N180 FINAL ATI Pharmacology Final

A nurse is providing discharge teaching to a pt who had a kidney transplant & has a new prescription for oral cyclosporine. Which of the following statements by the pt indicates an understanding of the teaching? "I will be able to stop taking this medication 6 months after my surgery." "I am likely to develop higher blood pressure while taking this medication." "I am likely to lose my hair while taking this medication." "I am taking this medication to boost my immune system."

"I am likely to develop higher blood pressure while taking this medication." Half the clients who take cyclosporine develop a 10% to 15% increase in blood pressure and might need to start antihypertensive therapy.

A nurse is providing teaching to a pt who is to start taking hydrochlorothiazide for hypertension. The nurse instructs the pt to eat foods rich in potassium. Which of the following statements by the pt indicates an understanding of the teaching? "This medication will not work unless I have enough potassium." "Potassium will increase the therapeutic effect of my blood pressure medication." "Potassium will lower my blood pressure." "This medication can cause a loss of potassium."

"This medication can cause a loss of potassium."

A nurse is planning to administer diltiazem via IV bolus to a client who has A Fib. When assessing the client, the nurse should recognize that which of the following findings is a contraindication to administer diltiazem? Hypotension Tachycardia Decreased level of consciousness History of diuretic use

Hypotension . . . Diltiazem can be a treatment option for essential hypertension. This medication will lower blood pressure and is contraindicated for a client who is hypotensive. The nurse should teach the client to self-monitor blood pressure and keep a record of the readings.

A nurse is providing teaching to a pt who has hypertension & type 1 diabetes & a new prescription for metoprolol. Which of the following statements by the pt indicates an understanding of the teaching? a. "I might have difficulty recognizing when my blood sugar is low." b. "I will have less risk for developing an infection while I take this medication." c. "I should be concerned about losing excess weight while I take this medication." d. "I could have more problems with high blood sugars while taking this medication."

a

A nurse is providing teaching to a pt who has HF & is taking spironolactone. Which of the following statements by the pt indicates an understanding of the teaching? a. "I will increase my intake of citrus fruits, bananas, and potatoes." b. "I will use salt substitutes on my food." c. "I will drink as much water as I can while taking this medication." d. "I will watch for increased breast tissue growth while taking this medication."

d.

A nurse in an outpatient facility is assessing a pt who is prescribed furosemide 40 mg daily, but the pt reports that she has been taking extra doses to promote weight loss. Which of the following findings should indicate tot he nurse that the pt is dehydrated? Urine specific gravity 1.035 Distended neck veins BUN 18 mg/dL Bounding radial pulses

urine specific gravity 1.035 . . . Oliguria, increased urine concentration, and an increase in urine specific gravity greater than 1.030 are expected findings in clients who are dehydrated.

A nurse is administering insulin glulisine 10 units subQ at 0730 to an adolescent pt who has Type 1 diabetes. The nurse should anticipate onset of action of the insulin at which of the following times? 0800 0745 0900 1030

0745 . . . Insulin glulisine has a very short onset of action of 15 min. The nurse should expect the onset of action around 0745 and ensure the client eats breakfast immediately following administration of the insulin.

A nurse is planning to administer epoetin alfa to a client who has chronic kidney failure. Which of the following data should the nurse plan to review prior to administration of this medication? Blood pressure Temperature Blood glucose levels Total protein level

Blood pressure . . . epoetin alfa can cause hypertension, which can lead to stroke or cardio problems. Monitor the BP & notify if it increases.

A nurse is visiting an older adult pt who has Alzheimer's disease. His caregiver tells the nurse that she has been administering prescribed lorazepam, 1 mg TID, to the pt for restlessness & anxiety during the past few days. For which of the following adverse effects should the nurse assess the client? Low-grade fever Sedation Diuresis Tonic-clonic seizures

Sedation Lorazepam is a benzodiazepine with anti-anxiety and sedative effects. Older adult clients, especially, are at risk for central nervous system depression even with low doses of benzodiazepines. Clients who are 50 years or older can have a more profound and prolonged sedation than younger clients.

A nurse is assessing a pt who has hypothyroidism & takes levothyroxine. Which of the following findings should alert the nurse that the pt is experiencing acute levothyroxine overdose? Bradycardia Cold intolerance Tremor Hypothermia

Tremor Tremor and anxiety are expected findings in acute levothyroxine overdose. These findings are similar to those seen in hyperthyroidism.

