RN Pharmacology Online Practice 2023B

A nurse is providing teaching to 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 be monitored during therapy. -Avoid contact with people who have known infections. -Take the medication 1 hr before breakfast. -Decrease dietary intake of foods containing potassium. -Grapefruit juice can increase the effects of the medication.

Blood glucose levels will be monitored during therapy is correct. The nurse should monitor the client for hyperglycemia while providing methylprednisolone to the client. Glucocorticoids, such as methylprednisolone, increase serum glucose levels and can require management with insulin or antihyperglycemics. Avoid contact with people who have known infections is correct. The nurse should instruct the client to avoid exposure to infectious agents, such as contact with those who have active infections or illnesses. Glucocorticoids, such as methylprednisolone, depress the immune system, placing the client at an increased risk for developing an infection. Take the medication 1 hr before breakfast is incorrect. The nurse should instruct the client to take the medication with food or milk to decrease gastrointestinal upset. Decrease dietary intake of foods containing potassium is incorrect. The nurse should instruct the client to increase dietary intake of potassium-rich foods while taking this medication. Glucocorticoids, such as methylprednisolone, deplete potassium in the body, which manifests as hypokalemia. Grapefruit juice can increase the effects of the medication is correct. The nurse should instruct the client that grapefruit and grapefruit juice can increase the level of methylprednisolone in the body.

A nurse is developing a teaching plan for a client who has a new prescription for simvastatin. Which of the following instructions should the nurse include in the teaching plan? (Select all that apply.) -Report muscle pain to the provider. -Avoid taking the medication with grapefruit juice. -Take the medication in the early morning. -Expect a flushing of the skin as a reaction to the medication. -Expect therapy with this medication to be lifelong.

Report muscle pain to the provider is correct. Myopathy is an adverse effect of simvastatin that can lead to rhabdomyolysis. The nurse should instruct the client to report this to the provider. Avoid taking the medication with grapefruit juice is correct. When taken with grapefruit juice, simvastatin increases the risk of muscle injury from elevations in creatine kinase. Take the medication in the early morning is incorrect. This medication is most effective when taken in the evening because cholesterol production generally increases overnight. Expect a flushing of the skin as a reaction to the medication is incorrect. The nurse should identify flushing of the skin as an adverse effect of the medication niacin, which can be used to decrease the client's triglyceride levels. Expect therapy with this medication to be lifelong is correct. If medication therapy is discontinued, cholesterol levels will return to their pretreatment range within several weeks to months.

A nurse is caring for a client in an outpatient clinic. Drag 1 condition and 1 client finding to fill in each blank in the following sentence. The nurse is reviewing the client's medical record, which of the following is the client at risk for developing _____ due to _____

Upon analyzing cues, the nurse should identify that the client is at risk for developing hypomagnesemia due to long-term use of omeprazole and should monitor magnesium laboratory values and observe for manifestations including tremors, seizures, and muscle cramps.

A nurse is monitoring a client after administering their prescribed medications. Click to highlight the findings from the client's medical record that indicates a potential adverse reaction to their prescribed medication and requires the nurse to report to provider. To deselect a finding, click on the finding again. NEURO Client is alert to person, place, time, and situation. Client reports headache and occasional anxiety. GI/GU Client reports nausea. Abdomen soft and rounded, non-distended. Bowel sounds are normoactive in all 4 quadrants. Bladder non-distended; continent. Urine output of 25 mL/hr. VITAL SIGNS Temperature 38.4° C (101.2° F) Heart rate 106/min Respiratory rate 20/min Blood pressure 140/64 mm Hg Oxygen Saturation 97% on room air INTEGUMENTARY Skin cool, dry and intact. Small pinpoint petechiae is present on bilateral extremities.

When analyzing cues, the nurse should identify that the client's report of headache, nausea, and small pinpoint petechiae is present on bilateral extremities are indications of a potential adverse reaction to enoxaparin. Low molecular weight heparins such as enoxaparin are anticoagulants that are used to prevent thrombus formation. Other findings of an adverse reaction include, peripheral edema, insomnia, hematuria, pruritis, and alopecia.

