Adaptive Quizzes Part 2

A nurse is caring for a client with MS and a neurogenic bladder who is receiving bethanechol. The nurse should identify that which of the following client statements indicates a therapeutic action of the medication?

"I am able to urinate more freely" Rationale: Bethanechol is administered for the treatment of urinary retention

A nurse is providing teaching for a client who has a new prescription for nitroglycerin administered through a transdermal patch. Which of the following client statements indicates an understanding of the teaching?

"I need to rotate the location of my patch every few days" Rationale: to prevent tolerance; apply to hairless areas of the body

A nurse is teaching a client who has a new prescription for alosetron. Which of the following client statements indicates an understanding of the teaching?

"I should contact my provider immediately if I experience constipation"

A nurse is teaching about the adverse effects of baclofen to a client who has MS with spasms. Which of the following statements should the nurse identify as an indication that the client understands the teaching?

"I should not stop taking this medication suddenly"

A nurse is providing discharge teaching to a client who has HF and a prescription for digoxin 0.125mg po qd and furosemide 20mg po qd. Which of the following statements by the client indicates an understanding of the teaching?

"I will eat fruits and vegetables that have a high potassium content every day" Rationale: Hypokalemia is caused by furosemide (loop diuretic), and digoxin toxicity can develop if the client does not have adequate potassium; keep potassium levels between 3.5-5mg/dL

A nurse is teaching a client who has a new prescription for Warfarin. Which of the following statements should the nurse identify as an indication that the client understands the teaching?

"I'll avoid contact sports like football" Rationale: this is to reduce the risk of bleeding with Warfarin therapy

a nurse is teaching a client who has severe chronic gout and a new prescription for pegloticase. The client has been taking allopurinol for 1 month. Which of the following instructions should the nurse include about pegloticase?

"If you experience a flare-up, you can take an NSAID while receiving this medication" Rationale: For a client with chronic gout, during the first few months of treatment an increase in manifestations is expected. To reduce the intensity of these manifestations, clients are instructed to take an NSAID such as Naproxen

A nurse is assessing an infant during a routine checkup. The parent asks the nurse about the infants immunization schedule. Which of the following responses should the nurse make?

"It is recommended that your infant receives 6 immunizations at 2 months of age"

A nurse is teaching a client about taking tetracycline PO. Which of the following statements should the nurse include in the teaching?

"Limit your consumption of dairy products while taking this medication"

A nurse is teaching a client about a new prescription for extended release oxycodone for pain management. Which of the following statements should the nurse include in the teaching?

"Swallow this medication whole" Rationale: Key word is EXTENDED RELEASE; these medications should not be crushed or cut

A nurse is teaching a client with chronic asthma who has a new prescription for cromolyn. Which of the following instructions should the nurse include in the teaching?

"The medication's therapeutic effects can take up to several weeks to develop" Rationale: Cromolyn Sodium is NOT for acute attacks

A nurse is teaching a client who is starting patient controlled analgesia (PCA) following a procedure. Which of the following client statements indicates an understanding of the teaching?

"This method works by keeping my opioid levels steady" Rationale: PCA pumps deliver a small amount of medication continuously rather than a large amount infrequently

What are the ADRs of both Albuterol and Salmeterol?

-Chest pain -Palpitations -Tremor -Nervousness

What are the 3 conditions doxazosin is used for?

1. BPH 2. Baldness 3. HTN

What is a C/I for receiving vasopressin?

A low creatinine clearance (indicates renal impairment)

A nurse is providing discharge teaching for a client who has a new prescription for metoprolol. Which of the following instructions should the nurse include? A. "Do not stop taking this medication abruptly" B. "Take the medication right before bedtime" C. "Avoid exposure to sunlight" D. "Count your radial pulse daily" E. "Change positions slowly"

A. "Do not stop taking this medication abruptly" D. "Count your radial pulse daily" E. "Change positions slowly" Rationale: Taking the medication right before bedtime is not recommended, since Metoprolol can cause insomnia; clients should take it qam once daily; if taking it bid, take the second dose with evening meal

A nurse is administering a medication parenterally to a client. Which of the following techniques should the nurse use to reduce fluctuations in plasma medication levels?

