Pharm 3 exam

A nurse is planning care for a client who requires an exact concentration of oxygen. Which of the following oxygen delivery systems should the nurse use? A. Nasal cannula B. Venturi mask C. Face tent D. Partial rebreather mask

B. Venturi mask

A nurse is caring for a client who has a new prescription for digoxin and takes multiple other medications. The nurse should recognize that concurrent use of which of the following medications places the client at risk for diigoxin? A. Phenytoin B. Verapamil C. Warfarin D. Aluminum hydroxide

B. Verapamil

A nurse in an emergency department is reviewing the medical record of a client who is being evaluated for angle-closure glaucoma. Which of the following findings are indicative of this condition? A. Insidious onset of painless B. Gradual reduction in peripheral vision C. Severe pain around eyes D. Intraocular pressure 12mm Hg

C. Severe pain around eyes - Severe pain around eyes that radiates over the face is a manifestation of acute angle-closure glaucoma

Which of the following information indicates to you that a patient who is taking theophylline (Theo-24) needs further instruction? A. The patient drives a school bus every day. B. The patient drinks 8 oz of wine with dinner. C. The patient exercises 1 hr each day. D. The patient drinks two cups of coffee each morning.

D. The patient drinks two cups of coffee each morning.

A nurse is caring for a client who is taking carvedilol and has a prescription for an oral antidiabetic drug to manage their new diagnosis of type 2 diabetes mellitus. By taking both drugs concurrently, the nurse should identify that the client is at an increased risk for which of the following conditions? A. Hyperglycemia B. Bradycardia C. Hypotension E. Hypoglycemia

E. Hypoglycemia - There are two factors that increase the client's risk for hypoglycemia. Alpha/beta blockers, such as carvedilol, potentiate the hypoglycemic effects of insulin and oral hypoglycemic drugs. Also, carvedilol can mask tachycardia in clients who have hypoglycemia. Carvedilol should be used with caution by clients who have diabetes mellitus.

What does the lower respiratory tract?

Lungs, Bronchioles, Alveoli, Bronchi

What does the upper respiratory tract consist of?

Nose, Sinuses, Trachea, Pharynx

A nurse is teaching a client who is taking prednisone for chronic asthma. Which of the following instructions should the nurse include? A. "Avoid taking nonsteroidal anti-inflammatory drugs." B. "Rinse your mouth after taking the medication to prevent a yeast infection." C. "Stop taking the medication if you become nauseous." D. "Change position slowly when standing up."

A. "Avoid taking nonsteroidal anti-inflammatory drugs"

A nurse is teaching a client who has angina how to use nitroglycerin transdermal ointment. The nurse should include which of the following instructions? A. "Remove the prior dose before applying a new dose." B. "Rub the ointment directly into your skin until it is no longer visible." C."Cover the applied ointment with a clean gauze pad." D. "Apply the ointment to the same skin area each time."

A. "Remove the prior dose before applying a new dose."

You should recognize that codeine is contraindicated for patients who have which of the following? A. Emphysema B. Cataracts C. Hyperthyroidism D. Nonproductive cough

A. Emphysema

A nurse is teaching a client about the adverse effects of pseudoephedrine. Which of the following should the nurse include (Select all) A. Restlessness B. Bradycardia C. Insomnia D. Muscle pain E. Anxiety

A. Restlessness C. Insomnia E. Anxiety - Restlessness is an adverse effect of pseudoephedrine, an oral sympathomimetic. -Insomnia is an adverse effect of pseudoephedrine. Muscle pain is incorrect. - Anxiety is an adverse effect of pseudoephedrine.

A nurse is monitoring plasma drug levels in a client who is taking theophylline. Which of the following findings should the nurse expect to see if the clients drug level indicates toxicity? A.Seizures B. Constipation C. Normal sinus rhythm D. Somnolence

A. Seizures - Seizures are likely when plasma drug levels of theophylline, a methylxanthine, are higher than 30 mcg/mL, which indicates toxicity.