A nurse is caring for a client in a clinic. Which client statements indicate an understanding of the teaching? Click to specify if the client statement indicates an understanding or need for further education. - "Coughing is expected while taking this medication." - "I will notify my provider if I feel sick." - "I will eat foods high in potassium." - "I should take acetaminophen instead of ibuprofen for a headache." - "I should take this medication with meals."

When evaluating outcomes, the nurse should identify that the client's statements: "I will notify my provider if I feel sick" and "I should take acetaminophen instead of ibuprofen for a headache" indicate an understanding of teaching. Captopril can cause neutropenia. If a client develops manifestations of infection such as a fever or sore throat, the provider should be notified. NSAIDS such as ibuprofen may reduce the effectiveness of captopril and should be avoided. The nurse should identify that the client's statements: "I will eat foods high in potassium," "Coughing is expected while taking this medication," and "I should take this medication with meals indicate a need for further education. Hyperkalemia is an adverse effect of captopril. The client should avoid potassium supplements and potassium-sparing supplements. Coughing is an adverse effect of captopril and the nurse should notify the provider. Captopril should be given one hour before meals or two hours after meals.

A nurse in an outpatient clinic is caring for a client. The nurse is planning teaching about the client's new medication. Which of the following information should the nurse include? Select all that apply. -This medication will decrease your blood pressure. -This medication can cause a feeling of pressure in your chest. -This medication can also be taken daily to prevent migraine headaches. -This medication may cause you to feel tired. -This medication will start to alleviate the headache within one hour after taking a dose. -You can take a second dose of this medication at least two hours after the initial dose if the headache persists.

When generating solutions and planning teaching about sumatriptan, an abortive medication for migraine, the nurse should inform the client that a feeling of pressure in the chest or arm heaviness is an expected adverse effect. Sumatriptan can also cause fatigue. Oral sumatriptan begins to alleviate migraine pain within one hour and a second dose can be taken at least two hours later if manifestations persist.

A nurse is caring for a client in a clinic and is reviewing their electronic medical record (EMR). For each body system below, click to specify the client's assessment findings that indicate an adverse effect of the client's prescribed medication. Choose the most likely option for the dropdowns in the table below by choosing from the lists of options.

When recognizing cues for a client who is taking atorvastatin, the nurse should identify that the findings of the client's urine characteristics, muscle weakness, and dizziness indicate an adverse reaction to the medication. Atorvastatin can cause dark urine, muscle pain, muscle spasms, and weakness, which could be an indication of injury to the muscle tissue. Atorvastatin can also cause neurological symptoms such as dizziness, headache, confusion, and fatigue.

The nurse is caring for a client in a mental health clinic. For each body system below, click to specify the adverse effect that the nurse should include when providing client education about the newly prescribed medication. Choose the most likely option for the dropdowns in the table below by choosing from the lists of options. Genitourinary - Adverse effects: Changes in libido Urinary retention Proteinuria Gastrointestinal - Adverse effects: Appendicitis Bloody stools Constipation Metabolic - Adverse affects: Weight loss Hypothyroidism Hypernatremia

When taking action, the nurse should educate the client about potential adverse effects of bupropion. Common adverse effects of this medication include changes in libido, constipation, and weight loss.

A nurse is providing discharge instructions to a client who has heart failure and a new prescription for captopril. Which of the following client statements indicates an understanding of the teaching? a. "I should take the medication with food." b. "I should take naproxen if I develop joint pain." c. "I should tell my provider if I develop a sore throat." d. "I should expect the medication to cause my urine to look orange."

a. "I should tell my provider if I develop a sore throat." The client should report a sore throat to the provider because this can indicate neutropenia, a serious adverse effect of captopril. Neutropenia can be reversed if it is identified early and the medication is promptly discontinued.