Administer a continuous infusion of the dose Rationale: this is to keep plasma levels nearly constant

A nurse is providing teaching to the parents of a school-aged child with asthma about medications for bronchospasm. Which of the following inhaled medications should the nurse instruct the parents to use to relieve an acute asthma attack?

Albuterol

Allergies to what medications are a C/I to receiving Celecoxib?

Allergy to Aspirin, NSAIDs or sulfonamides

What kind of razor should be recommended to patients on Warfarin therapy?

An ELECTRIC razor (NOT a safety razor)

What are the ADRs of Atropine?

Anticholinergic (blurred vision, dry mouth, urinary retention, constipation, tachycardia)

A nurse is teaching a client who is using topical lidocaine about preventing systemic toxicity. Which of the following pieces of information should the nurse include about the application of topical lidocaine?

Apply topical lidocaine to affected areas that are intact

What is another therapeutic use of lactulose, magnesium hydroxide, magnesium citrate, and polyethylene glycol?

Are osmotic laxatives used for hepatic encephalopathy due to a build up of ammonia in the body

Which medication is C/I in children who have viral infections and why?

Aspirin; Reyes Syndrome

What medications should be avoided while on Warfarin therapy?

Avoid NSAIDs and acetaminophen

A nurse is caring for a client with a pseudomonas infection who has a new prescription for ticarcillin-clavulanate. Which data should the nurse collect before administering this medication?

Baseline BUN & Creatinine levels Rationale: Ticarcillin-clavulanate is a penicillin abx and is excreted by the kidneys; therefore, any renal impairment could result in a toxic level of the med.

Why is there an increased risk for embolic events (PE, DVT, stroke), hot flashes and leg cramps when taking raloxifene?

Binds to estrogen receptors! -Increase Calcium & Vitamin D; weight bearing exercises; monitor bone density

A nurse is caring for a client who is experiencing cycloplegia following administration of atropine eye drops during an eye examination. Which of the following findings should the nurse expect as a result of cycloplegia?

Blurred vision

A nurse is caring for a client who has a prescription for a QT interval medication. Which of the following conditions should the nurse identify as an adverse effect of this medication?

Bradycardia

A nurse is caring for a client who has a new diagnosis of RA. The nurse should anticipate a prescription for which medication for daily management of this condition?

Celecoxib

A nurse is reviewing the lab results of a client who is taking tobramycin and notes that the medications peak level is 7mcg/mL. Which of the following actions should the nurse take?

Continue the medication as prescribed Rationale: the expected reference range of tobramycin is 5-10mcg/mL

What should the nurse do if NPH insulin appears cloudy?

Continue with administration; NPH insulin is a cloudy suspension. Discard other types of insulin (not NPH) if they appear cloudy

What is the MOA of Celecoxib?

Cox-2 inhibitor

A nurse is caring for a client who has Alzheimer's disease and a prescription for memantine. Which of the following laboratory findings should the nurse identify as a C/I to receiving this medication?

Creatinine clearance 35mL/min Rationale: Creatinine clearance is a value of the GFR; normal creatinine clearance levels should be above 87mL/min for females and above 107mL/min for males

A nurse is monitoring a client who is receiving lactulose for cirrhosis. Which of the following laboratory values related to this medication should indicate to the nurse that the treatment is effective.

Decrease serum ammonia Rationale: lactulose is a laxative that can be used for chronic liver disorders (e.g., cirrhosis) and improves the condition by decreasing ammonia levels through enhancing intestinal secretion of ammonia to be eliminated from the body

A nurse is caring for a client who takes Ginkgo biloba daily at home. Which of the following effects should the nurse expect from the use of this herbal supplement?

