ATI pharm questions

A nurse is teaching a client who has a prescription for a transdermal estradiol patch. In which of the following locations should the nurse instruct the client to apply the patch? A. Abdomen B. Breast C. Forearm D. Back of the thigh

Abdomen This area allows the estrogen from the patch to be absorbed through the skin directly into the client's blood

Epinephrine

Adrenergic drug used to treat bronchospasm, severe allergic reactions, and cardiac arrest

Atropine

Anticholinergic drug used to treat symptomatic bradycardia and AV blocks

A nurse in a postpartum unit is caring for a client who plans to breastfeed her newborn exclusively. The client as a prescription for depot medroxyprogesterone acetate (DMPA). At which of the following times should the nurse schedule the client to receive the first dose of the medication A. After 3 months postpartum B. At 6 weeks postpartum C. Within the first 5 days postpartum D. During the first week of the first postpartum menstrual cycle

At 6 weeks postpartum The second dose is administered 3 months after the first dose

A nurse is providing teaching to a client who has HTN and a new prescription for oral clonidine. Which of the following instructions should the nurse include in the teaching? A. Discontinue the med if a rash develops B. Expect increased salivation during the first few weeks of therapy C. Minimize fiber intake to prevent diarrhea D. Avoid driving until the client's reaction to the medication is known

Avoid driving until the client's reaction to the medication is known Clonidine can cause drowsiness, weakness, sedation, and other CNS effects. Until the client's response to the med is known, the nurse should instruct the client to avoid driving or handling other potentially hazardous equipment. SE: dry mouth, constipation

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 the med? A. Blood pressure B. Temperature C. Blood glucose levels D. Total protein level

Blood pressure Epoetin alfa often causes hypertension, which can lead to stroke or other cardiovascular complications. A client who receives epoetin alfa frequently requires concurrent use of an antihypertensive med

A nurse is teaching a client who has primary adrenal insufficiency (Addison's disease) and a prescription for hydrocortisone. Which of the following statements should the nurse include in the teaching? A. You may need to take a lower dose when you are ill or experiencing stress B. Take this med before going to bed because it will make you tired C. Carry a supply of pills and a single-use injectable preparation with you at all times D. You will need to stop this med before routine procedures such as a colonoscopy

Carry a supply of pills and a single-use injectable preparation with you at all times The client should take the med upon awakening because levels of cortisol secretion naturally peak in the morning

A nurse is caring for a client with a new diagnosis of rheumatoid arthritis. The nurse should anticipate a prescription from the provider for which of the following medications for daily management of this condition? A. Celecoxib B. Prednisone C. Adalimumab D. Abatacept

Celecoxib = an NSAID Prednisone is indicated for severe RA as well as Adalimumab and Abatacept

A nurse is caring for a client who has congestive HF and is taking digoxin. The client reports nausea and refuses to eat breakfast. Which of the following actions should the nurse take first? A. Encourage the client to eat the toast on the breakfast tray B. Administer the antiemetic C. Inform the client's provider D. Check the client's apical pulse

Check the clients apical pulse Nausea. anorexia, fatigue, visual effects, and cardiac dysrhythmias (often caused by a slow pulse rate) are possible findings for digoxin toxicity. Caring for this client requires the nursing process and assessment comes first. Before the nurse can formulate a plan of action, implement a nursing intervention, or notify the provider, the nurse must first collect adequate data from the client.

Aminoglycosides and most common SE

Gentamicin - ototoxicty Tobramycin - ototoxicity Amikacin - ototoxicity

A nurse is reviewing a new prescription for fexofenadine for a 7 year old who has seasonal allergies. Which of the following findings should the nurse clarify with the provider? A. The prescription says to avoid taking the med with orange juice B. The prescription says to take standard tablets C. The prescription says to take 30 mg twice daily D. The prescription says to administer the med orally

The prescription says to take standard tablets Standard tablets are appropriate for clients 12 years of age and older

A nurse is teaching about the adverse effects of morphine with a client who has acute pain. Which of the following statements should the nurse include in the teaching? A. You might notice that you see better in dim areas B. You should increase your fluid intake C. You should expect to have excessive urination D. You might experience difficulty sleeping

You should increase your fluid intake An adverse effect of morphine is constipation. Therefore increase oral fluids to promote motility of the bowel SE: pupillary constriction, urinary retention, sedation, drowsiness

A nurse is providing discharge teaching to a client who had a bleeding duodenal ulcer and has been prescribed omeprazole. Which of the following statements should the nurse include in the teaching? A. You will need to take this medication for the next 6 months B. Taking this medication will decrease your risk of pneumonia C. You should take this medication before breakfast every day Watch for serious adverse effects of tachycardia and heart palpitations

You should take this med before breakfast every day Clients who have active duodenal ulcer or GERD should take omeprazole once daily before a meal because the med is less effective when taken with food SE: diarrhea, n/v, headaches