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? a. Chest pressure b. White patches on the tongue c. Bruising ​d. Insomnia

a. Chest pressure Sumatriptan is an antimigraine agent that 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 prescribed oral morphine and docusate sodium. Which of the following adverse effects of morphine should the nurse instruct the client can be minimized by taking daily docusate sodium? a. Constipation b. Drowsiness c. Facial flushing d. Itching

a. Constipation Constipation is a common adverse effect of morphine that can be minimized by taking 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 is taking atorvastatin for hyperlipidemia. Which of the following client laboratory values should the nurse monitor? a. Creatinine kinase b. Erythrocyte sedimentation rate c. International normalized ratio d. Potassium

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

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? a. Perform a capillary blood glucose test. b. Provide the client with a protein-rich snack. c. Give the client 120 mL (4 oz) of orange juice. d. Schedule an early meal tray.

a. Perform a capillary blood glucose test. 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 administering digoxin immune Fab to a client following a medication error. Which of the following findings should the nurse identify as an indication that the medication was effective? a. Sinus rhythm b. A decrease in the platelet count c. An increase in the alanine transaminase (ALT) level d. Deep tendon reflexes 2+

a. Sinus rhythm Digoxin immune Fab is the antidote for digoxin toxicity. Dysrhythmias are a life-threatening adverse effect of digoxin toxicity. Therefore, the return of the client's heart to a sinus rhythm indicates a therapeutic response to the antidote, digoxin immune Fab.

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 that they should complete an incident report? a. The client reports shortness of breath. b. The client is also taking lisinopril. c. The client's pulse rate is 60/min. d. The client's WBC count is 14,000/mm3 (5,000 to 10,000/mm3).

a. 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 taking acetazolamide for chronic open-angle glaucoma. Which of the following adverse effects should the nurse instruct the client to monitor for and report to the primary care provider? a. Tingling of fingers b. Constipation c. Weight gain d. Oliguria

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

A nurse is teaching a client who is scheduled for a colonoscopy and has a prescription for polyethylene glycol-electrolyte solution and bisacodyl. Which of the following statements should the nurse make? a. "Expect a bowel movement 2 hr following the first dose of the bowel cleanser." b. "Plan to drink 2 liters of the bowel cleanser solution." c. "Plan to drink 1 large glass of red cranberry juice the day before the procedure." d. "Expect to drink the bowel cleanser solution over an 8 hr period."

b. "Plan to drink 2 liters of the bowel cleanser solution." The nurse should instruct the client to drink 240 mL (8 oz) of the bowel cleanser solution every 10 min until 2 L (67.6 oz) are consumed.

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? a. Cholelithiasis b. Asthma c. Angina pectoris d. Tachycardia

b. Asthma Asthma is a contraindication for receiving propranolol. Propranolol is an adrenergic antagonist that 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 receiving heparin therapy via continuous IV infusion to treat a pulmonary embolism. Which of the following findings should the nurse identify as an adverse effect of the medication and report to the provider? a. Vomiting b. Blood in the urine c. Positive Chvostek's sign d. Ringing in the ears

b. Blood in the urine The nurse should report blood in the urine to the provider because this can be a manifestation of heparin toxicity. Other manifestations can include bruising, hematomas, hypotension, and tachycardia.

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? a. Positive Chvostek's sign b. Client report of decreased paresthesia c. Client report of increased thirst d. Increase in urinary output

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

b. 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 planning care for a client who has hypertension and is to start taking metoprolol. Which of the following interventions should the nurse include in the plan of care? a. Weigh the client weekly. b. Determine apical pulse prior to administering. c. Administer the medication 30 min prior to breakfast. d. Monitor the client for jaundice.

b. Determine apical pulse prior to administering. Life-threatening bradycardia is an adverse effect that might affect this client. Therefore, the nurse should assess the client's apical pulse prior to administering the medication. If the client's pulse rate is less than 60/min, the nurse should withhold the medication and notify the provider.

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

b. 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 caring for a client who has heart failure and a prescription for enalapril. Which of the following findings as an adverse effect of the medication should the nurse monitor the client for? a. Bradycardia b. Hyperkalemia c. Loss of smell d. Hypoglycemia

b. 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 collecting a medication history from a client who has a new prescription for lithium. Which of the following over-the-counter medications should the nurse identify as needing to be discontinued by the client? a. Aspirin b. Ibuprofen c. Famotidine d. Bisacodyl

b. Ibuprofen Most NSAIDs can significantly increase lithium levels. Therefore, the client should not take ibuprofen and lithium concurrently.

