Capstone exam 2

A nurse is teaching a client with multiple sclerosis who has a new prescription for dantrolene (Dantrium). Which of the following client statements indicates that the client understands the teaching?

"I need to apply a sunscreen when I go outside."

A nurse is reviewing discharge instructions with a client who has rheumatoid arthritis and a new prescription for prednisone. Which of the following statements by the client indicates an understanding of the teaching?

"I should eat more bananas while taking this medication."

A nurse is reinforcing teaching with a client who has rheumatoid arthritis and a new prescription for methotrexate. Which of the following client statements indicates understanding?

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

A nurse is teaching a client who has a new prescription for nitroglycerin. The nurse should instruct the client that which of the following manifestations is a potential adverse effect of the drug?

Headache

Verapamil -nurse monitors what

Heart rate.EKG - 2nd degree AV block

Morphine- adverse effects

respiratory depression .Sedation

A nurse is preparing to discharge a child who has a new prescription for an oral antibiotic. Which of the following information should the nurse include in the discharge instructions?

The reason why the child is taking the medication. Written information about the medication.The adverse effects of the medication

Corticosteroid adverse effects

Think about the "S" in Steroids. Sugars - hyperglycemia. Soft bones - osteoporosis. Sick - decreased immunity/sepsis. Sad - depression .Salt - water and salt retention (HTN). Sex - decreased libido . Swollen - water gain = weight gain. Sight - risk for cataracts

A nurse is completing discharge teaching to a client about nutrition therapy for wound healing following major surgery. Which of the following vitamins that promote wound healing should the nurse include in the teaching? SATA

Vitamin A. Vitamin C

A nurse in an emergency department is preparing to administer alteplase accelerated therapy to a client who is having a myocardial infarction. Which of the following actions should the nurse plan to take? SATA

Administer within 30 min of the client's arrival to the ED.Reconstitute the medication with sterile water .Assess the client for back pain

A nurse is caring for a client who is experiencing anaphylactic shock in response to the administration of penicillin. Which of the following medications should the nurse administer first?

Epinephrine

Penicillin anaphylactic reactions- what do you do?

Epinephrine

A nurse is teaching a client who is starting to take alendronate effervescent tablets to treat osteoporosis. Which of the following info should the nurse include?

"Sit upright or stand for at least 30 minutes after taking this medication."

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

"This medication may cause your skin to appear yellow in color."

The patient runs 4 miles outdoors every afternoon (dehydration)

Adequate intake of sodium. Obtain daily weight. New prescription for valproic acid use? , Liver function tests must be monitored

A nurse is preparing a client who is to receive chemotherapy for treatment of ovarian cancer. Which of the following actions should the nurse plan to take?

Administer an antiemetic prior to the procedure

Client having MI given Alteplase which are the priority actions in administration

Administer within 3 hours of symptoms. No new injections Avoid IM injections. Avoid unnecessary IV punctures

Vancomycin-adverse effect

Audible inspiratory stridor. Ototoxicity.Nephrotoxicity .Phlebitis.Infusion reaction (Red man syndrome)

HCTZ CHECK LAB VALUES

Decrease in potassium .Increase in blood glucose (indication of adverse response). Magnesium. LDL and HDL. Increase in uric acid

A nurse is assessing a client who is receiving IV vancomycin. The nurse notes a flushing of the neck and tachycardia. Which of the following actions should the nurse take?

Decrease the infusion rate on the IV

Lorazepam what is the reversal

Flumazenil

Phenytoin given to infants has risk for becoming toxic WHY

Immature function of the liver

Multiple sclerosis- Baclofen- teaching

Increase fiber and fluid intake.Can cause dizziness. This medication will help control muscle spasms

Chronic Kidney- Epoetin alfa- increase what in the diet

Iron

Understand Methadone and if you had to reverse effects

Naloxone is the antidote

Discharge teaching -bipolar

New prescription for lithium that may cause lithium toxicity?. If patient is experiencing diarrhea/vomiting/muscle weakness

Gentamicin toxicity what are the manifestations

Ototoxicity. Hearing loss. Tinnitus. Nephrotoxicity

A nurse is planning care for a child who has asthma. Which of the following interventions should the nurse include in the plan of care? SATA

Place the child in an upright positioN. Monitor oxygen saturation .Administer bronchodilators

A nurse in a mental health clinic is caring for a client who has bipolar disorder and a prescription for an antipsychotic medication. The provider and nursing staff suspect the client is not adhering to his medication therapy. Which of the following interventions should the staff use to encourage the client's adherence? SATA

Provide for once-daily dosing.Use sustained-release forms. Engage the client in conversation following medication administration.

What are the lab values to report Amphotericin B

Serum potassium 3.5-5.0. Hematocrit 37-52%. Serum creatinine 0.5-1.1

PTL (PRETERM LABOR) TERBUTALINE - ADVERSE EFFECTS

Tachycardia.Angina.Hypokalemia.Dysrhythmias.Restlessness.Tremors

Alendronate taken when

Take first thing in the morning after getting out of bed (once a day or once a week). Take on an empty stomach - take with a full glass of water .Sit upright for 30 minutes after administering

A nurse is caring for a client who requires medication that is packaged in a single dose glass ampule. Which of the following techniques should the nurse use when opening the glass ampule?

