ATI RN Pharmacology Final

A nurse is providing 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?

"I can develop lithium toxicity if I experience vomiting or diarrhea."

A nurse is providing discharge teaching to a client who has been hospitalized for major depressive disorder and has a prescription for amitriptyline. Which of the following statements by the client indicates an understanding of the teaching?

"I will move slowly when I stand up because amitriptyline can cause my blood pressure to decrease."

A nurse is providing teaching to a client who has postmenopausal osteoporosis and a new prescription for intranasal calcitonin-salmon. Which of the following statements by the client indicates an understanding of the teaching?

"I will need to depress the side arms to activate the pump."

A nurse is providing teaching to a client who has heart failure and is taking spironolactone. Which of the following statements by the client indicates an understanding of the teaching?

"I will watch for increased breast tissue growth while taking this medication."

A nurse is providing discharge teaching to a client who has angina pectoris and a new prescription for verapamil. The client tells the nurse, "My brother takes verapamil for high blood pressure. Do you think the provider made a mistake?" Which of the following responses should the nurse make?

"Verapamil is used to treat both high blood pressure and angina."

TB TEST

*Bevel up -26-27 gauge -Inner aspect arm -NO massage

Cre

0.5-1.3

Cre

0.5-1.5

A nurse is preparing to administer digoxin 0.2 mg via IV bolus to a client. The amount available is digoxin 0.25 mg/1 mL. How many mL should the nurse administer? (Round to the nearest tenth)

0.8 mL

A nurse is teaching a client who has chronic stable angina pectoris and a prescription for sublingual nitroglycerin tablets. Identify the sequence of instructions that the nurse should tell the client to use if he experiences chest pain.

1. Stop activity. 2. Place a tablet under the tongue. 3. Wait 5 min. 4. Call 911 if the pain is not relieved.

PT *No more 26

11-13 coumadin/warfain

Hgb

12-14-16-18

Na+

136-146

Platelet (clots)

150-450,000

A nurse is preparing to administer heparin 900 units/hr via IV infusion. The amount available is heparin 25,000 units in 500 mL 5% dextrose in water. The nurse should set the IV pump to deliver how many mL/hr? (Round to the nearest whole number)

18 mL/hr

INR

2-3 coumadin/warfarin

A nurse is planning to administer chlorothiazide 20 mg/kg/day PO divided equally and administered twice daily for a toddler who weighs 28.6 lb. The amount available is chlorothiazide oral suspension 250 mg/5 mL. How many mL should the nurse administer per dose/ (Round to the nearest tenth)

2.6 mL

Hct

35-52

Digoxin Lanoxin REPORT Nausea check

APICAL PULSE* Sign Dig Tox

Isoniazid (INH) Lab needed

AST (liver)

Valproic Acid (Depakote) check labs

AST, ALT, Platelet -Liver fxn, dec platelets-thrombocytopenia

Asthma rescue med

Albuterol

Long Term oral gluccocorticoid therapy

Alternate days with meds to dec s/e

Epotein Alfa treats

Anemia -stimulate erythropoises bone marrow to produce RBC

Plavix is

Anti Thrombus (clot), Antiplatelet

Bismuth Pepto Bismol

Antimicrobial action

A nurse is caring for a client who has a positive tuberculin skin test and is beginning a prescription for isoniazid. The nurse should teach the client that which of the following laboratory values should be monitored while taking isoniazid?

Aspartate aminotransferase (AST)

A nurse is caring for a client and realizes after administering the 0900 medications that she administered digoxin 0.25 mg PO to the client instead of the prescribed digoxin 0.125 mg PO. Which of the following actions should the nurse take first?

Assess the client's apical pulse.

Pril priority assmt

BP -orthostatic hypotension

Plavix check for

Bleed

A nurse is planning to administer epoetin alfa to a client who has chronic kidney failure. Which of the following data shoals the nurse plan to review prior to administration of this medication?

Blood pressure

A nurse is providing discharge teaching to a client who has venous thrombosis and a prescription for warfarin. Which of the following instructions should the nurse include in the teaching?

Carry a medic alert ID card

A nurse is caring for a client who has congestive heart failure and is taking digoxin. The client reports nausea and refuses to eat breakfast. Which of the following actions should the nurse take first?