A nurse receives a verbal order from the provider to administer morphine five milligrams every 4 hours subcutaneously for severe pain as needed. The nurse should identify which of the following entries as the correct format for the medication administration record (MAR)? a. MSO4 5 mg subcut every 4 hr PRN severe pain b. Morphine 5 mg subcut every 4 hr PRN severe pain c. MSO4 5 mg SQ every 4 hr PRN severe pain d. Morphine 5.0 mg subcutaneously every 4 hr PRN severe pain

b. Morphine 5 mg subcut every 4 hr PRN severe pain The nurse should identify this entry as the correct format for the MAR. The medication name is spelled out and there are not any abbreviations from The Joint Commission's "Do Not Use" list included in the transcription.

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? a. Vitamin E b. Orange juice c. Milk d. Antacids

b. Orange juice The absorption of ferrous sulfate is enhanced by a vitamin C source, such as orange juice.

A nurse is assessing a client who is postoperative following an outpatient endoscopy procedure using midazolam. The nurse should monitor for which of the following findings as an indication that the client is ready for discharge? a. The client's capnography has returned to baseline. b. The client can respond to their name when called. c. The client is passing flatus. d. The client is requesting oral intake.

b. The client's capnography has returned to baseline. The nurse should identify that the client is ready for discharge when the capnography level indicates that gas exchange is adequate.

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? a. "If you do not take your furosemide, we might get in trouble." b. "You can double your dose of furosemide this evening if that would be better for you." c. "By not taking your furosemide, you might retain fluid and develop swelling." d. "I'll go ahead and mix the furosemide into your breakfast cereal."

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

c. "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 about the use of ethinyl estradiol/norelgestromin. Which of the following statements by the client indicates an understanding of the teaching? a. "I will apply the patch once a week for 2 weeks." b. "I will leave the existing patch on for 4 hours after applying the new patch." c. "I will fold the sticky sides of the old patch together before disposing it." d. "I will apply the patch within 14 days of menses."

c. "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 caring for a client who received 0.9% sodium chloride 1 L over 4 hr instead of over 8 hr as prescribed. Which of the following information should the nurse enter as a complete documentation of the incident? a. IV fluid infused over 4 hr instead of the prescribed 8 hr. Client tolerated fluids well, provider notified. b. 1 L of 0.9% sodium chloride completed at 0900. Client denies shortness of breath. c. 0.9% sodium chloride 1 L IV infused over 4 hr. Vital signs stable, provider notified. d. IV fluid initiated at 0500. Lungs clear to auscultation.

c. 0.9% sodium chloride 1 L IV infused over 4 hr. Vital signs stable, provider notified. The nurse should document the type and amount of fluid, how long it took to infuse, provider notification, and the client's physical status.

A nurse is caring for the parent of a newborn. The parent asks the nurse when their newborn should receive the first diphtheria, tetanus, and pertussis vaccine (DTaP). Which of the following ages should the nurse advise the parent to immunize their newborn? a. At birth b. 6 months c. 2 months d. 15 months

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

c. 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 (65 to 81 oz) a day to decrease the chance of kidney damage from crystallization.

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? a. Ondansetron b. Magnesium sulfate c. Flumazenil d. Protamine sulfate

c. Flumazenil The nurse should anticipate administering flumazenil, an antidote used to reverse benzodiazepines such as diazepam.

A nurse is assessing a client's vital signs prior to the administration of PO digoxin. The client's BP is 144/86 mm Hg, heart rate is 55/min, and respiratory rate is 20/min. The nurse should withhold the medication and contact the provider for which of the following findings? a. Diastolic BP b. Systolic BP c. Heart rate d. Respiratory rate

c. Heart rate Digoxin slows the conduction rate through the SA and AV nodes, thereby decreasing the heart rate. The nurse should withhold the medication and notify the provider for a heart rate of 55/min because this is an early indication of digoxin toxicity.

