ATI Pharm my second test

A nurse is teaching a client who has diet or diabetes mellitus and receive 25 units of NPH insulin every morning if her blood glucose level is above 200 mg/dL. Which of the following information should the nurse include?

Expected NPH insulin to peak in 6 to 14 hours. NPH insulin is an intermediate acting insulin. It's onset of action is 1 to 2 hours, peaking at 6 to 14 hours. It's duration of action is 16 to 24 hours. The client is at risk for hypoglycemia during the peak time.

Nurse is teaching a client who has a new prescription for sucralfate to treat a gastric ulcer. Which of the following statements by the client indicates an understanding of the teaching?

"I will take this medication one hour before meals and at bedtime." Client should take this medication on an empty stomach, one hour before each meal and at bedtime to create a protective coating over the ulcer.

A nurse is teaching a client who has a new prescription for fluoxetine to treat depression. Which of the following statements by the client indicates an understanding of the teaching?

"I'll take this medication first thing in the morning." The client should take fluoxetine in the morning to reduce the risk of insomnia.

Nurse is reviewing the laboratory results of a client who has liver failure with ascites and is receiving spironolactone. Which of the following findings should the nurse expect?

Decreased sodium level The nurse should expect a decrease sodium level. Spironolactone is a potassium sparing diuretic that inhibits the action of aldosterone, resulting in an increased excretion of sodium.

A nurse is caring for a client who has heart failure and is receiving IV furosemide. The nurse should monitor the client for which of the following electrolyte in balances?

Hyperuricemia The nurse should monitor the client who is receiving IV furosemide for hyperuricemia. The nurse should instruct the client to notify the provider for any tenderness or swelling in the joints.

Nurse is planning to administer butorphanol to a client who is in labor. Which of the following medication should the nurse plan to have available to reverse the action of this medication?

Naloxone Naloxone is an opioid and analgesic. The nurse should have the opioid reversal agent naloxone and resuscitation equipment available in the event that the client developed respiratory depression.

A nurse is planning care for a client who has a detached retina and is pre-operative for surgical repair. The nurse said prepare to administer which of the following medications?

Phenylephrine My geriatric medication, such as phenylephrine, are use preoperatively to dilate pupils to facilitate inter-ocular surgery.

The nurse is reviewing a clients admission record. The nurse knows that there are prescriptions for several medications. Which of the following factors of the nurse recognize as a primary consideration when determining the schedule of administration?

Specific characteristics of the medication's

A nurse is assessing a client who is receiving dopamine IV to treat left ventricular failure. Which of the following findings should indicate to the nurse that the medication is having a therapeutic effect?

Systolic blood pressure is increased When dopamine has a therapeutic effect, causes vasoconstriction peripherally and increases systolic blood pressure.

Nurse in the emergency department is caring for a client who took three nitroglycerin tablet sublingually for chest pain. The client reports relief from the chest pain but now he is experiencing a headache. Which of the following statements should the nurse make?

"A headache is an expected adverse effect of the medication." The vasodilation nitroglycerin induces increases blood flow to the head and typically results in a headache.

The nurse is teaching a client who has a new prescription for alprazolam to treat insomnia. Which of the following instruction should the nurse include?

"Avoid activities that require alertness such as driving." Play should avoid activities that require alertness. Diazepam is a benzodiazepine that causes sedation and dizziness.

Nurse is teaching a client who has a new prescription for docusate. Which of the following information should the nurse include in the teaching?

"Take the medication with a full glass of water." You should instruct the client to take this medication with a full glass of water, unless contra indicated, to reduce the risk for constipation.

The nurse is teaching a client who has a new prescription for transdermal nitroglycerin to treat angina pectoris. Which of the following instruction should the nurse include in the teaching?

Apply the transdermal patch in the morning. Client should apply the patch every morning and leave it in place for 12 to 14 hours, then remove it in the evening.

A nurse is completing a medical interview with a client who has elevated cholesterol levels and takes warfarin. The nurse should recognize that which of the following actions by the client can potentiate the effects of warfarin?

Client uses garlic to lower cholesterol levels. The nurse should recognize the garlic can potentiate the action of the warfarin.

A nurse is teaching a client who has a new prescription for diazepam. Which of the following information should the nurse include in the teaching?

Diazepam can cause drowsiness. Diazepam has sedative properties, so the client should not engage in potentially hazardous activities after receiving diazepam.

The nurse is preparing to administer heparin to a client. Which of the following action should the nurse plan to take?

