NUR 240 EAQ - Pharmacological and Parenteral Therapies

For clients experiencing an anaphylactic attack, which medication would the nurse initiate immediately?

Isoproterenol

A client is to receive an antibiotic by intravenous piggyback (IVPB). The antibiotic is available in 50 mL of solution to infuse in 20 minutes. The drop factor of the IV set is 15 gtt/mL. The nurse will set the piggyback to flow at how many drops per minute? Record your answer using a whole number. ___ gtt/min

38

The nurse understands which medication may cause gynecological malignancies in females?

Diethylstilbestrol

Which class of medications is frequently prescribed for a client with bipolar disorder (BPD) to induce sedation?

Benzodiazepines

A pregnant client with severe preeclampsia is receiving intravenous magnesium sulfate. Which item would the nurse keep at the bedside in case of magnesium sulfate toxicity?

Calcium gluconate

The nurse would instruct the client taking a progesterone oral contraceptive to take 1 pill daily during which point in the monthly cycle?

Entire menstrual cycle

When administering albumin intravenously, which fluid shift would the nurse anticipate?

Interstitial compartment to the intravascular compartment.

In which situation would the nurse anticipate naltrexone to be administered?

To decrease the recovering alcoholic's desire to drink.

Which site would the nurse use to administer vitamin K to a newborn?

Vastus lateralis

Which statements would the nurse include when teaching a client who is considering medroxyprogesterone injection as a form of hormonal birth control? Select all that apply. One, some, or all responses may be correct.

1.) It lasts for 3 months. 2.) It can cause nausea and vomiting. 3.) Side effects include drowsiness or insomnia and depression. 4.) The most severe undesirable effects are liver dysfunction and thromboembolic disorders.

An antidepressant is prescribed for a depressed older client. After 1 week, the client's son expresses concern that there does not seem to be much improvement. How should the nurse respond?

"Antidepressant therapy requires several weeks before it becomes effective."

A client has an anaphylactic reaction after receiving intravenous penicillin. Which would the nurse conclude is the cause of this reaction?

Antibodies to penicillin developed after a previous exposure.

Which mechanism of action applies to penicillin?

Inhibits cell wall synthesis of the pathogen.

Which medication is indicated for evacuation in case of a miscarriage?

Dinoprostone

A client is receiving combination chemotherapy for the treatment of metastatic carcinoma. For which systemic side effect would the nurse monitor the client?

Leukopenia

The nurse is teaching a female client about the most common side effects of estrogen in an oral contraceptive. Which common side effect identified by the client indicates to the nurse that the teaching was effective?

Nausea

Which instruction would the nurse provide to parents of a school-age child who has been on long-term phenytoin therapy to prevent side effects?

Provide good oral hygiene.

The nurse is preparing to apply nitroglycerin ointment. Before applying the ointment, which action will the nurse take?

Use the dose measuring application paper and spread the ointment in a thin layer to the prescribed amount.

The nurse understands that which antipsychotic medications have the highest risk of causing tardive dyskinesia? Select all that apply. One, some, or all responses may be correct.

1.) Loxapine 2.) Haloperidol

A client is receiving a monoamine oxidase inhibitor (MAOI). Which instruction would the nurse give the client?

Many prescribed and over-the-counter medications cannot be taken with this medication.

The nurse has administered sublingual nitroglycerin. Which outcome would the nurse use to determine the effectiveness of sublingual nitroglycerin?

Relief of anginal pain.

The nurse is assessing an adolescent after the administration of epinephrine. Which side effect is most important for the nurse to identify?

Tachycardia

A client with type 1 diabetes requests information about the differences between penlike insulin delivery devices and syringes. Which information would the nurse provide about the penlike devices?

"Penlike devices provide a more accurate dose delivery."

Which information would the nurse include when teaching a client about antacid tablets?

"They interfere with the absorption of other medications."

A health care provider prescribes 250 mg of an antibiotic intravenous piggyback (IVPB). A vial containing 1 gram of the powdered form of the medication must be reconstituted with 2.8 mL of diluent to form a volume of 3 mL. How many mL of the solution will the nurse administer? Record your answer using one decimal place and leading zero if applicable. Do not include units in your answer. __mL

0.8

Which assessments would the nurse perform for a woman prescribed clomiphene? Select all that apply. One, some, or all responses may be correct.

1.) Reproductive and uterine status. 2.) Concomitant use of antidepressants. 3.) Family stability and economic status.

The health care provider prescribes 1000 mL normal saline to be infused over 8 hours. The intravenous (IV) tubing delivers 15 drops per milliliter (drop factor). The nurse will administer the IV infusion at how many drops per minute? Record your answer using a whole number. ____ gtts/minute

31

Which is the most important nursing action involved in caring for a client receiving medications?

Administering the medications.

Which mechanism of action explains the ability of nitrogen mustard to interfere with growth of cancer cells?

Combining with DNA strands and interfering with cell replication.

A client has been given a prescription for furosemide 40 mg every day in conjunction with digoxin. Which concern would prompt the nurse to ask the health care provider about potassium supplements?

Digoxin toxicity occurs rapidly in the presence of hypokalemia.

The nurse identifies which physiological alteration associated with pregnancy that may change the client's response to medication?