A nurse is caring for a client who has COPD and has been taking fluticasone via inhaler for many years. Which of the following findings should the nurse identify as an adverse effect of long-term use A. GFR <60 B. ALT 82 units C. Anorexia and weakness D. Varicose veins in the lower extremities

Anorexia and weakness The nurse should identify adrenal insufficiency as an adverse effect of the long-term use of an inhaled corticosteroid such as flucatasone SE: anorexia, weakness, nausea, hypotension, hypoglycemia

Phenytoin

Anticonvulsant used to treat seizures, digoxin induced ventricular dysrhythmias, and neuropathic pain

A nurse working in the ED is admitting a client who has a gastric ulcer and a GI bleed. Which of the following factors in the client's history should the nurse report to the provider? A. Arthritis treated with ibuprofen every 8 hours as needed B. Previous tobacco smoking with cessation 5 years ago C. Negative H. pylori breath test 1 year prior D. Prescribed bismuth subsaliclate as needed for GI upset

Arthritis treated with ibuprophen NSAIDs can cause GI bleeding and are contraindicated for clients who have ulcer disease. NSAIDs inhibit prostaglandin secretion, which decreases blood flow in the GI tract and decreases bicarbonate and mucus secretion. This environment promotes the secretion of gastric acid and needs to be reported to the provider

A nurse is preparing to administer meds to a client who is NPO and is receiving enteral feedings through an NG tube. Which of the following prescriptions should be clarified with the provider? A. Aspirin EC 325 mg per day B. Atorvastatin 40 mg per day C. Propanolol 20 mg per day D. Sucralfate 2 g oral suspension BID

Aspirin EC 325 Enteric-coated tablets should not be crushed

A nurse is preparing to administer timolol eye drops to a client who has primary open-angle glaucoma (POAG). Prior to administering the med, the nurse should recognize that which of the following conditions in the client's medical history is a contraindication to receiving this med? A. HTN B. Peripheral vision loss C. Asthma D. Increased intraoculuar pressure

Asthma Timolol is a beta blocker that can cause blocking of the beta 2 receptors, causing bronchospasm. SE: hypotension

A nurse is providing teaching about food-drug interactions to a client who is prescribed sirolimus following a kidney transplant. Which of the following pieces of information should the nurse include in the teaching? A. Increase your intake of high-fat foods B. Avoid eating grapefruit while taking C. Drink apple juice just before dosing D. Reduce your intake of gluten

Avoid eating grapefruit while taking Grapefruit juice can inhibit the metabolism of sirolimus. This means that consuming grapefruit and grapefruit juice would cause the levels of the medication to rise, which could have adverse effects

A nurse is caring for a client with a pseudomonas infection who has a new prescription for ticarcillin-clavulanate. Which of the following data should the nurse collect before administering this medication? A. Indications of a superinfection B. Peak and trough levels C. Baseline BUN and creatinine D. Hx of allergy to amino glycoside antibiotics

Baseline BUN and creatinine Ticarcillin-clavulanate is a penicillin antibiotic and is excreted by the kidneys. Therefore, any renal impairment could result in a toxic level of the medication.

A nurse is caring for a client who has a prescription for clopidogrel. The nurse should monitor the client for which of the following adverse effects? A. Insomnia B. Hypotension C. Bleeding D. Constipation

Bleeding Clopidogrel is an antithrombotic med that inhibits platelet aggregation. It is used to prevent stenosis of coronary stents, MIs, and strokes. The nurse should monitor for coffee ground emesis, black tarry stools, ecchymosis, or any indication of bleeding

A nurse is administering insulin glulisine 10 units sub q at 0730 to an adolescent client who has type 1 DM. The nurse should anticipate the onset of action of the insulin at which time? A. 0800 B. 0745 C. 0900 D. 1030

0745 Glulisine has a very short onset of action of 15 minutes. The nurse should ensure the client eats breakfast immediately following the administration of the insulin

A nurse is preparing to administer azithromycin 150 mg liquid suspension PO every 12 hours. Available is 50mg/ 5mL. How many mL should the nurse administer per dose?

15

A nurse is caring for a client who is receiving sumatriptan for cluster headaches. Which of the following findings should the nurse expect as an adverse effect? A. Hypotension B. Tinnitus C. Urinary retention D. Chest pressure

Chest pressure A client who takes sumatriptan can develop sensations of chest pressure and heavy arms SE: alterations in vision, transient htn

A nurse is preparing to administer an epinephrine IV bolus to a client. which of the following should the nurse verify before initiating the IV med? A. Concentration of the formula B. Reversibility of the med C. Potential barriers to absorption D. Gastric emptying time