A nurse is assessing a pt who reports using several herbal & vitamin supplements daily, including saw palmetto. The nurse should recognize that saw palmetto is a supplement used by pt to elicit which of the following therapeutic effects? Urinary health promotion Immune system stimulation Decreased leg pain from arterial disease Prevention of nausea caused by motion sickness

Urinary health promotion Saw palmetto is used primarily for manifestations related to prostatic conditions, such as benign prostatic hypertrophy (BPH). Its effectiveness has not been scientifically proven, however. The nurse should teach the client to check with the provider about interactions between saw palmetto and other medications.

A nurse is planning discharge teaching for a pt who has major depressive disorder & a new prescription for phenelzine. Which of the following foods should the nurse include in the plan as safe for the pt to consume while taking phenelzine? a. Broiled beef steak b. Macaroni and cheese c. Pepperoni pizza d. Smoked salmon

a.

A nurse is preparing a discharge teaching plan for a 6-year-old pt who has asthma & several prescription medications using metered-dose inhalers (MDIs) which of the following interventions should the nurse include in the plan? a. Add a spacer to each MDI. b. Instruct the child to inhale more rapidly than usual when using an MDI. c. Request that the provider change the child's medications from inhaled to oral formulations. d. Administer oxygen by facemask along with the MDI.

a.

A nurse is providing discharge teaching to a pt who has angina pectoris & a new prescription for verapamil. The pt tells the nurse, "My brother takes verapamil for high BP. do you think the provider made a mistake?" Which of the following responses should the nurse make? a. "Verapamil is used to treat both high blood pressure and angina." b. "You should talk to your provider to make sure the prescription is correct for you." c. "Are you concerned that you might have high blood pressure?" d. "Your provider has prescribed verapamil so that you will not develop high blood pressure."

a.

A nurse is preparing to administer iron dextran IV to a pt. Which of the following actions should the nurse plan to take? a. Administer a small test dose before giving the full dose. b. Infuse the medication over 30 seconds. c. Monitor the client closely for hypertension after the infusion. d. Administer cyanocobalamin as an antidote if iron dextran toxicity occurs.

a. iron dextran adverse effect = anaphylaxis test small dose over 5 min before giving full dose

A nurse is planning care for a female pt who has severe irritable bowel syndrome w/ diarrhea (IBS-D) & a new prescription for alosteron. Which of the following interventions should the nurse include in the plan of care? a. The client must sign an agreement with the provider before beginning alosetron. b. The client must stop taking alosetron if diarrhea continues 1 week after beginning the medication. c. The client should expect to have a slower heart rate while taking alosetron. d. The client should use a barrier birth control method because alosetron interacts with oral contraceptives.

a. The client must sign an agreement with the provider before beginning alosetron. Alosetron has potentially fatal adverse effects associated with constipation and bowel obstruction. The FDA has allowed alosetron to be placed on the market only if clients sign and adhere to a risk management program, which includes signing a client-provider agreement before starting alosetron.

A nurse is monitoring lab values for a male pt who has leukemia & is receiving weekly chemo w/ methotrexate via IV infusion. Which of the following lab values should the nurse report to the provider? a. BUN 18 mg/dL b. Platelets 78,000/mm3 c. Hemoglobin 14.2 g/dL d. Aspartate aminotransferase (AST) 35 units/L

b

A nurse is caring for a pt who has a positive TB skin test & is beginning a prescription for isoniazid. The nurse should teach the pt that which of the following lab values should be monitored while taking isoniazid? a. Thyroid Stimulating Hormone level (TSH) b. Aspartate aminotransferase (AST) c. Potassium d. Sodium

b. 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 providing discharge teaching to a pt who has venous thrombosis & a prescription for warfarin. Which of the following instructions should the nurse include in the teaching? a. Take ibuprofen as needed for headache or other minor pains. b. Carry a medic alert ID card. c. Report to the laboratory weekly to have blood drawn for aPTT. d. Increase intake of dark green vegetables.

b. carry a med alert ID card

A nurse is administering adenosine via IV bolus for a pt who has developed paroxysmal atrial tachycardia. For which of the following findings should the nurse assess the pt during administration of adenosine? Seizures Cinchonism Dyspnea Transient pallor of the face

c

A nurse is providing discharge teaching to a pt who had a bleeding duodenal ulcer & is prescribed omeprazole. Which of the following statements should the nurse include in the teaching? a. "You will need to take this medication for the next 6 months." b. "Taking this medication will decrease your risk for acquiring pneumonia." c. "You should take this medication before breakfast every day." d. "Watch for the serious adverse effects of tachycardia and heart palpitations while taking this medication."

