of carbamazepine. The nurse should report this finding to the provider and monitor the client for manifestations of infection.

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? (Select all that apply.) "Blood glucose levels will need to be monitored during therapy." "Avoid contact with persons who have known infections." "Take the medication 1 hour before a meal." "Decrease intake of foods containing potassium. " "Grapefruit juice can increase the blood levels of the medication."

"Blood glucose levels will be monitored during therapy" is correct. The nurse should instruct the client that their blood glucose levels will be monitored during therapy because corticosteroids, such as methylprednisolone, can raise blood glucose levels. "Avoid contact with persons who have known infections" is correct. The nurse should instruct the client to avoid contact with persons who have known infections because corticosteroids, such as methylprednisolone, suppress the immune response and mask manifestations of infection. "Grapefruit juice can increase the blood levels of the medication" is correct. The nurse should instruct the client that grapefruit juice increases the absorption of the medication, which can lead to toxicity and adrenal suppression.

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? "This medication increases your risk for hypertension." "Avoid potassium-rich foods in your diet." "Take each dose of medication in the evening before bed." "Drink a glass of milk with each dose of medication."

"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 famotidine for peptic ulcer disease. Which of the following client statements should the nurse identify as understanding of the teaching? "I will stop taking famotidine when my stomach pain is gone." "I know smoking makes famotidine less effective." "I will take famotidine anytime my stomach hurts." "I know that famotidine will turn my stools black."

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

A nurse is providing teaching to a client who has depression and a new prescription for fluoxetine. Which of the following statements by the client indicates an understanding of the teaching? "I should start to feel better within 24 hours of starting this medication." "I will be sure to follow a strict diet to avoid foods with tyramine." "I will continue to take St. John's Wort to increase the effects of the medication." "I should take acetaminophen instead of ibuprofen for my headaches while taking this medication."

"I should take acetaminophen instead of ibuprofen for my headaches while taking this medication." Rationale: Fluoxetine suppresses platelet aggregation, which increases the risk of bleeding when used concurrently with NSAIDs and anticoagulants. Therefore, clients who are taking fluoxetine should take acetaminophen for headaches or pain, since acetaminophen does not suppress platelet aggregation.

A nurse is teaching a client who is starting to take diltiazem. Which of the following statements should the nurse identify as an indication that the client understands the teaching? "I will stop taking the medication if I get dizzy." "I should not drink orange juice while taking this medication." "I should expect to gain weight while taking this medication." "I will check my heart rate before I take the medication."

"I will check my heart rate before I take the medication." Diltiazem, a calcium channel blocker, has cardio-suppressant effects at the SA and AV nodes, which can lead to bradycardia. The client should check their heart rate before taking the medication and notify the provider if it falls below the expected reference range.

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 apply the patch once a week for 2 weeks." "I will leave the existing patch on for 4 hours after applying the new patch." "I will fold the sticky sides of the old patch together before disposing it." "I will apply the patch within 14 days of menses."

"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 following statements by the client indicates an understanding of the teaching? "I can apply the patch to a chest area that has hair." "I can take this medication while using an erectile dysfunction product." "I will remove the patch after 14 hours." "I need to apply a new patch to the same area every day."

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

A nurse is teaching about a new prescription for ciprofloxacin to a client who has a urinary tract infection. The nurse should identify which of the following statements as an indication that the client understands the teaching? "I will take this medication with an antacid to prevent gastrointestinal upset." "I will stop taking this medication when I no longer have pain upon urination." "I will report any signs of tendon pain or swelling." "I will take this medication with milk."

"I will report any signs of tendon pain or swelling." Rationale: Ciprofloxacin, a fluoroquinolone, is associated with a risk of tendon rupture. This risk is increased in older adult clients, so the client should notify the provider at the onset of tendon pain or swelling.

A nurse is providing discharge instructions 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 should avoid getting rid of the air bubble in the syringe." "I should inject the insulin into my thigh for the fastest absorption." "I will store my unopened bottles of insulin in the refrigerator." "I need to shake the insulin before using it to make sure it is well mixed."

"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 can remain at room temperature for up to 1 month.