Inject the medication into the admin above the level of the iliac crest. The nurse should inject medication into the abdomen above the level of the iliac crest, at least 2 inches from the umbilicus.

A nurse is teaching a client who has a new prescription for regular insulin and NPH insulin. Which of the following instruction should the nurse include in the teaching?

Keep the open vial of insulin at room temperature. The client should keep the vile and use at room temperature to minimize tissue injury and to reduce the risk for Lipodystrophy

Nurse is caring for a client who has prostate cancer. The nurse should expect the provider to prescribe which of the following medication to the client?

Leuprolide Leuprolide treats cancer of the prostate hormonally. It antagonizes the antigens that androgen-dependent neoplasms require.

A nurse is reviewing the medication list for a client who has a new diagnosis of type two diabetes mellitus. The nurse should recognize which of the following medications can cause glucose intolerance?

Prednisone Corticosteroid such as prednisone can cause glucose intolerance and hyperglycemia. The client might require increased dosage of a hypoglycemic medication.

The nurse is preparing to administer a unit of packed red blood cells to a client. Which of the following action should the nurse plan to take?

Remain with the client for the first 15 minutes of the transfusion. There should remain with the client for the first 15 to 30 minutes of the transfusion to monitor for a transfusion reaction, which occurs often during the first 50 mL of the transfusion.

A nurse is teaching a client about the adverse effects of cisplatin. Which of the following adverse effects should the nurse include in the teaching?

Tinnitus Tinnitus and hearing loss are adverse effects of cisplatin

A nurse is teaching a client who has multiple sclerosis about a new prescription for baclofen. Which of the following instruction should the nurse include in the teaching?

"Do not take antihistamines with this medication." The nurse should instruct the client not to take antihistamines while taking baclofen. Antihistamines will intensify the depressant effect of baclofen.

A nurse is teaching a client who takes warfarin daily. Which of the following statements by the client indicates a need for further teaching?

"I have started taking ginger root to treat my joints deafness." Ginger root can interfere with the blood clotting affect of warfarin and place the client at risk for bleeding. This team in indicates the client needs further teaching.

A nurse is teaching a client who has duodenal ulcer about his new prescription for cimetidine. The nurse should include which of the following instructions in the teaching?

"Your doctor might need to reduce your theophylline dose while taking this medication." The nurse should instruct the client that the provider might need to reduce his theophylline dose due to the possibility of increased medication levels.

The nurse is preparing to administer phenytoin IV to a client who has a seizure disorder. Which of the following action should the nurse plan to take?

Administer a saline solution after injection You should flush the injection site with saline solution after the injection of phenytoin to reduce and prevent venous irritation.

The nurse is caring for a child who is experiencing status asthmaticus. Which of the following interventions is a priority for the nurse to take?

Administer a short acting beta two agonist When using the urgent versus non-urgent approach to client care, the nurse should determine that the priority action is to administer a nebulizer high dose short acting beta two agonist to relieve bronchoconstriction and improve ventilation.

The nurse is caring for a client who is postoperative following a trans urethrorrhea resection of the prostate (TURP). The nurse should plan to administer the client PRN bethanechol when the client reports which of the following manifestations?

An inability to void Bethanechol is a cholinergic medication that stimulates the parasympathetic nervous system, that's improving the tone and motility of the smooth muscles of the urinary tract enough to initiate urination.

Nurse is assessing an older adult client who is receiving digoxin. The nurse should recognize that which of the following findings is a manifestation of the digoxin toxicity?

Anorexia Anorexia, vomiting, confusion, headache, and vision changes are a manifestation of digoxin toxicity.

A nurse is providing dietary teaching to a client who takes for Rosa made. The nurse should recommend which of the following foods has the best source of potassium?

Bananas The nurse determine the bananas are the best food source to recommend because one cup of bananas contains 806 mg of potassium. In addition to the potassium supplements the provider might prescribe, the client should increase his daily intake of foods that have high potassium content, such as bananas, orange juice, and spinach.

A nurse is assessing a client who has systemic lupus erythematosus and is taking hydroxychloroquine. The nurse should report which of the following adverse effects to the provider immediately?

Blurred vision When using the urgent versus non-urgent approach to client care, the nurse determines that the priority finding to report to the provider is blurred vision, as this is a manifestation of hydroxychloroquine toxicity and can be an indication of retinal damage.

A nurse is caring for four clients. After administering morning meds, she realizes that the nifedipine prescribed for one client was inadvertently administered to another client. Which of the following actions should the nurse take first?