c

A nurse is caring for a pt who is in preterm labor & has a new prescription for nifedipine. The pt states she is concerned bc her father takes nifedipine for his angina pectoris. The nurse should explain to the pt that nifedipine works for pt who are pregnant by which of the following mechanisms? a. It decreases the incidence of bacterial vaginosis, thus preventing uterine contractions. b. It inhibits uterine contractions by blocking entry of calcium into uterine cells. c. It decreases the activity within the CNS, which regulates all smooth muscle. d. It stimulates beta2 receptors in the uterus, which results in decreased frequency of contractions.

c Nifedipine, a calcium channel blocker, causes uterine relaxation by blocking the flow of calcium to the myometrial cells of the uterus.

A nurse is caring for a pt & realizes after administering the 0900 medications that she administered digoxin 0.25 mg PO to the pt instead of the prescribed digoxin 0.125 mg PO. Which of the following actions should the nurse take first? Notify the provider. Contact the nursing supervisor. Assess the client's apical pulse. Complete an incident report.

c.

A nurse is providing discharge teaching about lithium toxicity to a pt who has a new prescription for lithium. Which of the following statements by the pt indicates an understanding of the teaching? a. "I should take naproxen if I have a headache because aspirin can cause lithium toxicity." b. "I can develop lithium toxicity if I eat foods with lots of sodium." c. "I can develop lithium toxicity if I experience vomiting or diarrhea." d. "I might need to take a daily diuretic along with my lithium to prevent lithium toxicity."

c.

A nurse is caring for a pt who has alcohol use disorder & is admitted w/ lower extremity fractures following a motor-vehicle crash. A few hrs after admission, the pt develops restlessness & tremors. Which of the following medications should the nurse anticipate administering to the pt first? a. Acamprosate b. Naltrexone c. Chlordiazepoxide d. Disulfiram

c. Chlordiazepoxide, a long-acting oral benzodiazepine, is a first-line medication to use for a client who is experiencing manifestations of acute alcohol withdrawal. For clients who are nauseated or vomiting, another benzodiazepine, such as lorazepam, can be administered via IV. The nurse should apply the acute versus chronic priority-setting framework when caring for this client. Using this framework, acute needs (manifestations of acute alcohol withdrawal) are typically the priority need because they pose more of a threat to the client. Because chronic needs usually develop over a period of time, the client has more of an opportunity to adapt to the alteration in health.

A nurse is providing teaching to a pt who has postmenopausal osteoporosis & a new prescription for intranasal calcitonin-salmon. Which of the following statements by the client indicates an understanding of the teaching? a. "I will administer a spray into each nostril daily." b. "I should expect nasal bleeding for the first week." c. "I will need to depress the side arms to activate the pump." d. "I should expect to take this medication for a short-term course of treatment."

c. "I will need to depress the side arms to activate the pump." The nurse should instruct the client to activate the pump on the initial use by holding the bottle upright and depressing the two white side arms toward the bottle six times.

A nurse is preparing a discharge teaching plan for a pt who is to begin long-term oral prednisone for asthma. Which of the following instructions should the nurse include in the plan? a. Stop taking the medication if a rash occurs. b. Take the medication on an empty stomach to enhance absorption. c. Schedule the medication on alternate days to decrease adverse effects. d. Treat shortness of breath with an extra dose of the medication.

c. schedule the med on alternate days to decrease adverse effects

A nurse is preparing to administer oxytocin to a pt who is at 41 weeks of gestation & is experiencing ineffective labor. Which of the following actions should the nurse plan to take? a. Place the oxytocin from a pre-filled syringe into the posterior fornix of the vagina every 10 min until effective labor occurs. b. Check the client's blood pressure and pulse every 15 min while induction of labor is occurring. c. Stop the oxytocin for contractions that continue longer than 30 seconds. d. Increase the dose of oxytocin to obtain uterine contractions that occur every 2 to 3 min.

d.

A nurse is providing teaching to a pt who has hypertension & a new prescription for oral clonidine. Which of the following instructions should the nurse include in the teaching? a. Discontinue the medication if a rash develops. b. Expect increased salivation during the first few weeks of therapy. c. Minimize fiber intake to prevent diarrhea. d. Avoid driving until the client's reaction to the medication is known.

d.