Decreased platelet aggregation

A nurse is preparing to administer raloxifene to a client. Which of the following conditions is a C/I for the administration of this medication?

Deep-vein thrombosis Rationale: Raloxifene increases the risk of DVT, PE & stroke

What is the reasoning for using Vasopressin or desmopressin?

Diabetes insipidus MOA: mimics ADH to decrease urine output and increase urine osmolality

What are the ADRs of lubriprostone?

Diarrhea Nausea HA

What diet should be encouraged in a patient taking Furosemide?

Diet high in potassium (loop diuretic gets rid of it all) -Bananas -Dark leafy greens -Potatoes -Cantaloupe -Avocado -Tomatoes

A nurse is caring for a client who is taking selegiline. The nurse should monitor for the client for which of the following adverse effects of selegiline and notify the provider if it occurs?

Drowsiness Rationale: Drowsiness is a manifestation of serotonin syndrome while taking an MAOI

Which medication delivery device for the treatment of asthma is best for clients with deformities of the hands, require less hand-breath coordination and are easier to use?

Dry-powder inhaler (DPI)

A nurse is providing teaching to a client who has gout and a new prescription for allopurinol. The nurse should instruct the client to d/c the med for which ADR?

Fever Rationale: could indicate a potentially fatal hypersensitivity rxn

What is the therapeutic use of lubiprostone?

For constipation (IBS)

What is the therapeutic use of alosetron?

For loose stools (diarrhea- IBS)

A nurse is caring for a client who has hyperlipidemia and is receiving simvastatin 40mg po qd. Which of the following items should the nurse remove from the clients breakfast tray before it is delivered to the room?

Grapefruit juice Rationale: taking GFJ with simvastatin will raise blood levels of the med significantly

A nurse is caring for a client who has a new prescription for levothyroxine to treat hypothyroidism. Which of the following findings should the nurse identify as an indication that the client requires intervention?

Heart rate 106/min Rationale: the patient may be overmedicated and is now experiencing S/S of hypERthyroidism

A nurse is reviewing the laboratory results of a client who is taking a medication and notes that the client's blood tests show an elevated level of the enzymes AST and ALT. The nurse should recognize that these findings are potential indications of which condition?

Hepatic toxicity

What are the SE of taking Furosemide?

HypOkalemia HypOnatremia HypOtension Ototoxicity HypERglycemia Rash Dehydration

What is a C/I to administering diazepam for A-FIB?

Hypotension

A nurse is teaching a group of nurses about the effects of a client receiving spinal anesthesia. What is an adverse effect of spinal anesthesia?

Hypotension Rationale: The local anesthetic causes the client's BP to decrease due to venous dilation secondary to a SNS response

What dietary advice should be given to a client taking morphine for acute pain?

Increase fluid and fiber intake Rationale: opioids cause constipation

What should you advise dietary wise for patients taking baclofen?

Increase fluid and fiber, can cause constipation

A nurse is planning care for a client with thrombophlebitis who has a prescription to receive heparin via continuous IV infusion. Which of the following actions should the nurse include in the plan of care?

Infuse the heparin using an electronic IV pump Rationale: electronic IV pump should be used instead of gravity to prevent accidental increase or change in the rate of infusion

What do patients taking Warfarin need to carry with them?

Medical alert ID card

What is a C/I for receiving any/ALL vaccines?

Moderate illness without a fever Rationale: a client who has moderate OR severe illness with OR without fever has a true C/I to receiving a vaccine; postpone until the client has recovered

What should the nurse monitor for in a patient taking OTC Gingko biloba?

Monitor for increased bleeding, particularly if taking other antiplatelet agents (e.g., NSAIDs, clopidogrel)

Which medication is commonly given for unstable angina?

Nitroglycerin

A nurse is caring for a client who reports crushing chest pain. The nurse reviews the client's ECG results and notes ST changes. Which medication should the nurse administer?

