EXAM 3 PHARM FROM ATI

A nurse is teaching a client who has a new ezetimibe prescription for hyperlipidemia. Which of the following client statements should indicate to the nurse that the teaching was effective?

"I should let my doctor know if I have yellowing of my eyes." The nurse should include in the teaching that jaundice can be an adverse effect of ezetimibe as a result of hepatitis. The client should notify the provider if this occurs.

A nurse is preparing to administer nitroglycerin topical ointment to a client who has angina. Which of the following actions should the nurse take?

Apply the ointment using a dose-measuring applicator The nurse should apply the ointment using a dose-measuring applicator. This allows the nurse to measure the correct dose the client is to receive.

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

Aspartate aminotransferase (AST) Isoniazid can be toxic to the liver. Therefore, it is important to monitor liver enzymes such as AST during therapy with isoniazid. In addition, the nurse should instruct the client to notify the provider of jaundice, nausea, dark-colored urine, or other findings indicating hepatitis

A nurse is caring for a client who is receiving continuous cardiac monitoring. Which of the following medications should the nurse anticipate administering to treat atrial fibrillation?

Diltiazem Diltiazem, a calcium channel blocker, is used to slow the ventricular rate in atrial fibrillation or flutter. Diltiazem is also prescribed to treat hypertension, angina, and other supraventricular tachyarrhythmias.

A nurse is caring for a client who has hyperlipidemia and is receiving simvastatin 40 mg PO daily. Which of the following items should the nurse remove from the client's breakfast tray before it is delivered to the room?

Grapefruit juice is contraindicated for a client who is taking simvastatin because it raises blood levels of the medication significantly by inactivating a liver enzyme that is responsible for metabolism.

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?

Hypotension Enalapril, an angiotensin-converting enzyme (ACE) inhibitor, can cause hypotension and postural hypotension, especially during the first 3 hours following the initial dosage.

A nurse is reviewing the laboratory reports of a client who has been taking warfarin for atrial fibrillation. Which of the following results should the nurse report to the provider immediately?

INR 5.5 When using the urgent vs nonurgent approach to client care, the nurse should determine that the priority laboratory result is an INR of 5.5. A client who is taking warfarin for the treatment of atrial fibrillation is expected to have an INR in the range of 2 to 3. A level of 5.5 is considered a critical value and places the client at risk of bleeding; therefore, the nurse should report this result to the provider immediately.

A nurse is providing discharge teaching for a client who has a new prescription for metoprolol. Which of the following instructions should the nurse include? (Select all that apply.)

"Do not stop taking this medication abruptly." "Count your radial pulse daily." "Change positions slowly." Clients who stop taking metoprolol abruptly increase their risk of angina, hypertension, and myocardial infarction. They should reduce the dosage gradually over 1 to 2 weeks. Clients should count the radial pulse daily and report a heart rate slower than 60/min. Metoprolol can cause orthostatic hypotension; to prevent injury, the client should move slowly from lying down or sitting to standing.

A nurse is providing teaching to a client who has tuberculosis (TB) and a prescription for isoniazid. Which of the following instructions should the nurse include?

"You should take this medication on an empty stomach." The nurse should instruct the client to take isoniazid on an empty stomach to improve absorption of the medication. To ensure the stomach is empty, the client should take the medication either 1 hour before or 2 hours after a meal.

A nurse is assessing a client who has multidrug-resistant tuberculosis and takes ethambutol. The nurse should identify which of the following findings as an adverse effect of this medication?

Loss of red/green color discrimination Ethambutol is an antitubercular medication that impairs ribonucleic acid synthesis. A common adverse reaction is the loss of red/green color discrimination due to optic neuritis. The nurse should notify the provider of this finding and expect to discontinue the medication.

A nurse is caring for a client who has been taking isoniazid and rifampin for 3 weeks for the treatment of active pulmonary tuberculosis (TB). The client reports his urine is an orange color. Which of the following statements should the nurse make?

Rifampin can turn body fluids orange." Rifampin can cause body fluids, such as tears, sweat, saliva, and urine, to turn a reddish-orange color. The nurse should inform the client that this effect does not cause harm.

A nurse is admitting a client who has atrial fibrillation with a heart rate of 155/min. The nurse should anticipate a prescription from the provider for which of the following medications?

The nurse should anticipate the provider to prescribe diltiazem for a client who is experiencing atrial fibrillation. Diltiazem is an antiarrhythmic agent that reduces the ventricular rate in atrial fibrillation.

A nurse is caring for a client who had a myocardial infarction 2 hours ago and is receiving alteplase. Which of the following findings should the nurse identify as an adverse effect of receiving this medication?

The nurse should identify that an adverse effect of alteplase is bleeding. Severe bleeding can occur as a result of the alteplase-plasminogen complex, which catalyzes the conversion of other plasminogen molecules that digest fibrin clots. This action of the medication can contribute to hemorrhage.