A nurse is providing discharge teaching to a pt who has HF & a prescription for digoxin 0.125 mg PO daily & furosemide 20 mg PO daily. Which of the following statements by the pt indicates and understanding of the teaching? a. "I know that blurred vision is something I will expect to happen while taking digoxin." b. "I will measure my urine output each day and document it in my diary." c. "I will skip a dose of my digoxin if my resting heart rate is below 72 beats per minute." d. "I will eat fruits and vegetables that have high potassium content every day."

d. Hypokalemia is an adverse effect of diuretic therapy. Maintain potassium between 3.5 to 5.0 to avoid digoxin toxicity.

A nurse is planning to administer diphenhydramine 50 mg via IV bolus to a pt who is having an allergic reaction. The pt has an IV infusion containing a med that is incompatible w/ diphenhydramine in solution. Which of the following actions should the nurse take? a. Choose an IV port for IV bolus injection of the diphenhydramine as near as possible to the client's hanging IV bag. b. Flush the IV tubing with 2 mL of 0.9% sodium chloride before and after administering diphenhydramine. c. Allow the IV infusion to keep running while administering the diphenhydramine via IV bolus. d. Aspirate to check for IV patency before administering the diphenhydramine.

d. It is important to confirm IV patency prior to administering an IV bolus. Some medications cause severe tissue damage when inadvertently administered into tissue rather than into a vein.

A nurse is administering ciprofloxacin & phenazopyridine to a pt who has a severe UTI. The pt asks why both medications are needed. Which of the following responses should the nurse make? a. "Phenazopyridine decreases adverse effects of ciprofloxacin hydrochloride." b. "Combining phenazopyridine with ciprofloxacin hydrochloride shortens the course of therapy." c. "The use of phenazopyridine allows for a lower dosage of ciprofloxacin hydrochloride." d. "Ciprofloxacin hydrochloride treats the infection, and the phenazopyridine treats pain."

d. Ciprofloxacin hydrochloride treats the infection, and the phenazopyridine treats pain Ciprofloxacin hydrochloride is a broad-spectrum quinolone antibiotic and phenazopyridine is a bladder analgesic/anesthetic that relieves burning and pain in the bladder mucosa caused by bladder spasm and inflammation.

A nurse is caring for a pt who has CHF & is taking digoxin. The pt reports nausea & refuses to eat breakfast. Which of the following actions should then nurse take first? a. Encourage the client to eat the toast on the breakfast tray. b. Administer an antiemetic. c. Inform the client's provider. d. Check the client's apical pulse.

d. check the apical pulse Nausea, anorexia, fatigue, visual effects, and cardiac dysrhythmias, often caused by a slow pulse rate, are possible findings in digoxin toxicity. Caring for this client requires application of the nursing process priority-setting framework. The nurse can use the nursing process to plan client care and prioritize nursing actions. Each step of the nursing process builds on the previous step, beginning with assessment. Before the nurse can formulate a plan of action, implement a nursing intervention, or notify the provider about a change in the client's status, she must first collect adequate data from the client. Assessing will provide the nurse with knowledge to make an appropriate decision.

A nurse is administering oral diphenhydramine/hydroxyzine to a pt. Which of the following adverse effects should the nurse instruct the pt to expect? Diarrhea Anxiety Nausea and vomiting Dry mouth

dry mouth

A nurse is providing teaching to apt who has type 2 diabetes & a new prescription for metformin. Which of the following adverse effects of metformin should the nurse instruct the pt to watch for & report to the provider? Weight gain Myalgia Hypoglycemia Severe constipation

myalgia Myalgia, malaise, somnolence, and hyperventilation are manifestations of lactic acidosis, which rarely occur while taking metformin due to blockage of lactic acid oxidation. The nurse should instruct the client to report these findings promptly to the provider.

A hospice nurse is caring for a pt who has cancer & is taking naproxen 250 mg TID and gabapentin 1,800 mg TID PO to manage pain. The pt tells the nurse "I'm having pain that keeps me from doing what 'd like most of the time." Which of the following additions should the nurse anticipate to the pt's medication regimen? Oral meperidine Parenteral naloxone Parenteral diazepam Oral oxycodone

oral oxycodone

A nurse is caring for a pt who was brought to the ER by friends who report the pt has overdosed on heroin. Which finding should the nurse assess? Temperature 39.2° C (102.6° F) Respiratory rate 30/min Pinpoint pupils Severe abdominal cramping

pinpoint pupils (opioid toxicity)

A nurse is caring for a pt who has HF & is taking oral furosemide 40 mg daily. For which of the following adverse effects should the pt be taught to monitor & notify the provider if it occurs? Nasal congestion Tremors Tinnitus Frontal headache

tinnitus

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

tremors