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

c. Obtain WBC with absolute neutrophil count. 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 at a clinic is providing follow-up care for a client who is taking fluoxetine for depression. Which of the following findings should the nurse identify as an adverse effect of the medication? a. Tingling toes b. Absence of dreams c. Sexual dysfunction d. Pica

c. Sexual dysfunction Sexual dysfunction, including a decreased libido, impotence, and delayed orgasm, or anorgasmia, is a common adverse effect of fluoxetine and occurs in about 70% of clients who take this SSRI antidepressant.

A nurse on the acute care unit is caring for a client who is receiving gentamicin IV. Which of the following findings should the nurse report to the provider as an adverse effect of the medication? a. Constipation b. Hypoglycemia c. Tinnitus d. Joint pain

c. Tinnitus Aminoglycosides, such as gentamicin, are ototoxic, which can manifest as tinnitus and deafness. The nurse should monitor the client for high-pitched ringing in the ears and headaches and should notify the provider if these occur.

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? a. Muscle twitching b. Cough c. Urinary retention d. Increased libido

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

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? a. Update the client's medical record. b. Notify the provider. c. Withhold the medication. d. Inform the pharmacist of the client's allergy to penicillin.

c. Withhold the medication. 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 client.

A nurse is teaching a client about warfarin. The client asks if they can take aspirin while taking the warfarin. Which of the following responses should the nurse make? a. "It is safe to take an enteric-coated aspirin." b. "The INR lab work must be monitored more frequently if aspirin is taken." c. "Acetaminophen may be substituted for aspirin." d. "Aspirin will increase the risk of bleeding."

d. "Aspirin will increase the risk of bleeding." Aspirin inhibits platelet aggregation and can potentiate the action of the anticoagulant warfarin. Therefore, the client should avoid taking aspirin because it increases the risk for bleeding.

A nurse is planning discharge teaching for a client who has a prescription for furosemide. Which of the following statements should the nurse plan to include in the teaching? a. "This medication increases your risk for hypertension." b. "Avoid potassium-rich foods in your diet." c. "Take each dose of medication in the evening before bed." d. "Drink a glass of milk with each dose of medication."

d. "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 providing teaching to a client who has a prescription for ergotamine sublingual to treat migraine headaches. Which of the following information should the nurse include in the instructions? a. "Take one tablet three times a day before meals." b. "Take one tablet every 15 minutes until migraine subsides." c. "Take up to eight tablets as needed within a 24-hour period." d. "Take one tablet at onset of migraine."

d. "Take one tablet at onset of migraine." The client should take one tablet immediately after the onset of aura or headache.

A nurse is reviewing the assessment findings of a client who is taking carbamazepine for a seizure disorder. Which of the following findings should the nurse report to the provider as an adverse effect of carbamazepine? a. Hypersalivation b. Dysuria c. An increased uric acid level d. A decreased WBC count

d. A decreased WBC count Leukopenia, or a decreased WBC count, 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 caring for a client who has acute acetaminophen toxicity. Which of the following medications should the nurse anticipate administering? a. Vitamin K b. Physostigmine c. Benztropine d. Acetylcysteine

d. Acetylcysteine Acetylcysteine is a specific antidote for acetaminophen toxicity. It can prevent severe injury when given orally or by IV infusion within 8 to 10 hr.

A nurse is reviewing assessment findings for a client who has a new prescription for ceftazidime via intermittent IV bolus. Which of the following findings should the nurse identify as a contraindication to this medication? a. Increased WBC count b. Allergy to lamotrigine c. Increased LDL level d. Allergy to cephalosporins

d. Allergy to cephalosporins Ceftazidime is a third generation cephalosporin antibiotic. An allergy to cephalosporins is a contraindication to the administration of ceftazidime. Therefore, the nurse should not administer the medication and report this allergy to the provider.