Longer gastrointestinal emptying time.

After teaching a family member how to administer subcutaneous enoxaparin sodium, how will the nurse evaluate the effectiveness of the training?

Observing the family member administering enoxaparin sodium to the client.

A client reports frequently taking calcium carbonate. The nurse advises the client that this can have which effect?

Rebound hyperacidity

A client is prescribed a monoamine oxidase inhibitor (MAOI) for depression. The nurse includes teaching on foods and medications known to cause serious adverse effects when used in combination with MAOIs. Which adverse effect would the nurse include in the teaching plan?

A serious increase in blood pressure.

The nurse is teaching a class to a group of women of childbearing age on the topic of hormonal changes. The nurse concludes the teaching was effective when participants identify which hormone as one that causes skin discoloration?

Estrogen

Which sexually transmitted infection receives antiviral medications as the treatment of choice?

Genital herpes

Which condition may be the result of an adverse medication effect associated with administration of chloramphenicol in infants?

Gray syndrome

The nurse would identify which medication as the most common cause of extrapyramidal side effects (EPSs)?

Haloperidol

An adolescent who has been prescribed prednisone and vincristine for leukemia tells the nurse that he is constipated. Which reason would the nurse cite as the probable cause of the constipation?

It is a side effect of the vincristine.

Which antihistamine is considered safe for a woman who plans to breast-feed?

Loratadine

A client with heart failure is to receive digoxin. Which therapeutic effect is associated with this medication?

Slows and strengthens cardiac contractions.

The client's intravenous (IV) site is tender with erythema, warmth, and mild edema. Which action will the nurse take?

Change the IV site.

A client with supraventricular tachycardia (SVT) has a heart rate of 170 beats/minute. After treatment with diltiazem, which assessment indicates to the nurse that the diltiazem is effective?

Heart rate of 98 beats/minute.

A client with endometriosis reports having hot flashes. Which of the client's medications would the nurse identify as the cause of this side effect?

Leuprolide

The health care provider has prescribed an intravenous piggyback (IVPB) of 1200 mg vancomycin, which must be added to 50 mL of 5% dextrose in water (D5W). The nurse has a solution contains 1 gram of vancomycin per 3 mL. How much antibiotic solution will be added to the 50 mL of D5W? Record your answer using one decimal place. ___ mL

3.6

The primary health care provider prescribed benzoyl peroxide to a client with severe acne. During a follow-up visit, the nurse finds that the client did not respond to the therapy. Which other medications would the nurse suspect to be beneficial for the client? Select all that apply. One, some, or all responses may be correct.

1.) Minocycline 2.) Streptomycin 3.) Erythromycin

The nurse would assess a newborn for which teratogenic effects if a pregnant client was prescribed cyclophosphamide? Select all that apply. One, some, or all responses may be correct.

1.) Shortened limbs 2.) Internal organ defects 3.) Limb malformations 4.) Central nervous system malformation

An agitated, delusional client, who is acting out, is receiving large doses of haloperidol, and the nurse is concerned because this medication can produce untoward adverse effects. Which clinical manifestations will alert the nurse to stop the medication immediately? Select all that apply. One, some, or all responses may be correct.

1.) Jaundice 2.) Tachycardia

The health care provider prescribes alprazolam 5 mg by mouth three times a day for a client with anxiety. Which intervention will the nurse take before administering this prescription?

Clarify the prescription with the health care provider.

Which of the four clients with tuberculosis is at a risk for sunburn when taking their prescribed medication?

Client 4

A 15-year-old adolescent is diagnosed with endometriosis. The client has severe, acute, and incapacitating symptoms. Which would be the anticipated line of treatment?

Surgical intervention

Which action by a client taking alendronate requires correction? Select all that apply. One, some, or all responses may be correct.

1.) Taking medication twice a week. 2.) Taking medication before rising. 3.) Taking medication with breakfast. 4.) Taking medication before bedtime. 5.) Taking medication with apple juice.

The nurse must administer streptomycin 1 g intramuscularly (IM) to a client. The vial contains 500 mg/mL. How much solution must the nurse administer? Record your answer using a whole number. ___ mL

2

A client has an excision of a thrombosed external hemorrhoid. Which item will the nurse teach the client to use when cleaning the anus after a bowel movement?

Witch hazel-moistened pads

Which action does the nurse perform when completing the third accuracy check before administering ear drops to a 5-year-old child?

Check the label of the medication at the child's bedside.

The nurse reviews the medication list for a client undergoing treatment for infertility. Which medication would the nurse identify as one that should be discontinued?

Methyldopa

Which medication would the nurse identify as one that can be prescribed for the elective termination of a pregnancy?

Mifeprex

Which medication would the nurse identify as being used to induce abortion?

Mifepristone

A 6-year-old child is prescribed carbamazepine 15 mg/kg/day divided equally into two doses for clonic seizures. The child weighs 44 lb (20 kg). The medication available is carbamazepine suspension 100 mg/5 mL. How many milliliters would the nurse administer in one dose? Record your answer using one decimal place. ___ mL

7.5

A client is admitted to the emergency department with crushing chest pain. A diagnosis of acute coronary syndrome is suspected. Which medication is indicated to prevent progression to a myocardial infarction?

Aspirin