ATI Pharm Made Easy Exam 4

A nurse is caring for a client who is taking amiodarone to treat atrial fibrillation. Which of the following should the nurse instruct the client to avoid while taking this drug? A) Grapefruit juice B) Milk C) Foods high in vitamin K D) NSAIDs

A) Grapefruit juice Grapefruit juice, particularly in large amounts, can cause toxicity of potassium channel blockers, such as amiodarone.

A nurse is administering hydrochlorothiazide to a client who has gouty arthritis. The nurse should monitor the client for which of the following findings that indicates an adverse effect of this drug? A) Hyperuricemia B) Hypernatremia C) Hyperkalemia D) Hypoglycemia

A) Hyperuricemia Hyperuricemia, or increased uric acid levels, along with gouty arthritis, can occur in clients who have a history of these conditions and are taking hydrochlorothiazide.

A nurse is assessing a client who is taking a loop diuretic and is experiencing a thready, irregular pulse, orthostatic hypotension, and confusion. The nurse should identify that these manifestations indicate which of the following adverse effects? A) Hypokalemia B) Hypoglycemia C) Hypouricemia D) Hyponatremia

A) Hypokalemia Manifestations of hypokalemia include a thready, irregular pulse, orthostatic hypotension, anxiety, confusion, skeletal muscle weakness, hypoactive bowel sounds, polyuria, nausea, and vomiting.

A nurse is caring for a client who missed a dose of oral contraceptive. Which of the following instructions should the nurse give the client?

Take the missed dose as soon as possible.

A nurse is caring for a client who is taking spironolactone to treat hypertension. The nurse should recognize that which of the following client laboratory values requires immediate intervention? A) Sodium 140 mEq/L B) Potassium 5.2 mEq/L C) Chloride 100 mEq/L D) Magnesium 1.9 mEq/L

B) Potassium 5.2 mEq/L Spironolactone is a diuretic and an aldosterone antagonist that can cause hyperkalemia and places the client at risk for cardiac dysrhythmias. This potassium level is outside the expected reference range of 3.5 to 5.0 mEq/L and requires immediate intervention.

A nurse should question the use of conjugated equine estrogen by a client who has a history of which of the following?

Blood clots

A nurse is caring for a client who is taking combination oral contraceptive ethinyl estradiol and drospirenone and is about to begin taking rifampin to treat tuberculosis. Which of the following instructions should the nurse give the client due to a possible drug interaction?

"Use additional birth control methods"

After administering terbutaline to a client to inhibit preterm labor, the nurse should assess which of the following?

Heart ate

A nurse should question the use of ethinyl estradiol and drospirenone by a client who has a renal disease due to the increased risk of which of the following?

Hyperkalemia

A nurse is assessing a client who has a new prescription for the combination oral contraceptive ethinyl estradiol and drospirenone. Which of the following findings should the nurse identify as a contraindication to use of this medication?

Smokes half a pack of cigarettes a day

A nurse is providing teaching to a client who has a new prescription for losartan to treat hypertension. The nurse should instruct the client that which of the following findings could indicate an adverse reaction to the drug and needs to be reported? A) Facial edema B) Sleepiness C) Peripheral edema D) Constipation

A) Facial edema Losartan, an angiotensin II receptor blocker, can cause angioedema, which often manifests as swelling around the eyes and lips. Clients who develop this adverse effect should stop taking the drug and seek medical attention.

A nurse is teaching a client who has a new prescription for nitroglycerin. The nurse should instruct the client that which of the following manifestations is a potential adverse effect of this drug? A) Headache B) Constipation C) Hypertension D) Hyperglycemia

A) Headache Adverse effects of nitrates, such as nitroglycerin, include headaches, which can be severe at the beginning of nitrate therapy but decrease in severity with continued exposure to nitrates.

A nurse is caring for a client who is taking a diuretic. The nurse should instruct the client to include which of the following foods in their diet to increase potassium intake? A) Raisins B) Cabbage C) Cheese D) Eggs

A) Raisins Diuretics can deplete the body of potassium, so the nurse should instruct the client to include potassium-rich foods in their diet, such as raisins and other dried fruits.

A nurse is caring for a client who is about to begin captopril therapy. Which of the following adverse effects should the nurse instruct the client to report because it can indicate a need to discontinue drug therapy? (Select all that apply) A) Rash B) Distorted taste C) Swelling of the tongue D) Photosensitivity E) Dry cough

A, B, C, and E A) Captopril, an ACE inhibitor, can cause a persistent rash. This often indicates the need to discontinue drug therapy. B) Captopril can cause distortions in taste sensations and loss of taste, which can lead to anorexia and weight loss. This often indicates the need to discontinue drug therapy. C) Captopril can cause angioedema, often manifesting as edema of the tongue, pharynx, and glottis. Clients who develop this adverse effect should discontinue the drug and seek medical attention. E) Captopril can cause a dry cough because of an accumulation of bradykinin. This often indicates the need to discontinue drug therapy.