A nurse is preparing to administer 0.9% sodium chloride (NaCl) 1,500 mL to infuse over 8 hr to a client who is postoperative. The nurse should set the IV pump to deliver how many mL/hr? (Round to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

188 mL/hr

A nurse is completing an incident report for a medication error. Which of the following information should the nurse include in the report? This could have been avoided if I had double checked the medication administration record with the client's identification band. It was easy to get confused because another client is receiving a similar sounding medication. Administered propranolol 80 mg PO at 1800 to the client who did not have a prescription for the medication. While I rarely make medication errors, the client was given 80 mg of propranolol by mistake at 1800.

Administered propranolol 80 mg PO at 1800 to the client who did not have a prescription for the medication. The incident report should clearly and thoroughly report the facts of the error.

A nurse is precepting a newly licensed nurse who is caring for four clients. The nurse should complete an incident report for which of the following actions by the newly licensed nurse? Administers isosorbide mononitrate to a client who has BP 82/60 mm Hg Administers digoxin to a client who has a heart rate of 92/min Administers regular insulin to a client who has a blood glucose of 250 mg/dL Administers heparin to a client who has an aPTT of 70 seconds

Administers isosorbide mononitrate to a client who has BP 82/60 mmHg Isosorbide mononitrate is a nitrate used for clients with angina. Taking isosorbide mononitrate leads to vasodilation, which can result in hypotension. The nurse should withhold the medication and notify the provider if the client's systolic blood pressure is below the expected reference range of 120/80.

A nurse is caring for a client who has a magnesium level of 3.1 mEq/L. The nurse should expect to administer which of the following medications? Magnesium gluconate Cinacalcet Calcium gluconate Regular insulin

Calcium gluoconate The nurse should expect to administer IV calcium gluconate to the client and prepare to provide ventilatory support. The client is at risk for respiratory depression and cardiac dysrhythmias because a magnesium level of 3.1 mEq/L is above the expected reference range of 1.3 to 2.1 mEq/L.

A nurse is caring for a client who has hypocalcemia and is receiving calcium citrate. The nurse should identify that which of the following findings indicates a therapeutic response to the medication? Positive Chvostek's sign Client report of decreased paresthesia Client report of increased thirst Calcium level of 8.8 mg/dL

Client report of decreased paresthesia Paresthesia is a manifestation of hypocalcemia. A client report of a decrease in paresthesia is an indication of a therapeutic response to calcium citrate. The nurse should also monitor for a decrease in other manifestations of hypocalcemia, including muscle twitching and cardiac dysrhythmias.

A nurse is teaching about zolpidem to a client who has insomnia. The nurse should identify that which of the following client statements indicates an understanding of the teaching? "I will need to get laboratory testing prior to a refill of this medication." "I will use this medication for a short period of time." "I will need to take this medication for 1 week before results are seen." "I will need to change the medications to prevent building up a tolerance."

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

A nurse is assessing a client who is taking tamoxifen to treat breast cancer. Which of the following findings is the priority for the nurse report to the provider? Hot flashes Gastrointestinal irritation Vaginal dryness Leg tenderness

Leg tenderness

A nurse is preparing to administer a new prescription of amoxicillin/clavulanic to a client. The client tells the nurse that they are allergic to penicillin. Which of the following actions should the nurse take first? Update the client's medical record. Notify the provider. Withhold the medication. Inform the pharmacist of the client's allergy to penicillin.

Withhold the medication. Rationale: When using the urgent vs nonurgent approach to client care, the nurse should determine that the priority action is to withhold the medication to prevent injury to the clie

A nurse is providing teaching to a client who is to start therapy with digoxin. For which of the following adverse effects should the nurse instruct the client to monitor and report to the provider? Dry cough Pedal edema Bruising Yellow-tinged vision

Yellow-tinged vision Rationale: The nurse should instruct the client to monitor for and report yellow-tinged vision, which is a sign of digoxin toxicity. Other manifestations of digoxin toxicity include nausea, vomiting, loss of appetite, and fatigue. As the digoxin levels increase, the client can experience cardiac dysrhythmias.