ATI questions Pharm Semester 1

What lithium level indicate advanced toxicity?

1.5 to 2.0 mEq/L

What lithium level indicate severe toxicity?

2.0 to 2.5 mEq/L

A nurse is evaluating a group of clients at a heath fair to identify the need for folic acid therapy. Which of the following clients require folic acid therapy?

24 year old female who has no health problems, 55 year old female who has alcohol use disorder.

A nurse is admitting a toddler to the hospital after an acetaminophen overdose. Which of the following medications should the nurse anticipate administering to this client?

Acetylcysteine.

A nurse is teaching a client who has anemia and a new RX for a liquid iron supplement. Which of the following information should the nurse include in the teaching?

Add foods that are high in fiber to your diet, Rinse your mouth after taking the medication, Expect stools to be green or black in color, Add red meat to your diet.

A nurse is admitting a client to an acute care facility for a total hip arthroplasty. The client takes hydrocortisone for Addison's disease. Which of the following actions is the nurses priority?

Administering a supplemental dose of hydrocortisone.

A nurse is providing instruction to a client who has a new RX for calcitonin-salmon for postmenopausal osteoporosis. Which of the following instructions should the nurse include in the teaching?

Alternate nostrils each time calcitonin-salmon is inhaled.

A nurse is reviewing the health history of a client who has migraine headaches and is to begin prophylaxis therapy with propranolol. Which of the following findings in the client history should the nurse report to the provider?

An ECG indicates a first degree heart block.

A nurse is assessing a client who has chronic neutropenia and who has been receiving filgrastim. Which of the following actions should the nurse take to assess for an adverse effect of filgrastim?

Assess for bone pain.

What drug class does buspirone belong to?

Atypical anxiolytics

What lithium levels indicate early toxicity?

Below 1.5 mEq/L

A nurse is caring for a client who is taking propylthiouracil. For which of the following adverse effects of this medication should the nurse monitor?

Bradycardia

A nurse is preparing to administer butorphanol to a client who has a history of substance use disorder. The nurse should identify which of the following information as true regarding butorphanol?

Butorphanol can cause abstinence syndrome in opioid dependent clients.

A nurse is caring for a client who is taking for somatropin to stimulate growth. The nurse should plan to monitor the clients urine for which of the following?

Calcium

A nurse is caring for a young adult client whose serum calcium is 8.8 mg/dL. Which of the following medications should the nurse anticipate administering to this client?

Calcium carbonate.

A nurse is providing teaching to a client who has a new RX for amitriptyline for treatment of depression. Which of the following should the nurse include in the teaching?

Change positions slowly to minimize dizziness, Chew sugarless gum to prevent dry mouth.

A nurse is assessing a client who takes lithium carbonate for the treatment of bipolar disorder. The nurse should recognize which of the following findings as a possible indication to toxicity to this medication?

Coarse tremors.

A nurse is monitoring a client who takes aspirin 81 mg PO daily. The nurse should identify which of the following manifestations as adverse effects of daily aspirin therapy?

Coffee ground emesis, tinnitus, nausea

A nurse is caring for a client who takes paroxetine to treat PTSD and reports that he grinds his teeth during the night. The nurse should identify which of the following interventions to manage bruxism?

Concurrent administration of buspirone, Use of a mouth guard, Changing to a different class of antidepressent medication.

A nurse is caring for a client who has depression and a new RX for venlafaxine. For which of the following adverse effects should the nurse monitor this client?

Cough, Dizziness, Decreased Libido.

A nurse in the OR is caring for a client who received a dose of succinylcholine. During the operation, the client suddenly develops rigidity, and his body temperature begins to rise. The nurse should anticipate a RX for which of the following medications?

Dantrolene

A nurse is providing teaching for a client who is withdrawing from alcohol and has a new RX for propranolol. Which of the following information should the nurse include in the teaching?

Decreases cravings.

A nurse is caring for a client who is admitted to undergo a surgical procedure. Which of the following preexisting conditions can be a contraindication for the use of ketamine as an IV anesthetic?

Diabetes Mellitus

A nurse is reviewing the medication administration record fora client who is receiving transdermal fentanyl for severe pain. Which of the following medications should the nurse expect to cause an adverse effect when administered concurrently with fentanyl?

Diazepam.

A nurse is preparing to administer filgrastim for the first time to a client who has just undergone a bone marrow transplant. Which of the following interventions is appropriate?

Discard vial after removing one dose of the medication.

A nurse is assessing a client who has salicylism. Which of the following findings should the nurse expect?

Dizziness, Tinnitus, Headache

A nurse is providing teaching to a client who has a new RX for clonidine to assist with maintenance of abstinence from opioids. The nurse should instruct the client to monitor for which of the following adverse effects?