Concentration of the formula The nurse should verify the concentration of the formulation of the medication prior to administration. Epinephrine can be injected through several routes, and a solution prepared for use by a certain route can differ in concentration from others. Solutions intended for subcutaneous administration are generally concentrated, whereas solutions intended for intravenous use are dilute. If a solution prepared for subcutaneous administration is administered intravenously, the result could be fatal because intravenous administration of concentrated epinephrine can overstimulate the heart and blood vessels, causing severe hypertension, cerebral hemorrhage, stroke, and death Once a medication has been injected intravenously, it cannot be reversed. To minimize the risk of adverse reactions and toxicity, IV medications should be injected slowly to dilute in the largest volume of blood possile. If any manifestations of toxicity appear, the administration should be discontinued immediately IV administration places a medication directly into the bloodstream. When a medication is administered IV, there are no barriers to absorption because absorption is bypassed Gastric emptying time affects the absorption pattern of oral routes of administration. However, it has no effect on IV medication therapy. IV medication administration results in absorption that is both instantaneous and complete

A nurse is caring for a client who has asthma and advanced RA and deformity of the hands. The nurse should anticipate that the client will receive which of the following medication delivery devices for the treatment of asthma? A. Dry-powder inhaler (DPI) B. Metered-dose inhaler (MDI) with spacer C. Respimat D. Nebulizer

DPI DPI's do not require hand-breath coordination and are easier to use for clients who have deformities of the hands

A nurse is caring for a client who is taking budesonide to treat Crohn's disease. Which of the following findings should indicate to the nurse that the treatment is effective? A. Decreased blood glucose B. Increased potassium C. Increased prostaglandin synthesis D. Decreased inflammation

Decreased inflammation For a client with Crohn's disease, a decrease in inflammation of the GI lining of the client's large intestine is a therapeutic effect of taking budesonide. Budesonide is a glucocorticoid that works by suppressing the immune system. Glucocorticoids inhibit the actions of prostaglandins and leukotrienes

A nurse is monitoring a client who has asthma, takes albuterol, and recently started taking propranolol to treat a cardiovascular disorder. The client reports that the albuterol has been less effective. Which of the following factors should the nurse identify as a possible explanation for this change? A. Potentiative interaction B. Detrimental inhibitory reaction C. Increased adverse reaction D. Toxicity-reducing inhibitory interaction

Detrimental inhibitory interaction When taken together, propranolol can interfere with albuterol's therapeutic effects

A nurse is reviewing the medical record of a client who is receiving hydrochlorothiazide (HCTZ). The nurse should expect to find an improvement in which of the following conditions as a result of this medication? A. Gouty arthritis B. Dehydration C. Diabetes insipidus D. Hypokalemia

Diabetes insipidus Diabetes insipidus is a kondition in which there is an overproduction of urine. Thiazides reduce urine production by 30-50% SI: hypokalemia due to excessive potassium excretion

A nurse is caring for a client for a client who is taking acarbose to treat type 2 DM. Which of the following adverse effects should the nurse monitor for? A. Insonnia B. Diarrhea C. Joint pain D. Polycycthemia

Diarrhea The most common SEs of acarbose, an alpha glucosidase inhibitor, is GI. They include diarrhea, abdominal distention and cramping, and flatulence

A nurse is caring for a client who is taking acarbose to treat type 2 DM. For which of the following adverse effects of this medication should the nurse monitor for the client? A. Insomnia B. Diarrhea C. Joint pain D. Polycythemia

Diarrhea The most common adverse effect of acarbose, an alpha-glucosidase inhibitor, are GI. The include diarrhea, abdominal distention and cramping, and flatulence SE: sleepiness, headache, anemia

A nurse is caring for a client who is receiving continuous cardiac monitoring. Which of the following meds should the nurse anticipate administering to treat a fib? A. Atropine B. Diltiazem C. Epinephrine D. Phenytoin

Diltiazem Diltiazem , a calcium channel blocker, is used to slow the ventricular rate in a fib or flutter. Diltiazem is also used to treat htn, angina, and other supra ventricular tachyarrhythmias

A nurse is caring for a client who is receiving cefotetan 1 g via intermittent IV bolus every 12 hours to treat a postoperative infection. Which of the following manifestations should the nurse monitor for as an adverse effect of the med? A. Disorientation B. Epistaxis C. Constipation D. Jaundice

Epistaxis Cefotetan is an antibiotic that affects vitamin K levels, which can result in bleeding and epistaxis. The nurse should monitor for bleeding and notify the provider if it occurs so the med can be discontinued Other: Cefotetan is a second generation cephalosporin, a class of antibiotics that does not manifest disorientation as an adverse effect

A nurse is caring for a client who takes scheduled morphine for cancer pain. The client reports experiencing breakthrough pain. The nurse should anticipate a prescription from the provider for which of the following meds to treat breakthrough pain? A. Meperidine B. Buprenorphine C. Methadone D. Fentanyl

Fentanyl The nurse should expect a prescription for fentanyl trans mucosal (nasal spray) to treat breakthrough pain. Fentanyl is an opioid agonist with a rapid onset and a duration of 2 to 4 hours. Fentanyl should not interfere with the client's long-term opioid medication