Nitroglycerin Rationale: therapeutic use= angina (chest pain) and acts directly on vascular smooth muscle to promote vasodilation

What is the major SE of taking Vasopressin or Desmopressin?

OVERhydration with a pounding headache (more of the can't pee hormone- ADH)

A nurse is monitoring a client with pneumonia who has received penicillin G IM. Which of the following findings should the nurse plan to address first?

PRIORITY QUESTION- Answer: Laryngeal edema Rationale: indication of an allergic/anaphylactic rxn

A nurse in an acute care facility is preparing a reconciled list of medications for a client who is being discharged home. Which of the following actions should the nurse take?

Provide the client and the next care provider with a list of medications the client will take after discharge

What are the indications for using raloxifene?

RalOXIFene helps FIX Osteoporosis (postmenopausal); binds to estrogen receptors and decreases bone resorption

A nurse is caring for a client with DKA who has a prescription for an IV infusion of insulin. The nurse should document that which of the following types of insulin was administered intravenously to treat ketoacidosis?

Regular insulin

A nurse is providing teaching to a newly licensed nurse about administering morphine via IV bolus to a client. Which of the following pieces of information should the nurse include int he teaching?

Respiratory depression can occur 7 minutes after the morphine is administered

A nurse is teaching self-administration of NPH insulin to a client who has type 2 DM. Which of the following instructions should the nurse include?

Rotate injection sites within the same area Rationale: To prevent lipodystrophy, the client should rotate injection sites and keep them about 2.5cm (1in) apart within the same anatomical area

How are hormone injections normally administered to school aged children?

Subcutaneously Rationale: SubQ is preferred over IM because IM injections are more painful

If a client has been taking tetracycline for the past 7 days and now has a new diagnosis of oral candidiasis, what is this the result of?

Superinfection

What needs to happen prior to a client being started on alosetron for IBS with diarrhea (IBS-D)?

The client must sign an agreement with the provider before beginning aloestron Rationale: Alosetron has potentially fatal adverse effects a/w constipation and bowel obstruction; FDA requires clients sign and adhere to a risk management program, which includes signing a client-provider agreement before starting alosetron

A nurse is caring for a client who has HF and is taking oral furosemide 40mg po qd. For which of the following adverse effects should the client be taught to monitor and notify the provider if it occurs?

Tinnitus Rationale: Furosemide is a loop diuretic that can cause ototoxicity (full feeling in ear, ringing, hearing loss)

Why should an IV injection be administered slowly?

To reduce toxicity risk Rationale: infuse slowly over 1 minute

What is the antidote for Warfarin toxicity?

Vitamin K

What are the C/I for taking combination oral contraceptives?

-Liver disease -Thrombophlebitis -BREAST CA

What is the MOA of furosemide?

Blocks sodium and chloride reabsorption in ascending loop of henle to cause RAPID diuresis

A nurse is planning to administer Epoetin alfa to a client who has chronic kidney failure. Which of the following should the nurse plan to review prior to administering this medication?

Blood pressure Rationale: Epoetin alfa often causes HTN, which can lead to stroke or other CV complications; a client who receives epoetin alfa frequently requires concurrent use of an antihypertensive med

Sumatriptan (Imitrex) is used to treat migraine HA's. What is the major ADR?

CHEST PAIN

What should you recommend clients do with their diet while on Warfarin therapy?

Keep amount of Vitamin K CONSTANT in the diet

A nurse is caring for a client who is taking a prescription for glucocorticoid adrenal replacement medication for the long-term treatment of Addison's disease. Which of the following findings indicates that the client is experiencing an adverse effect of the medication?

Osteoporosis

What is Selegiline used in the treatment of?

Parkinson's disease (MAO-B inhibitor)

A nurse is reviewing the medical record of a client who is scheduled for induction of labor and has a prescription for misoprostol. Which of the following conditions should the nurse identify as a C/I to administering this medication?

Past cesarean delivery Rationale: Misoprostol causes a higher incidence of uterine tachysystole; C/I with past cesarean because high risk of uterine rupture

Aspirin is C/I in which patients?

