ATI PHARM:practice exam A

A nurse is provifing teaching to a client who has multiple sclerosis and a newprescription for methylprednisolone. which of the folowing instructions should the nurse include?

-Monitor blood glucose levels -Avoid contact with people. -Grapefruit Juice can increase the effects of the medication.

A nurse is developing a teaching plan for a client who has a new prescription for simvastatin. Which of the following instructions should the nurse include in the teaching plan.

-Report muscle pain -avoid taking grapefruit -expect therapy to be lifelong -simvastatin=works to slow the production of cholesterol.

A nurse is caring for a client who received 0.9% sodium chloride 1L over 4hr instead of over 8hr as prescribed. Which of the following information should the nurse enter as a complete documentation on the incident?

0.9% sodim chloride 1L IV infused over 4hr vital signs stable, provider notified. note the type and amount of fluid, how long it took to infuse, provider notification, and the clients physical status.

A nurse at an urgent care clinic is collecting a history from a female client who has a urinary react infection. the nurse anticipates a prescription for ciprofloxacin. the nurse should identify that which of the following client statements indicates a contraindication for administering the medication?

"I have tendonitis, so I haven't been able to exercise" The nurse should identify tendonitis as a contraindication for taking ciprofloxacin due to the risk of tendon rupture.

A nurse is teaching a client about the use of risedronate for the treatment of osteoporosis. The nurse should id which of the following statments as an indication that the client understands the teaching?

"I should sit up for 30 minutes after taking the risedronate." Sitting upright for at least 30 min after taking risedronate will reduce the adverse gastrointestinal effects of esophagitis and dyspepsia. Risedronate is contraindicated for a client who cannot sit or stand upright for this length of time.

A nurse is teaching the pt on cyclobenzaprine. Which of the following statments should indicate to the nurse that the teaching is effective?

"I will taper off the medication before discontinuing it." The client should taper off cyclobenzaprine before discontinuing it to prevent abstinence syndrome or rebound insomnia.

A nurse is providing teaching to a client who has a prescription for ergotamine sublingual to treat migrane headaches. Which of the following information should the nurse include in the instructions.

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

A nurse is preparing to administer a scheduled antibiotic at 0800 to a client and discovers the antibiotic is not present in the clients medication drawer, the nurse should id that administration of medication can occur at which of the following time periods without requiring an incident report.

0830 The nurse should identify that an antibiotic can be administered 30 min before or after the scheduled time to maintain therapeutic blood levels without requiring an incident report.

Calculation

100

A nurse is caring for the parent of a newborn. The parent asks the nurse when their newborn should receive the first diphtheria, tetanus, and pertussis vaccine. The nurse should instruct the parent that their newborn should receive the immunization at which of the ages.

2 months The CDC recommends that newborns receive the first dose of the five-dose series of the DTaP immunization at 2 months of age.

Ciprofloxin 15 mg/kg every 12h to a child who weighs 44lb

300mg every 12h

The nurse is teaching a group of unit nurses about medication reconcilliation. which of the following information should the nurse include in the teaching?

A transition in care requires the nurse to conduct medication reconciliation. The nurse should conduct medication reconciliation anytime the client is undergoing a change in care such as admission, transfer from one unit to another, or discharge. A complete listing of all prescribed and over-the-counter medications should be reviewed.

A nurse is caring for a client who has acute acetaminophen toxicity. the nurse shoud anticipate administering which of the following medications

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

The nurse is preparing to administer heparin subq to a client, Which of the following actions should the nurse plan to take?

Administer the medication outside the 5cm radius of the umbilicus. The nurse should administer the heparin by subcutaneous injection to the abdomen in an area that is above the iliac crest and at least 5 cm (2 in) away from the umbilicus.

A nurse is teaching a client about warfarin. the client asks if they can take asprin while taking the warfarin. WHat should the nurse say?

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

A nurse in an emergency department is caring for a client who has myasthenia gravis and is in a cholinergic crisis. which of the following medications should the nurse plan to administer.

Atropine (this med is an anti-cholinergic agent) A cholinergic crisis is caused by an excess amount of cholinesterase inhibitor, such as neostigmine. The nurse should plan to administer atropine, an anticholinergic agent, to reverse cholinergic toxicity.