A nurse is providing teaching to a client who has gout and a new prescription for allopurinol. The nurse should instruct the client to discontinue taking the medication for which of the following adverse effects? A. Nausea B. Metallic taste C. Fever D. Drowsiness

Fever A fever can indicate a potentially fatal hypersensitivity reaction. The client should discontinue allopurinol and notify the provider if a fever or rash develops SE: metallic taste, mild GI effects, drowsiness

A nurse is preparing to administer the varicella vaccine to a 12 month old. The nurse asks the infants guardian if the infant has any allergies. Which of the following allergies in a contraindication to receiving the vaccine? A. Gelatin B. Milk C. Eggs D. Peanuts

Gelatin

A nurse is providing teaching to a newly licensed nurse about caring for a client who has a prescription for gemfibrozil. The nurse should instruct the newly licensed nurse to monitor which of the following lab tests? A. Platelet count B. Electrolyte levels C. Thyroid function D. Liver function

Gemfibrozil reduces triglycerides by decreasing the liver's uptake of fatty acids. It can cause liver toxicity; therefore the nurse should monitor the client's liver funciton

A nurse is caring for a client who takes warfarin to treat chronic atrial fibrillation and has early manifestations of Alzheimer's disease. The client's partner asks the nurse if the client would benefit from taking ginkgo biloba. Which of the following responses should the nurse make? A. Ginkgo will likely interfere with the effectiveness of his other medication B. You should ask his provider if ginkgo is safe C. Ginkgo is most effective in the later stages of AD D. People who have AD should there to the medication regimen

Ginkgo will likely interfere with the effectiveness of his other medication Ginkgo may delay the mental deterioration of AD if taken in the early stages. Research has not demonstrated this, however. More importantly, ginkgo increases the client's risk of bleeding when taken with warfarin

A nurse is caring for a client who has osteoporosis and has been taking a vitamin D supplement. The nurse notes that the client reports also taking a multivitamin daily. Which of the following findings should indicate to the nurse that the client might be experiencing vitamin D toxicity? A. Hyperkalemia B. Hypermagnesemia C. Hypercalcemia D. Hypernatremia

Hypercalcemia Vitamin D increases plasma calcium levels by increasing reabsorption from bone, deceasing excretion by the kidneys and increasing absorption from the intestines. Clients who take a vitamin D supplement along with a multivitamin daily might be taking too much calcium

A nurse is caring for a client who has a new prescription for enalapril. the nurse should monitor the client for which of the following adverse effects of this medication? A. Ecchymosis B. Jaundice C. Hypotension D. Hypokalemia

Hypotension ACE inhibitors can cause hypotension and postural hypotension, especially during the first 3 hours following the initial dose

A nurse is planning to administer diltiazem via IV bolus to a client who has a fib. When assessing the client, the nurse should recognize that which of the following findings is a contraindication to administration of diltiazem? A. Hypotension B. Tachycardia C. Decreased LOC D. Hx of diuretic use

Hypotension Diltiazem can be a tx option for essential htn. This med will lower BP and is contraindicated for a client who is hypotensive

A nurse is caring for a client with benign prostatic hyperplasia who has a new prescription for doxazosin. Which of the following manifestations should the nurse monitor for as an adverse effect of doxazosin? A. Seizures B. Tachycardia C. Bronchodilaiton D. Hypotension

Hypotension Nonselective alpha-1 adrenergic antagonists like doxazosin block sympathetic receptors in the blood vessels as well as receptors in the bladder. These agents promote vasodilation, which can cause decreased BP

A nurse is providing discharge teaching to a client who had a kidney transplant and has a prescription for oral cyclosporine. Which of the following statements by the client indicates an understanding of the teaching? A. I will be able to stop taking this med within 6 months after my surgery B. I am likely to develop higher BP while taking this med C. I am likely to lose my hair while taking this med D. I am taking this med to boost my immune system

I am likely to develop higher BP while taking this med Half the clients who take cyclosporine develop a 10-15% increase in BP and might need to start antihypertensive therapy

A nurse is proving discharge teaching about lithium toxicity to a client who has a new prescription for lithium. Which of the following statements by the client indicates an understanding of the teaching? A. I should take naproxen if I have a headache B. I can develop lithium toxicity if I eat foods with lots of sodium C. I can develop lithium toxicity if I experience vomiting or diarrhea D. I might need to take a daily diuretic along with my lithium to prevent lithium toxicity

I can develop lithium toxicity if I experience vomiting or diarrhea Vomiting or diarrhea can cause electrolyte imbalances. If serum sodium decreases, lithium is retained by the kidneys and the risk of lithium toxicity increases

A nurse is monitoring a client who received diphenoxylate-atropine. Which of the following statements by the client should indicate to the nurse that the med has been effective? A. I feel a little drowsy with this medication B. I am now drinking much more water C. I have not had a bowel movement today D. I no longer feel chest tightness

I have not had a bowel movement today Diphenoxylate-atropine is an opioid used to treat diarrhea

