PCC 2 - ATI Dynamic Quiz Questions

A nurse is teaching a client who has primary adrenal insufficiency (Addison's disease) and a prescription for hydrocortisone. Which of the following statements should the nurse include in the teaching about this medication? - "You may need to take a lower dosage when you are ill or experiencing stress." - "Take this medication before going to bed because it will make you tired." - "Carry a supply of pills and a single-use injectable preparation with you at all times." - "You will need to stop this medication before routine procedures such as a colonoscopy."

"Carry a supply of pills and a single-use injectable preparation with you at all times." Rationale: The nurse should tell the client to carry an emergency supply of the medication to take during times of unexpected stress. The client should carry an adequate supply at all times, which should include an injectable preparation plus a supply equal to the regular oral dosage. The single-use injectable preparation should be administered IM if the client has an emergency and needs an extra dose of the glucocorticoid.

A nurse is teaching a client who has type 2 diabetes mellitus about a prescription for insulin lispro. Which of the following statements should the nurse include in the teaching? - "The effects of the insulin lispro can last for 8 to 12 hours." - "Administer insulin lispro 30 to 60 minutes before eating." - "Insulin lispro has an onset of about 15 minutes." - "This insulin can be given as a continuous intravenous bolus."

"Insulin lispro has an onset of about 15 minutes." Rationale: Insulin lispro is a rapid-acting insulin and has an onset of 15 to 30 minutes.

A nurse is providing teaching to a client who has chronic constipation and a new prescription for psyllium. Which of the following instructions should the nurse provide? - "This medication is for short-term use only." - "You should eat a low-residual diet while taking this medication." - "Mix this medication with water and follow with an additional glass of liquid." - "The medication's adverse effects of stomach cramps and nausea will go away in time."

"Mix this medication with water and follow with an additional glass of liquid." Rationale: The nurse should direct the client to administer the medication mixed in a full glass of water or juice followed by an additional glass of liquid. The client should also be instructed to increase intake of fluids to help decrease constipation.

A nurse is teaching a client who is postmenopausal and has a Rx for alendronate. Which of the following statements should the nurse include in the teaching? - "You can lie down 15 minutes after taking this medication." - "Take this medication on an empty stomach." - "Crush this medication to improve absorption." - "Avoid taking antacids or supplements that contain calcium while taking this medication."

"Take this medication on an empty stomach." Rationale: The nurse should instruct the client to avoid taking alendronate with food or liquids other than water because it can decrease absorption. The client should only take this medication with water 30 minutes before breakfast.

A nurse is teaching a client who has a prescription for doxycycline for the treatment of a Helicobacter pylori infection. Which of the following instructions should the nurse include in the teaching? - "Take this medication with meals to decrease gastrointestinal upset." - "Continue this medication if you become pregnant." - "Wear protective clothing while in the sun." - "Expect to have severe diarrhea while taking this medication."

"Wear protective clothing while in the sun." Rationale: The nurse should include in the teaching that all tetracycline medications increase the sensitivity to the skin to ultraviolet light and sunlight. Therefore, clients are encouraged to avoid prolonged exposure to the sun and to wear protective clothing while outside and exposed to the sun.

A nurse is planning care for a client who is postoperative and scheduled to ambulate. At which of the following times should the nurse plan to administer PO morphine to the client for peak analgesic effect during the ambulation. - 3 to 4 hr before ambulation - 10 to 15 min prior to ambulation - 60 to 90 min prior to ambulation - Immediately before ambulation

60 to 90 min prior to ambulation. Rationale: The peak effect of PO morphine takes 60 to 90 minutes to occur. Medicating the client 60 to 90 minutes prior to ambulation will provide the greatest analgesic effect.

A nurse is evaluating how a client who is pregnant is responding to a medication. Which of the following physiological effects of pregnancy should the nurse take into consideration? - Increased intestinal transit rate - Accelerated excretion of fluids - Reduced renal blood flow - Decreased hepatic metabolism

Accelerated excretion of fluids. Rationale: There are physiological changes in the kidneys with pregnancy, including accelerated excretion from increased renal blood flow. This results in increased glomerular filtration. To compensate for accelerated excretion, dosages of medications that glomerular filtration eliminates must be increased to achieve a comparable therapeutic effect.