Check the client's vital signs

A nurse is preparing to initiate a transfusion of packed red blood cells for a client who has anemia. Which of the following actions should the nurse plan to take?

Check the clients vital signs every hour during the transfusion. The nurse should check the clients vital signs every 15 minutes at the start of the transfusion, then every hour to monitor for a transfusion reaction.

A nurse is assessing a client prior to administering a seasonal influenza vaccine. The client says he read about an influenza vaccine that is given as a nasal spray and wants to receive it. The nurse should recognize that which of the following findings is a contra indication for the client receiving the live attenuated influenza virus?

Clients age is 62. Clients must be between the ages of two and 49 to receive the live attenuated influenza vaccine, therefore, it is contraindicated for this client. Pregnancy and immunocompromised status are also contraindications

The nurse is teaching a client how to draw a regular insulin and NPH insulin into the same syringe. Which of the following instruction should the nurse include?

Discard regular insulin that appears cloudy. The nurse should teach the client to discard any regular insulin that appears cloudy, as regular insulin should be clear. NPH insulin has a cloudy appearance.

I clinic nurse is giving instructions to a mother on the proper technique of applying ophthalmic to her pre-school age child who has conjunctivitis. Which of the following should the nurse include in the instructions?

Discard the first bead of ointment before each application.

A nurse is assessing a client who is receiving peritoneal lipid infusion. Which of the following findings is a manifestation of fat overload syndrome?

Elevated temperature An elevated temperature is an early manifestation of fat overload syndrome. The client is at risk for coagulopathy and multiorgan system failure due to fat overload syndrome.

Nurse is caring for a client who is postoperative following hip arthroplasty. The nurse should anticipate which of the following prescriptions for this client?

Enoxaparin The nurse should anticipate a prescription for enoxaparin as prophylaxis therapy for venous thromboembolism. Client following hip arthroplasty are usually on anticoagulants for 3 to 6 weeks after surgery.

A nurse is caring for a client who has just begun therapy with alprazolam to treat anxiety. The nurse should monitor the client for which of the following adverse effects of this medication?

Insomnia Nurse should monitor the client for paradoxical effects such as insomnia and excitation. If this occurs, the medication should be withdrawn.

A nurse is caring for a client who is experiencing severe nausea and vomiting after a course of chemotherapy. The nurse should monitor the client for which of the following clinical manifestations?

Metabolic alkalosis Metabolic alkalosis can occur in clients who have excessive vomiting because of the loss of hydrochloric acid.

A nurse is preparing to administer nalbuphine to a postoperative client who is experiencing pain. The nurse should monitor the client for which of the following potential adverse effects of this medication

Miosis Adverse effects to nalbuphine include visual disturbances such as meiosis, blurred vision, and diplopia.

A nurse is teaching a client who has a new prescription for dimenhydrinate. Which of the following instruction should the nurse include in the teaching?

Monitor for dizziness Client should monitor for dizziness and avoid activities that require alertness because dimenhydrinate can cause dizziness and drowsiness.

There's is caring for a client who has thrombophlebitis and is receiving a continuous heparin infusion. Which of the following medication should the nurse have available to reverse heparin effect?

Protamine sulfate Protamine sulfate reverses the effects of heparin by binding the heparin to form a heparin-protamine complex that has no anticoagulant properties.

A nurse is assessing a client who is on long-term omeprazole therapy. Which of the following findings should indicate to the nurse the medication is effective?

Reduce dyspepsia Omeprazole, a protein pump inhibitor, reduces gastric acid secretion and treats duodenal and gastric ulcers, prolong dyspepsia, gastrointestinal reflux disease, and erosive esophagus

A nurse is assessing a client prior to the administration of morphine. The nurse should recognize that which of the following assessments is the priority?

Respiratory rate When using the airway, breathing, circulation approach the client care, the nurse should determine the priority assessment is respiratory rate. Morphine can cause respiratory depression. The nurse should withhold the medication and notify the prescriber if the client has a respiration rate of less than 12 per minute.

A nurse is assessing a client who is receiving a unit of packed red blood cells. The client appears flushed and reports low back pain. Which of the following actions is the nurses priority?

Stop the infusion The greatest race to the client is injury due to further hemolysis, therefore the priority action is to stop the transfusion.

A nurse is caring for a client who is receiving a transfusion of packed red blood cells and suspects that the client is experiencing a hemolytic reaction. Which of the following intervention is the priority?