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? A. I need to wear the patch continuously for it to be effective B. I will stop using the patch immediately if it gives me a headache C. I should change the patch whenever I have chest pain D. I need to rotate the location of my patch every few days

I need to rotate the location of my patch every few days The nitro patch should be rotated to different hairless areas of the client's body every few days to avoid local skin irritation A common SE is headache Nitro patches should be worn for 12-14 hours and removed at night so that tolerance to the med doesn't develop

A nurse is teaching a client who has a new prescription for disulfiram to treat alcohol use disorder. Which of the following statements by the client indicates an understanding of the teaching? A. If I have a strong urge to drink alcohol, I should skip my dose for the day B. Even when I'm not drinking alcohol, adverse effects can include seizures C. Medication therapy can begin as soon as I enter the detoxification program D. I should check the labels of my skin care products, medications, and food for alcohol

I should check the labels of my skin care products, medications, and food for alcohol The nurse should inform the client that 7mL of alcohol is needed to precipitate adverse effects of the med. Alcohol can be found in cough syrups, vinegar, and sauces

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? A. Nausea is a common adverse effect of this med B. I should contact my provider immediately if I experience constipation C. If I do not respond to tx at the lowest dose, my provider may continue to increase the dosage at weekly intervals D. Abdominal pain with diarrhea can indicate a serious complication

I should contact my provider immediately if I experience constipation

A nurse is teaching a client who will be taking dexamethasone daily for the pain due to spinal edema. The nurse should identify which of the following client statements as an indication that the teaching has been effective? A. I should eat a snack at bedtime to avoid low blood glucose B. I should stay away from people who are ill C. I should increase my fluid intake to about 3 quarts per day D. I should call my provider if I am experiencing too much sedation

I should stay away from people who are ill This med is a glucocorticoid that decreases inflammation by affecting the client's immune system. As a result, the client is susceptible to infection and should avoid large crowds and people who are ill

A nurse is teaching a client who will be taking dexamethasone daily for pain due to spinal edema. The nurse should identify which of the following client statements as an indication that the teaching has been effective? A. I should eat a snack at bedtime to avoid low BG B. I should stay away from people who are ill C. I should increase my fluid intake to about 3 quarts/ day D. I should call my provider if I am experiencing too much sedation

I should stay away from people who are ill This med is a glucocorticoid that decreases inflammation by affecting the client's immune system. As a result the client is susceptible to infection. SE: high BG, fluid retention

A nurse is providing teaching to a client with chronic bronchitis about administering acetylcysteine using a hand held nebulizer. Which of the following client statements indicates an understanding of the teaching? A. I should discard an open vial of the med after 24 hours B. I should limit my fluid intake while using this med C. I should try to cough productively just before I begin the tx D. If the med becomes discolored, I should throw it out and get a new supply

I should try to cough productively just before I begin the tx A productive cough prior to the beginning of tx will clear sputum from lung surfaces, allowing better absorption of the med Other: Can be stored for 96 hours, after opening the med might develop a light purple color

A nurse is teaching a client who has osteoporosis and a new prescription for alendronate. Which of the following client statements indicates that the teaching was effective? A. I should take the med with a glass of orange juice B. I will allow the med to dissolve slowly in my mouth C. I will sit upright for 30 minutes after taking this med D. I should take the med right after eating breakfast

I will sit upright for 30 minutes after taking this med B. Esophagitis is an adverse effect. To minimize the risk, the nurse should instruct the client to take the med with a full glass of water and not OJ or coffee D. Absorption of alendronate is significantly diminished when taken with food. The med is to be taken on an empty stomach, and the client should wait 30 min before consuming food

A nurse is reviewing the medical record for a client who has a migraine and a prescription for sumatriptan. Which of the following factors in the client's medical history should the nurse identify as a contraindication? A. Renal impairment B. Ischemic heart disease C. Severe osteoporosis D. Cirrhosis

Ischemic heart disease Sumatriptan is a serotonin receptor agonist that can cause vasoconstriction and coronary vasospasm. This med is also contraindicated in clients who had an MI, coronary artery disease, or uncontrolled htn

A nurse is providing teaching to a client who has ulcerative colitis and a new prescription for sulfasalazine. The nurse should instruct the client to monitor for which of the following adverse effects of this med? A. Jaundice B. Constipation C. Oral candidiasis D. Sedation

Jaundice Sulfasalazine can cause a yellow discoloration of the skin and yellow/ orange discoloration of the urine. The nurse should instruct the client to notify the provider if these occur SE: bloody diarrhea, stomatitis, headache, peripheral neuropathy

A nurse is teaching a client about the use of a dinoprostone vaginal insert pouch to stimulate labor. Which of the following statements should the nurse include in the teaching? A. It is inserted using a catheter B. One pouch is given every 4 hours until labor occurs C. Lie on your back for at least 2 hours without getting up D. If labor doesn't occur within 6 hours, a second dose can be administered