Dry mouth.

A nurse is caring for a client who has a new diagnosis of fibromyalgia. Which of the following medications should the nurse anticipate being prescribed for this client?

Duloxetine

A nurse is preparing a teaching plan for a female client who has bipolar disorder and a new RX for carbamazepine. Which of the following instructions should the nurse include in the teaching?

Eliminate grapefruit juice from your diet, you will need to have a complete blood count and carbamazepine levels drawn periodically, notify your provider if you develop a rash, avoid driving for the first few days after starting this medication.

A nurse is preparing to administer a medication to a client who has absence seizures. The nurse should anticipate administering which of the following medications to the client?

Ethosuximide, Valproic acid, Lamotrigine

A nurse is caring for a client who has a prescription for bethanechol to treat urinary retention. The nurse should recognize that which of the following findings is a manifestation of muscarinic stimulation?

Excessive perspiration.

A nurse is caring for a client who has been taking sertraline for the past 2 days. Which of the following assessment findings should alert the nurse to the possibility that the client is developing serotonin syndrome?

Fever

A nurse is caring for a client who is receiving moderate sedation with diazepam IV. The client is oversedated. Which of the following medications should the nurse anticipate administering to this client?

Flumazenil

A nurse is caring for a hospitalized client who has an aPTT greater than 1.5 times the expected reference range. Which of the following blood products should the nurse prepare to transfuse?

Fresh frozen plasma.

A nurse is teaching a client who has a new RX for ramelteon. The nurse should instruct the client to avoid which of the following foods while taking this medication?

Fried chicken

A nurse is assessing a client during transfusion of a unit of whole blood. The client develops a cough, SOB, elevated blood pressure, and distended neck veins. The nurse should anticipate a prescription for which of the following medications?

Furosemide.

A nurse is reviewing the health care record of a client who reports urinary incontinence and asks about a RX for oxybutynin. The nurse should recognize that oxybutynin is contraindicated in the presence of which of the following conditions?

Glaucoma

A nurse is providing information to a client who has early Parkinson's disease and a new RX for pramipexole. The nurse should instruct the client to monitor for which of the following adverse side effects of this medication?

Hallucinations

A nurse is assessing a client who takes desmopressin for diabetes insipidus. For which of the following adverse effects should the nurse monitor?

Headache

A nurse is planning to administer IV alteplase to a client who is demonstrating manifestations of a massive PE. Which of the following interventions should the nurse plan to take?

Hold direct pressure on puncture sites for up to 30 minutes.

A nurse is providing teaching to a client who is taking raloxifene to prevent postmenopausal osteoporosis. The nurse should advise the client that which of the following are adverse effects of this medication?

Hot flashes, Swelling or redness in calf, Shortness of breath.

A nurse is monitoring a client who is receiving epoetin alfa for adverse effects. The nurse should identify which of the following findings as an adverse effect of this medication?

Hypertension, Headache

A nurse is teaching a client who has a new RX for baclofen to treat muscle spasms. Whichh of the following statements by the client indicates an understanding of the teaching?

I know the doctor will gradually increase my dose of this medication, I should increase fiber to prevent constipation from this medication, I won't be able to drink alcohol while i'm taking this medication.

A nurse is teaching a client who has a new RX for escitalopram for treatment of generalized anxiety disorder. Which of the following statements by the client indicates understanding of the teaching?

I need to d/c this medication slowly.

A nurse is teaching a female client who has tobacco use disorder about nicotine replacement therapy. Which of the following statements by the client indicates understanding of the teaching?

I should avoid eating right before i chew a piece of nicotine gum.

A nurse is evaluating teaching for a client who has rheumatoid arthritis and a new RX for methotrexate. Which of the following statements by the client indicates understanding of the teaching?

I'll let the doctor know if i develop sores in my mouth while taking this medication.

A nurse is providing teaching to a client who has type 2 diabetes mellitus and is starting repaglinide. Which of the following statements by the client indicates understanding of the administration of this medication?

I'll take this medication 30 minutes before I eat.

A nurse is providing teaching to a client who is experiencing migraine headaches. Which of the following instructions should the nurse provide?

Identify and avoid trigger factors, Lie down in a dark quiet room at the onset of a migraine, Avoid foods that contain tyramine.

A nurse working in an emergency department is caring for a client who has benzodiazepine toxicity due to an overdose. Which of the following actions is the nurses priority?

Identify the clients level of orientation

A nurse is providing instructions to a client who has been experiencing insomnia and has a new RX for temazepam. The nurse should inform the client that which of the following manifestations are adverse effects of temazepam?