Stop the transfusion Greatest risk for the client is injury due to further hemolysis, therefore, the priority action is to stop the transfusion. Unsuspecting a hemolytic reaction, the priority action by the nurse is to immediately stop the transfusion to prevent further hemolysis.

A nurse is teaching a client who has iron deficiency anemia about ferrous sulfate. Which of the following instruction should the nurse include in the teaching?

Take the ferrous sulfate between meals. The client should take the medication between meals for optimal absorption.

Nurse is assessing a client who is receiving a unit of packed red blood cells. Which of the following findings is a manifestation of acute hemolytic reaction?

The client reports low back pain. Manifestations of an acute hemolytic reaction include apprehension, tachypnea, hypertension, chest pain, and lower back pain.

A home health nurse is assessing an older adult client who reports falling a couple of times over the past week. Which of the following findings should the nurse expect is contributing to the clients Falls?

The client takes alprazolam. Alprazolam is a CNS depressant that can cause dizziness and orthostatic hypotension, which can cause the client to lose his or her balance and fall down

A charge nurse is supervising a newly licensed nurse care for a client who is receiving a transfusion of packed red blood cells. The nurse suspects a possible hemolytic reaction. After stopping the blood transfusion, which of the following actions by the new nurse requires intervention by the charge nurse?

The nurse starts the transfusion of another unit of blood product. When suspecting a hemolytic reaction, the nurse should immediately stop the transition of all blood products. The transfusion of additional products can increase the clients risk for further complication.

The nurse is preparing to transfuse one unit of packed red blood cells to a client who experienced a mild allergic reaction during a previous transfusion. The nurse should administer diphenhydramine prior to the transfusion for which of the following allergic responses?

Urticaria For clients who have previously had allergic reactions to blood transfusions, administering an antihistamine such as diphenhydramine prior to the transfusion may prevent further reactions. Allergic reactions typically induce uticaria which are hives

A nurse is providing discharge teaching for a client who has a new prescription for warfarin. Which of the following instruction should the nurse include in the teaching?

Use an electric razor while on this medication. Warfarin, an anticoagulant, increases the clients risk for bleeding. The nurse should teach the client safety measures, such as using an electric razor, to decrease the risk for injury and bleeding.

Nurse is instructing the parents of a client who has a new prescription for methylphenidate. Which of the following instruction should the nurse include?

Void activities that require alertness such as driving The client should avoid driving and other activities that require alertness until the effects of this medication or known.

A nurse is educating a group of clients about the contra indications of warfarin therapy. Which of the following statements should the nurse include in the teaching?

Clients who are pregnant should I take warfarin Warfarin therapy is contra indicated in the pregnant client because it crosses the placenta and places the fetus at risk for bleeding.

A nurse is teaching a client who has a new prescription for pancrelipase to aid in digestion. The nurse should inform the client to expect which of the following gastrointestinal changes?

Decreased fats in stools Pancrelipase is a combination of pancreatic enzymes used to increase digestion of fats, carbohydrates and proteins. The client should expect a reduction in fat in the stools.

A nurse is teaching a client who has a new prescription for disulfiram. Which of the following information should the nurse include in the teaching?

"Do you not drink alcohol while taking this medication." Disulfiram is the type of inversion therapy that helps maintain abstinence from alcohol. Drinking alcohol while taking this medication can produce a life-threatening response that can include palpitations, headache, and hypotension. Therapy was not begin until the client has abstain from alcohol for at least 12 hours. The client should avoid all forms of alcohol including cough syrup and aftershave lotion's.

Nurse is teaching a client who has a new prescription for colesevelam to lower his low density lipoprotein level. Which of the following instruction should the nurse include?

"Take this medication four hours after other medications." The client should take this medication for hours after other medication's to increase absorption of the medication.

The nurse is teaching a client who has a new prescription for aluminum hydroxide to treat heartburn. The nurse should instruct the client to monitor for and report which of the following adverse reactions?

Constipation Aluminum hydroxide can cause constipation. The nurse should tell the client to increase fluid and fiber intake to reduce the risk for constipation.

A nurse is caring for a client who is receiving mydriatic eye drops. Which of the following manifestations indicates to the nurse that the client has developed a systemic anticholinergics effect?

Constipation Mydriatic eye drops can cause systemic anticholinergic effects such as constipation and dry mouth.

A nurse is reviewing discharge instructions with a client who has bipolar disorder and is taking lithium. Which of the following manifestations should the nurse include as an indication of mild toxicity?

Muscle weakness The nurse should instruct the client that muscle weakness is a manifestation of mild toxicity.