Lie on your back for at least 2 hours without getting up Remaining supine allows a slow release of the medication from the pouch Lasts up to 12 hours

A nurse is teaching a client with type 2 DM about a prescription for insulin lispro. Which of the following statements should the nurse include in the teaching? A. The effectiveness can last for 8-12 hours B. Administer 30 to 60 minutes before eating C. Lispro has an onset of about 15 minutes D. This insulin can be given as a continuous IV bolus

Lispro has an onset of about 15 minutes Lispro is a rapid-acting insulin and has an onset of 15 to 30 minutes Duration 3 to 6 hours

A nurse is monitoring a client who is receiving terbutaline to suppress preterm labor. Which of the following findings should indicate to the nurse that the client is experiencing an adverse effect of the med? A. BP 132/84 B. Blood glucose 106 C. Decreased deep tendon reflexes D. Maternal HR >120

Maternal HR >120 A client receiving terbutaline can experience tachycardia, which poses a significant risk to the mother. Therefore, when the maternal HR exceeds 120, the med should be stopped. Adverse effects result from activating beta1 receptors as well as beta2 receptors

A nurse is providing teach to a client who has type 2 DM and a new prescription for metformin. Which of the following adverse effects of metformin should the nurse instruct the client to watch for and report to the provider? A. Weight gain B. Myalgia C. Hypoglycemia D. Severe constipation

Myalgia Myalgia, malaise, somnolence, and hyperventilation are manifestations of lactic acidosis, which rarely occurs while taking metformin due to the blockage of lactic acid oxidation. SE: weight loss, n/v, diarrhea

A nurse is providing teaching to a nurse who has type 2 DM and a new prescription for metformin. Which of the following adverse effects of metformin should the nurse instruct the client to watch for and report to the provider? A. Weight gain B. Myalgia C. Hypoglycemia D. Severe constipation

Myalgia Myalgia, malaise, somnolence, and hyperventilation are manifestations of lactic acidosis, which rarely occurs while taking metformin due to the blockage of lactic acid oxidation. SE: weight loss, n/v, diarrhea

A nurse is caring for a client who has a new prescription for amphotericin B. The nurse plans to monitor the client for which of the following adverse effects? A. Hyperkalemia B. HTN C. Constipation D. Nephrotoxicity

Nephrotoxicity Amphotericin B is an antifungal used to treat severe fungal infections. The nurse should monitor the client's creat every 3-4 days and increase fluid intake. The dosage should be decreased if the creat is >3.5 SE: hypokalemia, hypotension, diarrhea

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 of the following meds should the nurse administer? A. Simvastin B. Furosemide C. Nitroglycerin D. Sildenafil

Nitroglycerin Nitro acts directly on vascular smooth muscle to promote vasodilation

A nurse is caring for a client who has schizophrenia and a prescription for chlorpromazine. For which of the following adverse effects should the nurse monitor? A. Orthostatic hypotension B. Diarrhea C. Urinary frequency D. Bradycardia

Orthostatic hypotension SE: palpitations, tachycardia, constipation, sedation, photosensitivity

A nurse is planning care for a client who has seizure disorder and a new prescription for valproic acid. Which of the following lab results should the nurse plan to monitor? A. BUN B. PTT C. AST D. Urinalysis E. ALT

PTT, AST, ALT Valproic acid can alter coagulation (monitor PT and PTT). It can also cause life threatening hepatotoxicity; the client should have baseline liver function tests before starting this med and during

A nurse is assessing a client who was recently admitted and has a history of alcohol use disorder. The client displays ataxia, altered LOC, and nystagmus. Which of the following meds should the nurse anticipate administering to the client? A. Parenteral thiamine B. Niacin extended release capsules C. Parenteral pyridoxine D. Riboflavin tablets

Parenteral thiamine This client is exhibiting manifestations of Wernicke-Korsakoff syndrome due to a thiamine deficiency

A nurse is assessing a child who has acute lymphocytic leukemia and is receiving vincristine sulfate. Which of the following findings is the nurse's priority? A. Paresthesia B. Alopecia C. Stomatitis D. Constipation

Paresthesia The greatest risk to this client is neurotoxicity. Vincristine, a cell cycle specific chemo agent interrupts cellular reproduction at mitosis and can cause neurotoxicity. An early finding with neurotoxicity is paresthesia (numbing) of the peripheral extremities. As neurotoxicity progresses, the client can develop autonomic and central nervous system dysfunction

A nurse is providing teaching to a client who has a new prescription for doxycycline. The nurse should instruct the client to monitor for which of the following adverse effects? A. Photosensitivity B. Constipation C. Ototoxicity D. Blurred vision

Photosensitivity An adverse effect of doxycycline, a tetracyclic antibiotic, is photosensitivity. This makes the skin react abnormally to light, especially ultraviolet radiation or sunlight. SE: diarrhea