A nurse in a postpartum unit is caring for a client who plans to breastfeed her newborn exclusively. The client has a prescription for depot medroxyprogesterone acetate (DMPA). At which of the following times should the nurse schedule the client to receive the first dose of the medication? - After 3 months postpartum. - At 6 weeks postpartum. - Within the first 5 days postpartum. - During the first week of the first postpartum menstrual cycle.

At 6 weeks postpartum. Rationale: The nurse should tell the client that the first dose should be administered at 6 weeks postpartum if the client is exclusively breastfeeding and after ensuring the client is not pregnant.

A nurse in a provider's office is assessing a client who reports taking a dietary supplement to reduce hot flashes related to menopause. Which of the following supplements should the nurse expect the client to report taking? - Flaxseed - Ginkgo biloba - Black cohosh - St. John's wort

Black cohosh Rationale: Black cohosh is an herb that is used for treatment of menopausal symptoms such as hot flashes, vaginal dryness, irritability, and sleep disturbances.

A nurse is caring for a client who takes sulfasalazine twice daily for rheumatoid arthritis. Which of the following values should the nurse review prior to the administration of the medication? - Respirations. - Serum creatinine level. - Blood pressure. - Complete blood count.

Complete blood count. Rationale: The nurse should identify that sulfasalazine can cause bone marrow suppression, which can lead to agranulocytosis, hemolytic anemia, and macrocytic anemia. As a result, the client's complete blood count should periodically monitored, and the nurse should review it prior to administering this medication.

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? - Atropine. - Diltiazem. - Epinephrine. - Phenytoin.

Diltiazem. Rationale: 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 monitoring a client who has diabetes insipidus and was administered desmopressin. Which of the following findings should indicate to the nurse the client is experiencing an adverse effect of this medication? - Thirst - Nocturia - Headache - Heart Palpitations

Headache Rationale: Headaches are an indicator of the adverse effect of water intoxication, which can occur as a result of taking desmopressin. This medication causes fluid retention and places the client at risk of water intoxication.

A nurse is monitoring a client who has diabetes insipidus and was administered desmopressin. Which of the following findings should indicate to the nurse the client is experiencing an adverse effect of this medication? - Thirst. - Nocturia. - Headache. - Heart palpitations.

Headache. Rationale: Headaches are an indicator of the adverse effect of water intoxication, which can occur as a result of taking desmopressin. This medication causes fluid retention and places the client at risk of water intoxication.

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

Increase the dose of oxytocin to obtain uterine contractions that occur every 2 to 3 minutes. Rationale: Effective uterine contractions should occur every 2 to 3 minutes.

A nurse working in a mental health facility is admitting a client with opioid use disorder who is experiencing withdrawal. The nurse should anticipate a prescription for which of the following medications from the provider? - Methylnaltrexone. - Methadone. - Naloxone. - Hydromorphone.

Methadone. Rationale: The nurse should anticipate a prescription from the provider for methadone for a client who is experiencing opioid withdrawal. Methadone is an opioid medication that is used for pain management and treatment of withdrawal manifestations in clients who have opioid use disorder.

A nurse is caring for a client who is at 28 weeks gestation and is experiencing preterm labor. Which of the following medications should the nurse plan to administer? - Oxytocin - Nifedipine - Dinoprostone - Misoprostol

Nifedipine Rationale: Nifedipine is a tocolytic medication that is administered to stop preterm labor.

A nurse is caring for a client who is at 28 weeks gestation and is experiencing preterm labor. Which of the following medications should the nurse plan to adminsiter? - Oxytocin. - Nifedipine. - Dinoprostone. - Misoprostol.

Nifedipine. Rationale: Nifedipine is a tocolytic medication that is administered to stop preterm labor.

A nurse is caring for a client who has schizophrenia and a prescription for chlorpromazine. For which of the following adverse effects should the nurse monitor. - Orthostatic hypotension. - Diarrhea. - Urinary frequency. - Bradycardia.

Orthostatic hypotension. Rationale: Orthostatic hypotension is an adverse effect of chlorpromazine. Other adverse effects include palpitations, tachycardia, constipation, sedation, and photosensitivity.