A nurse is planning care for a client who is receiving mannitol via continuous IV infusion. The nurse should monitor the client for which of the following adverse effects.

Bibasilar crackles Mannitol, an osmotic diuretic, can precipitate heart failure and pulmonary edema. Therefore, the nurse should recognize lung crackles as an indicator of a potential complication and stop the infusion.

A nurse is caring for a client who is receiving heparin therapy via continuous IV infusion to treat a pulmonary embolism. which of the following findings should the nurse id as an adverse effect of the medication and report to the provider.

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

A nurse is reviewing the medication list of a client who wants to begin taking oral contraceptives. the nurse should id that which of the following client medications will interfere with the effectiveness of oral contraceptives.

Caebamazepine (anticonvulsant) Carbamazepine causes an accelerated inactivation of oral contraceptives because of its action on hepatic medication-metabolizing enzymes.

A nurse administers a dose of metformin. to a client instead of the prescribed dose of metoclopramide. Which of the following actions should the nurse take first?

Check the clients blood Glucose The first action the nurse should take using the nursing process is to assess the client. The client is at risk for hypoglycemia. The nurse should monitor the client's blood glucose and provide the client with a snack to reduce the risk for hypoglycemia.

A nurse is caring who has a cancer and is taking oral morohine and docusate sodium. the nurse should instruct the client that taking the docusate sodium daily can minimize which of the following adverse effects of morphine.

Constipation Constipation is a common adverse effect of morphine that can be minimized by taking docusate sodium, a stool softener that promotes easier evacuation of stool by increasing water and fat in the intestine.

a nurse is teaching a client who is to start taking hydrocodone with acetaminophen tablets for pain. which of the following information should the nurse include in the teaching?

Decreased respirations might occur The nurse should instruct the client that hydrocodone with acetaminophen might cause respiratory depression, which is an adverse effect of the medication. The client should avoid taking over-the-counter medications or newly prescribed medications without consulting their provider to avoid increased respiratory depression.

A nurse is planning care for a client who has hypertension and is to start taking metropolol. which of the following interventions should the nurse include in the plan of care?

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

A nurse is reviewing the medication administration recordof a client who has hypocalcemia and a new prescription for IV calcium gluconate. the nurse should id that which of the following medications can interact with calcium gluconate.

Digoxin The nurse should identify that calcium gluconate can cause hypercalcemia, which increases the risk of digoxin toxicity.

a nurse is preparing to administer medications to a client who tells the nurse, "I don't want to take any fluid pill until i get home today". Which of the following actions should the nurse take?

Document the refusal and inform the client's provider. The nurse has the responsibility to verify that the client understands the risks of refusing the medication so that an informed decision can be made. The nurse should then document the refusal in the client's medical record and notify the health care provider.

client is to begin taking oxybutin for urinary incontinence. Which of the following adverse effects should the nurse include in the teaching.

Dry mouth Blurred vision dry eyes

A nurse is administering donepezil to a client who has alzheimers desease, which of the following findings should the nurse report to the provider immediatly?

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

A nurse is assessing a client after administerig a second dose of cefazolin IV. The nurse notes the client has anxiety, hypotension, and dyspnea. Which of the following medications should the nurse administer first?

Epinephrine According to evidence-based practice, the nurse should administer epinephrine first to induce vasoconstriction and bronchodilation during anaphylaxis.

A nurse in an emergency department is caring for a client whose family reports the client has taken large amounts of Diazepam. Which of the following medications should the nurse anticipate administering?

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

the nurse is providing teaching to a client who has peptic ulcer disease and is to start a new prescription of sucralfate. which of the following actions of sucralfate should the nurse include in the teaching

Forms a protective barrier over ulcers Secretions by the parietal and cheif cells, hydrochloric acid and pepsin, can further irritate the ulcerated areas, Sucralfate, a mucosal protectant, forms a gel like substance that coats the ulcer, creating a barrier to hydrochloric acid and pepsin.