A nurse is teaching about benzos to a client who is discontinuing long-term alprazolam use. Which of the following pieces of info should the nurse include in the teaching? A. You might experience somnolence B. Plan to taper the dose slowly over several months C. Call the provider if you have muscle weakness D. Confusion is common during this process

Plan to taper the dose slowly over several months The nurse should instruct the client to plan to taper the alprazolam dose slowly over several weeks or months to ease the physiological and psychological manifestations of withdrawal Alprazolam, a benzodiazepine and CNS depressant, can cause drowsiness. However, during discontinuation of the medication, the client might experience periods of insomnia The client should call the provider if muscle twitching occurs. Alprazolam can cause muscle twitches and convulsions if it is discontinued too rapidly Alprazolam can cause confusion if acute toxicity occurs from oral overdose. However, the client might experience periods of paranoia and delirium if the medication is discontinued too rapidly

A nurse is monitoring the laboratory values of a male client who has leukemia and is receiving weekly chemotherapy with methotrexate via IV infusion. Which of the following lab values should the nurse report to the provider? A. BUN 18 B. Platelets 78,000 C. Hgb 14.2 D. AST 35 units

Platelets 78,000 This med can cause thrombocytopenia. This client's platelet count is very low and puts the client at risk for severe bleeding

A nurse is providing teaching to a client who has chronic kidney failure with an AV fistula for hemodialysis and a new prediction for epoetin alfa. Which of the following therapeutic effects of epoetin alfa should the nurse include in the teaching A. Reduces BP B. Inhibits clotting of fistula C. Promotes RBC production D. Simulates growth of neutrophils

Promotes RBC production Epoetin alfa stimulates erythropoiesis in the bone marrow to increase RBC production and reduce anemia. Anemia is common in clients who have chronic kidney failure since erythropoietin is produced by the kidneys

A nurse is caring for a client who is experience an acute asthma exacerbation. Which of the following meds should the nurse identify as being contraindicate for this client? A. Dextromathorphan B. Montelukast C. Ciprofloxcain D. Propranolol

Propranolol The nurse should identify that a client who is experiencing an acute asthma exacerbation requires the use of a beta2 agonist to alleviate bronchospasm and relax the client's airway. Therefore, propranolol is contraindicated for this client. Propranolol is a beta blocker that is used to treat cardiac condition, including htn. Blocking the beta receptors prevents the action of beta2 agonists such as albuterol

A nurse is providing teaching to a client who has cirrhosis and a new prescription for lactulose. The nurse should instruct the client that lactulose has which of the following therapeutic effects? A. Increases BP B. Prevents esophageal bleeding C. Decreases HR D. Reduces ammonia levels

Reduces ammonia levels Lactulose is a laxative that promotes the excretion of ammonia in a client who has hepatic encephalopathy from cirrhosis of the liver

A nurse is caring for a client who received naloxone for a suspected opioid overdose. Which of the following findings should the nurse identify as an adverse effect of this med? A. Report of pain B. RR 8/ min C. Report of numbness D. Report of abdominal cramping and diarrhea

Report of pain Excess doses of naloxone can cause the return of pain but can improve the client's RR SE: hypotension or hypertension

A nurse is caring for a client with asthma who has been taking an inhaled glucocorticoid and long-acting beta 2 agonist combination dry-powdered inhaler (DPI) for maintenance therapy. The nurse should identify that which of the following is a disadvantage of this medication? A. Restricted dosage flexibility B. Complicated delivery device C. Serious systemic effects D. Limited efficacy over time

Restricted dosage flexibility The dosages of these meds are fixed, so the dose cannot be adjusted

A nurse is caring for a client who has RA and a new prescription for etanercept. Which of the following values should the nurse review prior to the administration of the new med? A. Ability to swallow B. Results of last purified protein derivative (PPD) test C. Serum creatinine D. Blood glucose level

Results of last purified protein derivative (PPD) test A client who is taking etanercept is at risk for infections such as TB. To reduce this risk, the client should be tested for latent TB; if it is positive, the client should undergo TB treatment before receiving etanercept

A nurse is assessing a client who is receiving a continuous morphine IV infusion and finds the client's RR has decreased from 20/ min to 12/ min. Which of the following actions should the nurse take? A. Flush the IV with saline B. Administer flumazenil C. Lower the head of the bed D. Slow the rate of infusion

Slow the rate of infusion

A nurse is providing teaching for a client who has received a liver transplant and has a prescription to transition from cyclosporine to tacrolimus. Which of the following instructions should the nurse include? A. Take both meds together for 72 hrs and then stop taking cyclosporine B. Stop taking cyclosporine for 24 hrs and then begin taking tacrolimus C. Alternate taking the med for 48 hrs and then only take tacrolimus D. If adverse reactions to tacrolimus occur, stop taking it and restart the cyclosporine

Stop taking cyclosporine for 24 hrs and then begin taking tacrolimus The nurse should instruct that these meds should not be taken concurrently due to the increased risk of developing nephrotoxicity