Incoordination, Sleep driving, Amnesia

A nurse is teaching a client about a new RX for celecoxib. Which of the following information should the nurse include in the teaching?

Increases the risk for a myocardial infarction.

A nurse is preparing to administer potassium chloride IV to a client who has hypokalemia. Which of the following actions should the nurse take?

Infuse medications through a large bore needle, Implement cardiac monitoring, Administer the infusion using an IV pump.

A nurse is providing teaching to a client who has a RX for pramlintide for type 1 diabetes mellitus. Which of the following should the nurse include in the teaching?

Inject pramlintide just before a meal, Discard open vials after 28 days.

A nurse is planning to administer subcutaneous enoxaparin 40 mg using a prefilled syringe of enoxaparin 40 mg/0.4 mL to an adult client following hip arthroplasty. Which of the following actions should the nurse plan to take?

Insert the needle completely into the clients tissue.

A nurse is caring for a client who requests information on the use of feverfew. Which of the following responses should the nurse make?

It can decrease the frequency of migraine headaches.

A nurse is teaching a client who has OCD and has a new RX for paroxetine. Which of the following instructions should the nurse include?

It can take several weeks before you feel like the medication is helping.

A nurse is caring for a client who has increased liver enzymes and is taking herbal supplements. Which of the following herbal supplements should the nurse report to the provider?

Kava.

A nurse is planning care for a client who is to receive tetracaine prior to a bronchoscopy. Which of the following action should the nurse include in the plan of care?

Keep the client NPO until pharyngeal response returns.

A nurse is caring for a client in an outpatient facility who has been taking acarbose for type 2 diabetes mellitus. Which of the following laboratory tests should the nurse plan to monitor?

LFT

A nurse is caring for a client who has a new RX for lithium carbonate. When teaching the client about ways to prevent lithium toxicity, the nurse should advise the client to do which of the following?

Limit aerobic activity in hot weather.

A charge nurse is planning a staff education session to discuss medications used during the care of a client experiencing alcohol withdrawal. Which of the following medications should the charge nurse include in the discussion?

Lorazepam, Diazepam

What drug class does phenelzine belong to?

MAOIs

A nurse is preparing to administer belimumab for a client who has systemic lupus erthematosus. Which of the following actions should the nurse plan to take?

Monitor the client for hypersensitivity reactions.

A nurse is providing teaching for a client who has gout and a new RX for allopurinol. For which of the following adverse effects should the client be taught to monitor?

Nausea, Rash, Increased gout pain.

A nurse in the PACU is caring for a client who received nondepolarizing neuromuscular blocking agent and has muscle weakness. The nurse should anticipate a RX for which of the following medications?

Neostigmine

A nurse is providing instructions to a female client who has a new RX for zolpidem. Which of the following instructions should the nurse include?

Notify the provider if you plan to become pregnant.

A nurse in an acute mental health facility is caring for a client who is experiencing withdrawal from opioid use and has a new RX for clonidine. Which of the following actions should the nurse identify as the priority?

Obtain baseline vital signs.

A nurse is preparing to transfuse a unit of PRBCs for a client who has severe anemia. Which of the following interventions will prevent an acute hemolytic reaction?

Obtain help from another nurse to confirm the correct client and blood product.

A nurse is caring for a client who has afib and a new RX for dabigatran to prevent development of thombosis. Which of the following medications is prescribed concurrently to treat and adverse effect of dabigatran?

Omeprazole.

A nurse is caring for a client with a new RX for phenelzine for the treatment of depression. Which of the following indicates that the client has developed an adverse effect of this medication?

Orthostatic hypotension

A nurse is reviewing laboratory findings and notes that a clients plasma lithium level is 2.1 mEq/L. Which of the following is an appropriate action by the nurse?

Perform immediate gastric lavage

A nurse in the PACU is caring for a client who is experiencing malignant hyperthermia. Which of the following actions should the nurse take?

Place a cooling blanket on the client, Administer oxygen at 100%, Administer iced 0.9% sodium chloride, Monitor core body temperature.

A nurse is caring for a client who is receiving daily doses of opprelvekin. Which of the following lab values should the nurse monitor to determine effectiveness of this medication?

Platelet count.

A nurse is providing teaching to a client who has migraine headaches and a new RX for ergotamine. For which of the following adverse effects should the nurse instruct the client to stop taking the medication and notify the provider?

Positive home pregnancy test, Numbness and tingling in fingers, Muscle pain.

A nurse is teaching a client who has Graves' disease about her prescribed medications. Which of the following statements by the client indicates an understanding of the use of propranolol in the treatment of Graves' disease?