A nurse is assessing a clients vital signs prior to the administration of PO digoxin, the client's BP is 144/86 mm hg, heart rate is 55/min, and respiratory rate is 20/min. the use should withhold the medication and contact the provider for which of the following findings?

Heart Rate Digoxin shlows the conduction rate through the SA and AV nodes, thereby decreasing the heart rate. the nurse should notify the provider for a heart rate of 55/min.

A nurse is teaching a client who is to begin taking tamoxifen for the treatment of breast cancer. Which of teh following adverse effect should the nurse include in the teaching?

Hot Flashes. The estrogen receptor blocking action of tamoxifen commonly results in the adverse effect of hot flashes.

A nurse is providing discharge instructions to a client who has heart failure and a new prescription of captopril. Which of the following client statements indicates an understanding of the teaching?

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

A nurse is instructing a client on the application of nitroglycerine transdermal patches. which of the following statements by the client indicates an understanding the teaching

I will take the patch off right right after my evening meal must be taken off 12-14 hrs after application to avoid developing a tolerance.

A nurse is collecting a medication history from a client who has a new prescription for lithium. the nurse should id that the client should discontinue which of the following over the counter medications?

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

A nurse is assessing a client who is taking propylithiouracil for the treatment if graves disease. Which of the following findings should the nurse identify as an indication that the medication has been effective?

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

A nurse is providing teaching to a client who is taking bupropion as an aid to quit smoking.which of the following findings should the nurse id as an adverse effect of the med?

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

A nurse is assessing a client who has myasthenia gravis and is taking neostigmine. which of the following findings should indicate to the nurse that the client is experiencing an adverse effect?

Miosis (pupillary constriction) Miosis, which is pupillary constriction, is a common adverse effect of neostigmine due to the excessive muscarinic stimulation that causes difficulty with visual accommodation.

The nurse is preparing to administer PI sodium polystyrene sulfonate to a client who has hyperkalemia. Which of the following actions should the nurse plan to take.

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

A nurse receive a verbal order from the provider to administer morphine five milligrams every 4 hr subq for severe pain as needed. The nurse should identify which of the following entries as the correct format for the medication administration record (MAR)?

Morphine 5 mg subcut every 4 hr PRN severe pain.

A nurse in an emergency department is caring for a client who has heroin toxicity. He is unresponsice with pinpoint pupils and a respiratory rate of 6/min. Which of the following medications should the nurse plan to administer.

Naloxone The nurse should administer naloxone, an opioid antagonist, to a client who has heroin toxicity to reverse the respiratory depressive effects of the heroin. However, the nurse should not administer naloxone too quickly because naloxone can cause hypertension, tachycardia, nausea, vomiting, and might cause the client to enter a state of opioid withdrawal.

The nurse is preparing to administer medication to a client who has gout. the nurse discovers that an error has made during the previous shift and the client received atenolol insted of allopurinol. Which of the following actions should the nurse rake first?

Obtain the clients blood pressure.

A nurse is planning to teach about the use of a spacer to a child who has a new prescription for a fluticasone inhaler to treat chronic asthma. the nurse should include that the spacer decreases the risk for which of the following adverse effects of the medication?

Oral Candidiasis Dysphonia and oral candidiasis are adverse effects of inhaled corticosteroids. Using a spacer and rinsing the mouth after inhalation will minimize the amount of medication remaining in the oropharynx, preventing the development of these adverse effects.

a nurse is reviewing the laboratory results for a client who is receiving heparin via continuouse IV infusion for deep vein thrombosis. The nurse should discontinue the medication infusion for which of the client findings?

Platelets 96,000/mm3 A platelet count of 96,000/mm3 is below the expected range of 150,000 to 400,000/mm3. A platelet count less than 100,000/mm3 while receiving heparin can indicate heparin-induced thrombocytopenia, a potentially fatal condition that requires stopping the infusion.

A nurse is reviewing the laboratory results of a client who is taking digoxin for heart failure. Which of the following results should the nurse report to the provider

Potassium Level 2.8 mEq/L A potassium level of 2.8 mEq/L is below the expected reference range of 3.5 to 5 mEq/L. The nurse should notify the provider if a client has hypokalemia prior to administration of digoxin due to the increased risk of developing digoxin toxicity and cardiac dysrhythmias.