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? a. Bradycardia b. Hypotension c. Muscle weakness d. Disorientation

d. Disorientation 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 administering donepezil to a client who has Alzheimer's disease. Which of the following findings should the nurse report to the provider immediately? a. Dyspepsia b. Diarrhea c. Dizziness d. Dyspnea

d. Dyspnea When using the airway, breathing, circulation approach to client care, the nurse should report the adverse effect of dyspnea, caused by bronchoconstriction, to the provider first. Bronchoconstriction, dyspepsia, diarrhea, and dizziness are caused by the increase in acetylcholine levels, which is a primary effect of donepezil.

A nurse is planning to administer IV midazolam for a client who is receiving moderate sedation. Which of the following actions should the nurse plan to take? a. Ensure that naloxone is available in the event of toxicity. b. Administer the midazolam over one minute. c. Expect the client's respiratory rate to increase. d. Expect the client to respond to simple commands.

d. Expect the client to respond to simple commands. The nurse should expect the client to maintain spontaneous respirations and respond to simple commands.

A nurse is reviewing the electronic medical record for a client who is receiving heparin via continuous IV infusion for deep vein thrombosis. Which of the following findings should the nurse identify as an adverse effect of heparin that requires notification of the provider? a. Urinary frequency b. Xerostomia c. Diplopia d. Generalized petechiae

d. Generalized petechiae The nurse should identify that generalized petechiae is an indication of thrombocytopenia, which is a potential adverse effect of heparin. The client is at an increased risk for hemorrhage, which can be fatal. Therefore, the nurse should notify the provider of this finding.

A nurse is assessing a client who is taking propylthiouracil for the treatment of Graves' disease. Which of the following findings should the nurse identify as an indication that the medication has been effective? a. Decrease in WBC count b. Decrease in amount of time sleeping c. Increase in appetite d. Increase in ability to focus

d. Increase in ability to focus A client who has Graves' disease can experience psychological manifestations such as difficulty focusing, restlessness, and manic-type behaviors. Propylthiouracil is a thyroid hormone antagonist that decreases the circulating T4 hormone, reducing the manifestations of hyperthyroidism. An increased ability to focus indicates that the medication has been effective.

A nurse is providing teaching to a client who is taking bupropion for smoking cessation. Which of the following findings should the nurse identify as an adverse effect of the medication? a. Cough b. Joint pain c. Alopecia d. Insomnia

d. Insomnia Bupropion, an atypical antidepressant, has stimulant properties which can result in agitation, tremors, mania, and insomnia.

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 to report to the provider? a. Hot flashes b. Gastrointestinal irritation c. Vaginal dryness d. Leg tenderness

d. Leg tenderness The greatest risk to this client is the development of a thromboembolism, which is an adverse effect of tamoxifen. The nurse should also monitor the client for other manifestations of a thromboembolism, including leg tenderness, redness, swelling, and shortness of breath.

A nurse is assessing a client who has myasthenia gravis and is taking neostigmine. Which of the following findings should indicate to the nurse that the client is experiencing an adverse effect? a. Tachycardia b. Oliguria c. Xerostomia d. Miosis

d. 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 preparing to administer PO sodium polystyrene sulfonate to a client who has hyperkalemia. Which of the following actions should the nurse plan to take? a. Hold the client's other oral medications for 8 hr post administration. b. Inform the client that this medication can turn stool a light tan color. c. Keep the client's solution in the refrigerator for up to 72 hr. d. Monitor the client for constipation.

d. Monitor the client for constipation. The nurse should monitor the client for the adverse effect of constipation and report it to the provider because this can lead to fecal impaction.

A nurse in the 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? a. Methadone b. Bupropion c. Diazepam d. Naloxone

d. 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 preparing to administer 0.9% sodium chloride 1,500 mL to infuse over 8 hr to a client who is postoperative. How many mL/hr should the nurse set the IV pump to deliver? (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 preparing to administer ciprofloxacin 15 mg/kg PO every 12 hr to a child who weighs 20 kg. How many mg should the nurse administer per dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

300 mg/dose

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. How many gtt/min should the nurse set the manual IV infusion to deliver? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

31 gtt/min