Check the client's apical pulse.

Amophocetirin B (Fungizone) check

Cre- kidney/renal fxn -monitor every other day till reach therapeutic level -then weekly till med d/c

Hypertonic **

D5LR -osmotic pressure greater blood

Neupogen used to if you have

Dec neutrophil count from Chemo/Neutropenia (hint-all Neu)

Digoxin Lanoxin Antedote

Digibind

Vistaril Hydroxyzine Anticholinergic expect

Dry Mouth Constipation -reduces n/v

A nurse is administering oral hydroxyzine to a client. Which of the following adverse effects should the nurse instruct the client to expect?

Dry mouth

Elavil/Tricyclic Antidepressant test

EEG (Electroencephlogram) -Abnormal szr electric activity brain

Allopurinol Zyloprim discontinue med for

FEVER

Asthma LONG TERM prophylaxis meds

Flovent, Intal, Singulair (FI

Zyloprim expect s/e GI

GI N/V, abd pain, drhea, drowsy, metallic taste

Zyloprim treats

GOUT -arthritis joints

Phenytoin Dylantin (10-20) watch for

Gingival Hyperplasia -tell dentist on it -massage gums

Aldactone Spironlactone (K+ sparing)

HYPERkalemia

A nurse is planning to administer diltiazem via IV bolus to a client who has atrial fibrillation. When assessing the client, the nurse should recognize that which of the following findings is a contraindication to administration of diltiazem?

Hypotension

Thrombocytopenia PLATELETS

If dec prolong bleed time

Dexamethasone Decadon gluccocosteroid-Immunosupressant

Inc BS, delay wound healing, blood dyscraisis-bruise

A nurse is preparing to administer oxytocin to a client who is at 41 weeks of gestation and is experiencing ineffective labor. Which of the following actions should the nurse plan to take?

Increase the dose of oxytocin to obtain uterine contractions that occur every 2 to 3 min.

Reglan contraindicated

Instestinal obstruction

A nurse is caring for a client who is in preterm labor and has a new prescription for nifedipine. The client states she is concerned because her father takes nifedipine for his angina pectoris. The nurse should explain to the client that nifedipine works for clients who are pregnant by which of the following mechanisms?

It inhibits uterine contractions by blocking entry of calcium into uterine cells.

Ginko Bloba

Memory/Cognition

Thiazide Diuretic (K+ wasting)

Muscle weakness -sign HYPOkalemia

Lithium

NO diet/fasting -Mild exercise ok-replace Na+ sweating -DONT just inc Na+=dec lithium level by excreting meds

Intal Asthma

NOT rescue med -rinse mouth, MDI-breath in slow, spacer-get all med

Isotonic solution

NS LR D5W -osmotic pressure equal blood

Neuopogen Filgrastim Check CBC for

Nuetrophil count

NPH (cloudy) insluin

Onset action: 1-2 hours

Reg Insulin

Onset action: 30-60 min Peak: 2-4 hours

A hospice nurse is caring for a client who has cancer and is taking naproxen 250 mg 3 times daily PO and gabapentin 1,800 mg three times daily to manage pain. The client tells the nurse, "I'm having pain that keeps me from doing what I'd like most of the time." Which of the following additions should the nurse anticipate to the client's medication regimen?

Oral oxycodone

Preggo need CST use

Oxytocin/pitocin -stimulate contractions

Rocephin allergy to

PIPERACILLIN

Amotryptaline Elavil Major Depression Avoid

PREGNANCY -fetal abnormalaties

A nurse is caring for a client who was brought to the emergency department by friends who report the client has overdosed on heroin. Which of the following findings should the nurse expect to assess?

Pinpoint pupils

A nurse is monitoring laboratory values for a male client who has leukemia and is receiving weekly chemotherapy with methotrexate via IV infusion. Which of the following laboratory values should the nurse report to the provider?