A nurse is preparing to administer levothyroxine to a client who has hypothyroidism. The nurse should identify which of the following lab results as supporting the administration of this med? A. Thyroid-stimulating hormone (TSH) 8 microunits/ mL B. Free triiodothyronine (T3) 300 pg/dL C. Free thyroxine (T4) 7 mcg/ dL D. Thyroxine-binding globulin 2.3 mg/dL

TSH 8 microunits/mL The expected range for TSH is 0.3-5. When a client has primary hypothyroidism, the TSH level becomes elevated in an attempt to normalize the thyroid gland's function. When the client has had a therapeutic response to treatment, the TSH level returns to the expected reference range

A nurse is planning care for a female client who has severe IBS-diarrhea and a new prescription for alosetron. Which of the following interventions should the nurse include in the plan of care? A. The client must sign an agreement with the provider before beginning alosetron B. The client must stop taking alosetron if diarrhea continues for 1 week C. The client should expect to have a slower HR while taking D. The client should use barrier birth control because of alosetron interacts with oral contraceptives

The client must sign an agreement with the provider before beginning Alosetron has potentially fatal adverse effects associated with constipation and bowel obstruction. The FDA has allowed alosetron to be placed on the market only if clients sign and adhere to a risk management program, which includes signing a client-provider agreement before starting

A nurse in a long-term care facility is administering medications to a group of older adult clients. Which of the following factors of pharmacokinetics should the nurse consider with this age group?

The excretion of medication is reduced The absorption level of medications is reduced

A nurse is assessing an infant who is scheduled to receive the rotavirus vaccine. Which of the following criteria should the nurse identify as a potential contraindication for administering this vaccine? A. The infant is teething B. The infant has a history of intussusception C. The infant has been constipated for 3 days D. The infant is 9 weeks old

The infant has a history of intussusception Rotavirus vaccine is also contraindicated for infants who have an uncorrected GI congenital malformation that could result in intussusception

A nurse is reviewing the med history of a client who has asthma. Which of the following med combinations should the nurse identify as incompatible? A. Albuterol and montelukast B. Theophylline and zileuton C. Aminophylline and fluticasone D. Salmeterol and levalbuterol

Theophylline and zileuton Zileuton, a leyukotrine modifier, impairs the metabolism of certain meds. Concurrent use of zileuton with theophylline can cause toxicity due to elevated theophylline, which is a systemic methylxanthine used to relax the smooth muscles of the airway. Therefore, these medications are incompatible when used together Albuterol is a short-acting beta2-agonist bronchodilator, and montelukast is a leukotriene modifier. These medications are often prescribed together to treat the immediate manifestations of asthma as well as to help prevent asthma attacks Aminophylline is a systemic methylanthine that helps decrease smooth muscle contraction, dilating the bronchioles. Fluticasone is an inhaled corticosteroid that decreases airway inflammation. These medications can be administered concurrently without causing additional harm to the client Salmeterol is a long-acting beta2-agonist bronchodilator, and levalbuterol is a short-acting beta2-agonist bronchodilator. These medications are often prescribed together for both short- and long-term control of asthma manifestations

A nurse in a community health clinic is assessing a new client who has prescriptions for isoniazid and rifampin. Which of the following disorders should the nurse expect the client to have? A. Tuberculosis B. HTN C. DM D. Cirrhosis

Tuberculosis Isoniazid and rifampin are first line anti tubercular meds used to treat active TB. The meds are used in a combination therapy

A nurse is teaching a client who has a prescription for doxycycline for the treatment of H. Pylori infection. Which of the following instructions should the nurse include in the teaching? A. Take this mediation with meals to decrease GI upset B. Continue this med when you become pregnant C. Wear protective clothing while in the sun D. Expect to have severe diarrhea while taking this med

Wear protective clothing while in the sun The nurse should include in the teaching that all tetracycline meds increase the sensitivity of the skin to UV light and sunlight Edu: food reduces the absorption of this med

A nurse is caring for a client who was recently diagnosed with RA. The nurse should expect the provider to prescribe methotrexate at which of the following times? A. Within 3 months of the initial diagnosis B. When NSAIDs have not provided pain relief C. During an exacerbation of symptoms D. Once bone degeneration progresses

Within 3 months of the initial diagnosis Current guidelines recommend starting a disease-modifying antirheumatic drug (DMARD) such as methotrexate within 3 months of a diagnosis to prevent or delay joint degeneration

A nurse is providing teaching to a client who has multiple sclerosis and a new prescription for baclofen PO. Which of the following pieces of information should the nurse include? A. You should take the med on an empty stomach to increase absorption B. You can stop taking the med once your back spasms disappear C. You can expect to experience urinary frequency when you first start taking D. You should change positions slowly while taking this medication

You should change positions slowly Dizziness and hypotension are adverse effects Edu: take with milk or food to minimize gastric irritation