Tap the top of the ampule, place a sterile gauze pad around the ampule neck, and break off the top by bending it toward the body.

Glucosamine- use

Treats osteoarthritis

Discharge teaching nutrition therapy- vitamins

Vegetarians are at risk for B9 and B12 deficiency.Vitamin D enhances calcium.Vitamin C enhances iron absorption

Parenteral drugs reduce blood flow to the stomach- what is that called

first-pass effect.

Parenteral drugs bypass the first-pass effect. Rationale: Drugs given by the parenteral route bypass the first-pass effect. Reduced blood flow to the stomach and the presence of food in the stomach apply to enteral drugs (taken orally)

not to parenteral drugs. Parenteral drugs must be absorbed into cells and tissues from the circulation before they can exert their effects; they do not exert their effects while circulating in the bloodstream.

A nurse suspects anaphylaxis when caring for a client following the initial administration of an oral antibiotic. Which of the following should be the nurse's priority intervention?

Count the respiratory rate

Amiodarone what should one avoid in diet

Grapefruit

A nurse is caring for a client who has streptococcal pneumonia and a prescription for penicillin G by intermittent IV bolus. 10 minutes into the infusion of the third dose

the client reports that the IV site itches and that he feels dizzy and short of breath. Which of the following actions should the nurse take first? , Stop the infusion

A nurse is preparing a client for surgery. Prior to administering the prescribed hydroxyzine

the nurse should explain to the client that the medication is for which of the following indications. SATA ,Controlling Emesis. Diminishing Anxiety. Reducing the amount of narcotics needed for pain relief. Drying secretions

A nurse is caring for a client who has osteoarthritis & asks about the use of glucosamine. Which of the following statements should the nurse make?

Glucosamine might increase bleeding. Glucosamine can increase blood glucose levels. Client who has a shellfish allergy might experience reactions when taking glucosamine

A nurse is administering hydrochlorothiazide to a client who has arthritis. The nurse should monitor the client for which of the following findings indicates an adverse effect of this drug?

Hyperuricemia

A nurse is administering IV amphotericin B to a client who has a systemic fungal infection. The nurse should monitor for which of the following lab values? SATA

Hypokalemia is a serious adverse effect of amphotericin B.Amphotericin B can cause bone marrow suppression -monitor CBC and platelets.Can cause nephrotoxicity -monitor kidney function (creatinine and BUN)

Mag Sulfate -preterm labor -nursing assessment

Loss of DTRs. Respiratory depression (if respiratory and urine are both an option, go with respiratory)

A nurse is preparing to administer magnesium sulfate IV to a client who is experiencing preterm labor. Which of the following is the priority nursing assessment for this client?

Respiratory rate

A nurse is teaching an adolescent to self-administer a corticosteroid medication using a metered-dose inhaler (MDI). Which of the following instructions should the nurse include? SATA

Rinse and expectorate after administration,Inhale slowly with medication administration .(Hold breath for 5-10 secs, wait 1 minute in between puffs)

Prednisone - discharge teaching- understanding

Taper off medication to prevent adrenal insufficiency (Cushing's syndrome). Report new stressors .Cause weight gain .Increase calcium and vitamin D

A nurse is caring for a client who has an E. coli infection and a prescription for gentamicin 5mg/kg/day by intermittent IV bolus every 8 hr. Which of the following manifestations indicate the client is experiencing gentamicin toxicity? SATA

Tinnitus. dizziness

A nurse is assessing a client who is at 35 weeks' gestation and is receiving magnesium sulfate via continuous IV infusion for severe pre-eclampsia. Which of the following findings should the nurse report to the provider?

Urine output 20 mL/hr

A nurse is admitting a client who states he is taking ginkgo biloba every day to improve his memory. The nurse should identify a potential interaction with which of the following medications the client is taking?

Warfarin

A nurse is caring for a client who has an infection and a prescription for gentamicin intermittent IV bolus every 8 hr. A peak and trough is required with the next dose. Which of the following actions should the nurse take to obtain an accurate gentamicin serum level?

Draw a trough level immediately prior to administering the medication and a peak level 30 minutes after.

Methotrexate needs instructions to client What would that be? Precautions?

Drink at least 2 L water dailyFolic acid is the antidote. Avoid pregnancy 3 months prior, during, and 6 months after treatment. (Use contraception). No live vaccines - flu shot is ok - NO herpes zoster. Notify provider asap for s/s of infection

Dantrolene- teaching- understanding

Drowsiness, sedation, and dizziness are normal side effects - do not stop taking .Do not stop abruptly - can cause rebound effects

A nurse is caring for a client who is in premature labor and is receiving terbutaline. The nurse should monitor the client for which of the following adverse effects that should be reported to the provider?

Dyspnea

A nurse is preparing to administer verapamil by IV bolus to a client who is having cardiac dysrhythmias. For which of the following adverse effects should the nurse monitor when giving this medication?

Hypotension

A nurse is caring for a client who has a DVT and has been on heparin continuous infusion for 5 days. The provider prescribes warfarin PO without discontinuing the heparin. The client asks the nurse why both anticoagulants are necessary. Which statement should the nurse make?

Warfarin takes several days to work, so the IV heparin will be used until the warfarin reaches a therapeutic level.