Platelets 78,000/mm3

Lrazepam Ativan Older 50

Profound SEDATION

Saw Palmetto

Promote urinary health

Gentamicin Sulfate Garamycin adverse effect

Proteinuria -indicates renal damage/nephrotoxicity

Rhogam given mom before baby born to what

RH (-) mom Prevent hemolytic NB

Cirrhosis use LACTULOSE

Reduce ammonia -shit out

Aspirin contraindicated

Reye's Syndrome (Flu/Chick Pox)

Nifidipine Procardia preggo used

STOP PTL -pre term labor

A nurse is preparing a discharge teaching plan for a client who is to begin long-term oral prednisone for asthma. Which of the following instructions should the nurse include in the plan?

Schedule the medication on alternative days to decrease adverse effects.

Prednisone R/F

Stress Fracture -osteoperosis Expect: wt gain, edema, HTN from Na+ & fluid retention

Theoyphilline cause

TREMORS -no caffeine -no double dose -tachycardia

A nurse is planning care for a female client who has severe irritable bowl syndrome with diarrhea (IBS-D) and a new prescription for alosetron. Which of the following interventions should the nurse include in the plan of care?

The client must sign an agreement with the provider before beginning alosetron.

A nurse is caring for a client who has heart failure and is taking oral furosemide 40 mg daily. For which of the following adverse effects should the client be taught to monitor and notify the provider if it occurs?

Tinnitus

Atropine/Lomotil ulcerative colitis monitor

Toxic Megacolon -peristalsis issue Expect: inc HR, inc temp, dec BP, abd distention, cramp, reduction/stop of Drhea

Digoxin Lanoxin Affect GI

anorexia, n/v, YELLOW HALO, HYPOkalemia

A nurse is providing teaching to a client who is to start taking hydrochlorothiazide for hypertension. The nurse instructs the client to eat foods rich in potassium. Which of the following statements by the client indicates an understanding of the teaching?

"This medication can cause a loss of potassium."

Nitroglycerin

3 tabs/5 min apart

K+

3.5-5.0

RBC

4.5-5 million

WBC (infxn)

5-10,000

Ginseng

Libido

A nurse is assessing a client who has hypothyroidism and takes levothyroxine. Which of the following findings should alert the nurse that the client is experiencing acute levothyroxine overdose?

Tremor

A nurse is assessing a client who takes oral theophylline for relief of chronic bronchitis. The nurse should recognize that which of the following findings indicates toxicity to theophylline?

Tremors

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?

"I am likely to develop higher blood pressure while taking this medication."

A nurse is preparing to administer codeine 30 mg PO every 4 hr PRN to a client for pain. The amount available is codeine oral solution 15 mg/5ml. How many mL should the nurse plan to administer per dose? (Round to the nearest whole number)

10 mL

PTT *No more 70

25-35 Heparin

A nurse is preparing to administer ampicillin 500 mg in 50 ml of dextrose 5% in water (D5W) to infuse over 15 min. The drop factor of the manual IV tubing is 10 gtt/mL. The nurse should set the manual IV infusion to deliver how many gtt/min? (Round to the nearest whole number)

33 gtt/min

A nurse is preparing to administer dextrose 5% in 0.45% sodium chloride 400 mL IV to an older adult client over 8 hr. The nurse should set the IV pump to deliver how many mL/hr? (Round to the nearest whole number)

50 mL/hr

Fuorsemide Lasix (K+ wating)

HYPOkalemia

Aldactone Spironlactone

Limit foods Na+ NO salt substitute Take w/food Weigh 2-3 days, and report weight gain 5 pounds/more

Lopid check

Liver Fxn

Plavix used

MI/Stroke

A home health nurse is visiting an older adult client who has Alzheimer's disease. His caregiver tells the nurse she has been administering prescribed lorazepam, 1 mg three times per day, to the client for restlessness and anxiety during the past few days. For which of the following adverse effects should the nurse assess the client?

Sedation

A nurse is assessing a client who reports using several herbal and vitamin supplements daily, including saw palmetto. The nurse should recognize that saw palmetto is a supplement used by clients to elicit which of the following therapeutic effects?

Urinary health promotion

A nurse in an outpatient facility is assessing a client who is prescribed furosemide 40 mg daily but the client reports she has been taking extra doses to promote weight loss. Which of the following findings should indicate to the nurse that the client is dehydrated?

Urine specific gravity 1.035