A nurse is caring for a client who has a new prescription for aliskiren to treat hypertension. The nurse should monitor the client for which of the following findings as an adverse effect of the drug? (Select all that apply) A) Hyperkalemia B) Throat swelling C) Constipation D) Cough E) Joint pain

A, B, and D A) Aliskiren, a direct renin inhibitor, can cause elevated potassium levels, especially when taken in combination with an ACE inhibitor, potassium supplements, or potassium-sparing diuretics. The nurse should obtain a potassium level at baseline and periodically monitor the client's potassium level thereafter. B) Aliskiren can cause angioedema, which is swelling of the mouth and throat. Clients who develop this adverse effect should stop taking the drug and seek medical attention. D) Aliskiren, a direct renin inhibitor, can cause a cough.

A nurse is caring for a client who has a new prescription for propanolol to treat a tachydysrhythmia. The nurse should instruct the client to avoid taking which of the following types of over-the-counter drugs while taking propanolol? A) Antihistamines B) Potassium supplements C) NSAIDs D) Vitamin C

C) NSAIDs NSAIDs can interact with propranolol and decrease the anti-hypertensive action because vasoconstriction can occur in some COX-2 inhibitors. The nurse should instruct the client to avoid taking NSAIDs and propranolol at the same time.

A nurse is caring for a client who has a new prescription for verapamil. The nurse should clarify the prescription with the provider if the client has a history of which of the following conditions? A) Migraine headaches B) Pancreatitis C) Second-degree AV block D) Angina pectoris

C) Second-degree AV block Verapamil, a calcium channel blocker, can affect AV conduction and is contraindicated for clients who have sick sinus syndrome or second- or third-degree AV block. Verapamil is indicated for hypertension, angina pectoris, and the management of atrial flutter and fibrillation. It is also prescribed for the management of migraine headaches.

A nurse is caring for a client who will begin using transdermal nitroglycerin to treat angina pectoris. When speaking to the client about the drug, which of the following instructions should the nurse include? (Select all that apply) A) "Apply a new patch at the onset of anginal pain." B) "Apply the patch to dry skin and cover the area with plastic wrap." C) "Apply the patch to a hairless area and rotate sites." D) "Apply a new patch when you start your day." E) "Remove patches for 10 to 12 hours each day."

C, D, and E C) Hair can interfere with the adhesion of the patch. Rotating patch application sites helps prevent skin irritation. D) The therapeutic preventive effects of transdermal nitroglycerin patches begin 30 to 60 min after application and last for up to 14 hr. Because angina pain is more likely to occur with activity, most clients require this protection during waking hours. E)Removing the patches for 10 to 12 hr each day helps prevent the development of tolerance to the drug. For most clients, sleeping hours are the best time to remove the patch and go "patch-free," because angina pain is more likely during activity.

A nurse is caring for a client who is taking carvedilol and has a prescription for an oral antidiabetic drug to manage their new diagnosis of type 2 diabetes mellitus. By taking both drugs concurrently, the nurse should identify that the client is at an increased risk for which of the following conditions? A) Hyperglycemia B) Bradycardia C) Hypotension D) Hypoglycemia

D) Hypoglycemia There are two factors that increase the client's risk for hypoglycemia. Alpha/beta blockers, such as carvedilol, potentiate the hypoglycemic effects of insulin and oral hypoglycemic drugs. Also, carvedilol can mask tachycardia in clients who have hypoglycemia. Carvedilol should be used with caution by clients who have diabetes mellitus.

A nurse is caring for a client who has a new prescription for verapamil to treat atrial fibrillation. The nurse should instruct the client to avoid drinking grapefruit juice while taking verapamil because it can cause the client to experience which of the following conditions? A) Tachycardia B) Dehydration C) Diarrhea D) Hypotension

D) Hypotension Large amounts of grapefruit juice can increase blood levels of verapamil by inhibiting its metabolism. An excess amount of the drug in the body can intensify otherwise therapeutic effects like hypotension, causing serious risk for syncope and dizziness.

A nurse is caring for a client who has glomerular filtration rate of 10 mL/min and a reduced urine output. The nurse should clarify a prescription for hydrochlorothiazide for this client because of which of the following characteristics of the drug? A) The drug can cause hypoglycemia in clients who have a low urine output. B) The drug does not reduce blood pressure for clients who have a low urine output. C) The drug can increase the risk of pulmonary edema for clients who have renal insufficiency. D) The drug does not promote diuresis for clients who have renal insufficiency.

D) The drug does not promote diuresis for clients who have renal insufficiency. Adequate kidney function is essential for clients who take hydrochlorothiazide, a thiazide diuretic, to promote urine production and effective excretion.