A nurse is caring for a client who is experiencing acute alcohol withdraw. For which of the following client outcomes should the nurse administer chlordiazepoxide.

Precent Delirium Tremens The client should take chlordiazepoxide to prevent delirium tremens during acute alcohol withdrawal.

A nurse is caring for a 20 yearold female client who has a prescription for isotretinoin for severe nodulocystic acne vulgaris. before she optains a refil, what test is required before the refil.

Pregnancy test

A nurse is providing teaching to a client who has a gastric ulcer and a new prescription for ranitidine. Which of the following instructions should the nurse include?

Report Yellowing of the skin Ranitidine can be hepatotoxic and cause jaundice. The nurse should instruct the client to monitor for and report yellowing of the skin or eyes to the provider.

A nurse is providing teaching to a client who is to start treatment for asthma with beclomethasone and albuterol inhalers Which of the following instructions should the nurse include in the Teaching?

Rinse your mouth after inhaling the beclomethasone The client should rinse their mouth after using beclomethasone, a glucocorticoid inhaler, to prevent oropharyngeal candidiasis and hoarseness.

A nurse is planning care for a client who is prescribed metoclopramide following bowel surgery. For which of the following adverse effects should the nurse monitor?

Sedation Metoclopramide has multiple CNS adverse effects, including dizziness, fatigue, and sedation.

A nurse at a clinic is providing follow-up care to a client who is taking fluoxetine for depression. Which of the following findings should the nurse id as an adverse effect of the medication.

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

A nurse is providing discharge teaching about handling medication to a client who is to continue taking oral transmucosal fentanyl raspberry-flavored lozenges on a stick. Which of the following information should the nurse include in the teaching.

Store unused medication sticks in a storage container The nurse should instruct the client to store unused, used, or partially used medication sticks in the safe storage container that comes in the kit when the medication is initially prescribed.

A nurse is assessing a client who has schizophrenia and is taking haloperidol. the nurse should report which of the following findings to the provider as a manifestation of neuroleptic malignant syndrome?

Temp of 39.7 (103.5 F) The nurse should report fever to the provider as an indication of NMS, an acute life-threatening emergency. Other manifestations can include respiratory distress, diaphoresis, and either hyper- or hypotension.

A nurse is assessing a client 1 hr after administeration morphine for pain. the nurse should id which of the following findings as the best indication that the morphine has been effective?

The cient rates pain as a 3 on a scale of 0-10

A nurse is assessing a client who is postoperative following an outpatient endoscopy procedure using midazolam. the nurse should monitor for which of teh following findings as an indication that the client is ready for discharge?

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

A nurse is caring for a client who is taking acetazolamide for chronic open-angle glaucoma. for which of the following adverse effects should the nurse instruct the client to monitor and report?

Tingling of the fingers The client should report any adverse effects of paresthesia, and tingling sensation in the extremities, when taking acetazolamide

A nurse on the acute care unit is caring for a client who is receiving gentamicin IV. the nurse should report which of the following findings to the provider as an adverse effect of the medication?

Tinnitus aminoglycosides, can manifest as tinnitus and deafness. The nurse should monitor the client for high-pitched ringing in the ears and headaches and should notify the provider if these occur.

A nurse is caring for a client who is in labor. the client is receiving oxytocin by continuous IV infusion with a maintenance IV solution. The external FHR monitor indicates late decelerations. Which of the following actions should the nurse take first?

Turn the client to a side-lying position. The greatest risk to the fetus experiencing late decelerations is injury from uteroplacental insufficiency. Therefore, the priority action the nurse should take is to place the client in a lateral position.

A nurse is caring for a client who is receiving filgrastim. Which of the following findings should the nurse document to indiate the effectiveness of the

increased neutrophil count Filgrastim stimulates the bone marrow to produce neutrophils. For clients receiving chemotherapy, the risk of infection is minimized.

The nurse is reviewing the ECG of a client who is receiving IV furosemide for heart failure.. the nurse should id which of the following findings as an indication of hypokalemia.

presence of U-waves The presence f U-waves is a manifestation of hypokalemia, an adverse effect of furosemide.