-Children with fever (Reyes) -Patients with PUD or bleeding disorders

Besides hypotension, what are the other SE of doxazosin?

-Dizziness -HA -Issues with ejaculation

A nurse has administered a medication to a client. Which of the following circumstances should the nurse identify as a medication error that resulted from a performance deficit by the nurse?

An intramuscular injection was given instead of a subcutaneous injection Rationale: improper route of administration are the most common causes of medication errors resulting from human error; if the nurse is not following the rights of medication administration, then the nurse has a performance deficit

How should insulin be mixed?

Roll between the palms, do not shake it

A nurse is teaching a client who has a prescription for a combination oral contraceptive that uses a 28 day cycle. Which of the following instructions should the nurse include in the teaching?

"You can miss up to 7 pills with little risk in getting pregnant as long as you have taken the pills regularly for the previous 3 weeks"

What are the 3 main SE of taking a penicillin abx?

-GI upset (diarrhea, N/V) -Allergic reaction -Renal toxicity

What needs to be monitored in a patient taking furosemide?

-Monitor I&Os -Weight patients daily -Monitor electrolytes

What are the therapeutic uses of Aspirin?

-Pain -Inflammation -Fever -Kawasaki disease -Prevention of TIAs/MIs

What are the indications for using furosemide?

-Pulmonary edema -Edema r/t HF, liver disease, kidney disease -HTN

What are the therapeutic uses of Atropine?

-Sinus bradycardia (gets HR back up) -Heart block -Used to decrease secretions during sx

What are the clinical manifestations of salicylism that a patient may experience while taking aspirin?

-Tinnitus -Vomiting/diarrhea -Respiratory alkalosis

If using Albuterol (short acting beta 2 agonist) or salmeterol (long acting beta 2 agonist) with an inhaled glucocorticoid, what is the order of which to use it?

-Use bronchodilator FIRST; -Wait 5 minutes; -THEN use glucocorticoid *B before G*

A nurse is administering oral hydroxyzine to a client. Which of the following adverse effects should the nurse instruct the client to expect?

Dry mouth Rationale: Hydroxyzine is a 1st gen H1 receptor antagonist (antihistamine) with anticholinergic properties

A nurse is administering adenosine via IV bolus for a client who has developed paroxysmal atrial tachycardia. For which of the following findings should the nurse assess the client during the administration of adenosine?

Dyspnea Rationale: Dyspnea can occur during the administration of adenosine due to bronchoconstriction

A nurse is caring for a client with BPH who has a new Rx for doxazosin. Which of the following manifestations should the nurse monitor for as an adverse effect of doxazosin?

Hypotension Rationale: non-selective alpha 1 adrenergic antagonist

A nurse is reviewing the medical record of a client who has an Rx for a combination oral contraceptive. The nurse should identify that which finding is a C/I for this med?

Liver disease

A nurse is assessing a client who is receiving IV gentamicin tid. Which of the following findings indicates that the client is experiencing an adverse effect of this medication?

Proteinuria Rationale: Proteinuria is a manifestation of nephrotoxicity, an ADR of Gentamicin; monitor for oliguria & hematuria

A nurse is preparing to administer an otic medication to an adult client. Which of the following actions should the nurse take?

Pull the pinna of the client's ear upwards and outwards

A nurse is caring for a school-aged child who has CF and has been using a corticosteroid inhaler for long term treatment. Which of the following findings should the nurse identify as an adverse effect of long-term use of this medication?

Small stature for age Rationale: long term corticosteroid inhaler use in children causes concern for delayed growth & development

A nurse is preparing to administer levothyroxine to a client who has hypothyroidism. The nurse should identify which of the following lab values as supporting the administration of this medication?

TSH is 8 micro units/mL Rationale: the expected reference range for TSH is 0.3-0.5; when a client has primary hypOthyroidism, the TSH level becomes elevated in an attempt to normalize the thyroid glands function