A nurse is teaching a client who has ADHD and is starting therapy with an amphetamine/dextrophetamine mixture. Which of the following manifestations should the nurse instruct the client to identify as an adverse effect and report to the provider? - Restlessness - Insomnia - Palpitations - Weight Gain

Palpitations Rationale: The nurse should instruct the client that palpitations can be a sign of a cardiovascular adverse reaction and requires immediate attention. The nurse should instruct the client to contact the provider if palpitations develop.

A nurse is caring for a client who is at 6 weeks of gestation and has just received a diagnosis of hyperthyroidism. The nurse should anticipate a prescription from the provider for which of the following medications? - Propylithiouracil - Liothyronine - Methimazole - Iodine-131

Propylthiouracil Rationale: This medication is used to treat hyperthyroidism during the first trimester of pregnancy because it does not cross the placental barrier well, posing little risk to the fetus. However, methimazole is the preferred medication in the second and third trimesters of pregnancy.

A nurse is assessing a client who is receiving IV gentamicin 3 times daily. Which of the following findings indicates that the client is experiencing an adverse effect of this medication? - Hypoglycemia - Proteinuria - Nasal Congestion - Visual Disturbances

Proteinuria Rationale: Proteinuria is a manifestation of nephrotoxicity, an adverse effect of gentamicin. The nurse should monitor for oliguria and hematuria.

The nurse is caring for a client who has a levonorgestrel-releasing intrauterine device (IUD) in place for 1 year. Which of the following findings should indicate that the client is experiencing an adverse effect? - Developed sensitivity to copper. - Vaginal irritation or inflammation. - Decreased menstrual bleeding. - Spotting between menses cycle.

Spotting between menses cycle. Rationale: Light spotting and amenorrhea are common adverse effects for clients who use a levonorgestrel-releasing IUD. IUDs can alter menses, prompting spotting between menstruation periods.

A nurse is caring for a female client who has osteoporosis and is taking raloxifene. Which of the following findings should indicate to the nurse that the client is experiencing an adverse effect of this medication? - Severe leg cramps - Urinary frequency - Jaw pain - Sudden onset of dyspnea

Sudden onset of dyspnea Rationale: The nurse should identify that raloxifene is a selective estrogen receptor modulator (SERM), which can have estrogenic effects in some tissues and antiestrogenic effect in other tissues. Clients who are taking raloxifene have an increased risk of thromboembolic events such as DVT, PE, or CVA. Therefore, the nurse should notify the provider is the client is experiencing this adverse effect of raloxifene.

A nurse is assessing a client who is receiving clozapine to treat schizophrenia. The nurse should identify an increase in which of the following parameters as an early indication of an adverse effect of this medication? - Urine specific gravity - Urine output - Blood pressure - Temperature

Temperature Rationale: Antipsychotic medications such as clozapine can cause agranulocytosis, which is the depletion of WBC's. This increases the client's risk of infection. A fever is an early indication to check the client's WBC count to detect agranulocytosis.

A nurse is assessing a client who has cystic fibrosis. Which of the following pieces of information indicates a therapeutic response to pancreatic enzyme replacement? - The client is having 1-2 bowel movements per day. - The client's glucose level is elevated. - The client has experienced weight loss. - The client has abdominal distention.

The client is having 1-2 bowel movements per day. Rationale: One to two bowel movements per day indicates adequate absorption of food and a therapeutic response to pancreatic enzyme replacement for clients who has cystic fibrosis. Frequent stooling, defined as more than one to two bowel movements per day, indicates inadequate replacement.

A nurse is assessing an infant who is scheduled to receive the rotavirus vaccine. Which of the following criteria should identify as a potential contraindication for administering this vaccine? - The infant is teething. - The infant has a history of intussusception - The infant has been constipated for 3 days - The infant is 9 weeks old

The infant has a history of intussusception. Rationale: The nurse should identify that the rotavirus vaccine is contraindicated for infants who have a history of intussusception. The rotavirus vaccine is also contraindicated for infants who have an uncorrected gastrointestinal congenital malformation that could result in intussusception.

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 it it occurs? - Nasal congestion. - Tremors. - Tinnitus. - Frontal headache.

Tinnitus. Rationale: Loop diuretics such as furosemide can cause ototoxicity. The client should be taught to notify the provider if tinnitus, a full feeling in the ears, or hearing loss occurs.

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. - Immune system stimulation. - Decreased leg pain from arterial disease. - Prevention of nausea caused by motion sickness.

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