Propranolol will decrease my tremors and fast heart beat.

A nurse is caring for a hospitalized client who is receiving IV heparin for a DVT. The client begins vomiting blood. After the heparin has been stopped, which of the following medications should the nurse prepare to administer?

Protamine

A nurse is teaching clients in an outpatient facility about the use of insulin to treat type 2 diabetes mellitus. For which of the following types of insulin should the nurse expect a peak effect 1 to 5 hours after administration?

Regular insulin

A nurse in an emergency department is performing an admission assessment for a client who has severe aspirin toxicity. Which of the following findings should the nurse expect?

Respiratory depression.

What drug class does venlafaxine belong to?

SNRIs

What drug class does escitalopram belong to?

SSRIs

What drug class does fluoxetine belong to?

SSRIs

What drug class does sertraline belong to?

SSRIs

A nurse is caring for a client who receives a local anesthetic of lidocaine during the repair of a skin laceration. For which of the following adverse reactions should the nurse monitor the client?

Seizures

A nurse is caring for a client who has a new RX for calcitonin-salmon for osteoporosis. Which of the following tests should the nurse tell the client to expect before beginning this medication?

Skin test for allergy to the medication.

A nurse is providing teaching for a clients who has a new RX for metformin. Which of the following adverse effects of metformin should the nurse instruct the client to report to the provider?

Somnolence

A nurse is transfusing a unit of PRBCs for a client who has anemia due to chemotherapy. The client reports a sudden headache and chills. The clients temp is 2 degrees F higher than her baseline. In addition to notifying the provider, which of the following actions should the nurse take?

Stop the transfusion, Remove the blood bag and tubing from the IV catheter, Obtain a urine specimen.

What drug class does amitriptyline belong to?

TCAs

A nurse is teaching a client who has osteoporosis and a new RX for alendronate. Which of the following instructions should the nurse provide?

Take the medication in the morning before eating, Drink an 8 oz glass of water with each tablet, Avoid laying down after taking this medication.

A nurse is teaching a client who has a new RX for levodopa/carbidopa for Parkinson's disease. Which of the following instructions should the nurse include?

Take this medication with food.

A nurse is caring for an older adult client in a long term care facility who has hypothyroidism and a new RX for levothyroxine. Which of the following dosage schedules should the nurse expect for this client?

The client will start on a low dose, which will be gradually increased.

A nurse is caring for a client who has end stage cancer and is receiving morphine. The clients daughter asks why the provider prescribed methylnaltrexone. Which of the following responses should the nurse make?

The medication will relieve your mothers constipation.

A nurse is caring for a client who has a new RX for adalimumab for rheumatoid arthritis. Based on the route of administration of adalimumab, which of the following should the nurse plan to monitor?

The subcutaneous site for redness following injection.

A nurse is providing teaching to a client who has a new RX for buspirone to treat anxiety. Which of the following information should the nurse include?

This medication has a low risk for dependency.

A nurse is caring for a client who has a new RX for valproic acid. The nurse should instruct the client that while taking this medication he will need to have which of the following laboratory tests completed periodically?

Thrombocyte count, amylase, LFT.

A nurse is preparing to administer an opioid agonist to a client who has acute pain. Which of the following complications should the nurse monitor?

Urinary retention

A nurse is reviewing a new RX for oxcarbazepine with a female client who has partial seizures. Which of the following instructions should the nurse include?

Use caution if given a prescription for a diuretic medication, Consider using an alternate form of contraception if you are using oral contraceptives, Avoid driving until you see how the medication affects you, Notify your provider if you develop a skin rash.

A nurse is completing an assessment of a clients current medications. The client states she also takes gingko biloba. Which of the following medications is contraindicated for a client taking gingko biloba?

Warfarin.

A nurse is taking a history for a client who reports that he is taking aspirin about four times daily for a sprained wrist. Which of the following prescribed medications taken by the client is contraindicated with aspirin?

Warfarin.

A nurse is planning to administer morphine IV to a client who is postoperative. Which of the following actions should the nurse take?

Withhold the medication if the respiratory rate is less than 12/min.

A nurse is preparing to administer a transfusion of 300 mL of pooled platelets for a client who has severe thrombocytopenia. The nurse should plan to administer the transfusion over which of the following time frames?

Within 30 min/unit

A nurse is providing d/c teaching to a client who has a new RX for fluoxetine for PTSD. Which of the following statements should the nurse include in the teaching?

You may have a decreased desire for intimacy while taking this medication.

Prototype drug for benzodiazepines?

alprazolam (Xanax)

Prototype drug for SSRIs?

paroxetine (Paxil)