A nurse is administering a dopamine infusion at a low dosage to a client who has a severe heart failure. Which of the following findings is an expected effect of this medication? A. Lowered heart rate B. Increased urine output C. Decreased conduction through the AV node D. Vasoconstriction of renal blood vessels

B. Increased urine output

A nurse is teaching a client who is taking digoxin and has a new prescription for colesevelam. Which of the following instructions should the nurse include in the teaching? A."Take digoxin with your morning dose of colesevelam." B. 'Your sodium and potassium levels will be monitored periodically while taking colesevelam." C. "Watch for bleeding or bruising while taking colesevelam." D."Take colesevelam with food and at least one glass of water"

D. "Take colesevelam with food and at least one glass of water"

A nurse is assessing a client who has taken procainamide to treat dsrhythimas for the last 12 months. The nurse should assess the client for which of the following manifestations as an adverse effect of this medication? (Select all that apply) A. Hypertension B. Widened QRS complex C. Narrowed QT interval D. Easy bruising E. Swollen joints

D. Easy bruising E. Swollen joints B. Widened QRS complex

A patient's atrial dysrhythmia fails to respond to other antidysrhythmia therapies. You should anticipate that the primary care provider might try which of the following drugs whose off-label use includes refractory atrial dysrhythmias? A. Propranolol (Inderal) C. Lidocaine (Xylocaine) D. Flecainide (Tambocor) E. Amiodarone (Cordarone)

D. Flecainide (Tambocor)

A nurse in a provider's office is instructing a guardian of a toddler how to administer ear drops. Which of the following instructions should the nurse include? (Select all that apply) A. "Place the child on the unaffected side when you are ready to administer the medication." B. "Warm the medication by gently rolling it between your hands for a few minutes." C. "Gently shake medication that is in suspension form." D. "Keep the child on their side for 5 minutes after installation of the ear drops." E. "Tightly pack the ear with cotton after installation of the ear drops."

A. "Place the child on the unaffected side when you are ready to administer the medication." B. "Warm the medication by gently rolling it between your hands for a few minutes." C. "Gently shake medication that is in suspension form." D. "Keep the child on their side for 5 minutes after installation of the ear drops."

A nurse is teaching a client who has a new prescription for beclomethasone. Which of the following instruction should the nurse include? A. "Rinse your mouth after each use of this medication." B. "Limit fluid intake while taking this medication." C. "Increase your intake of vitamin B12 while taking this medication." D. "You can take the medication as needed."

A. "Rinse your mouth after each use of this medication."

A nurse should recognize that milrinone is contraindicated for a client who has which of the following conditions? A. Acute myocardial infarction B. Peripheral vascular disease C. Ulcerative colitis D. Ventricular tachycardia

A. Acute myocardial infarction - Milrinone, a phosphodiesterase inhibitor, is contraindicated for clients who have had an allergic reaction to phosphodiesterase inhibitors and for clients who have an acute myocardial infarction and aortic or pulmonary valve disorders.

A nurse is teaching a client who has a prescription for albuterol via inhaler and fluticasone/salmeterol via inhaler for asthma management. For which of the following reasons should the nurse instruct the client to use the albuterol inhaler before using the fluticasone inhaler? A. Albuterol will increase the absorption of fluticasone. B. Albuterol will decrease inflammation. C. Albuterol will reduce nasal secretions. D. Fluticasone will reduce the adverse effects of albuterol.

A. Albuterol will increase the absorption of fluticasone - Albuterol, an inhaled, short-acting beta2 agonist, causes bronchodilation, which will increase the absorption of fluticasone, an inhaled glucocorticoid.

A nurse is preparing to administer phenylephrine to a client. The nurse should identify that which of the following manifestations is an adverse effect of this drug? A. Headache B. Sleepiness C. Hypotension D. Constipation

A. Headache - Oral sympathomimetics stimulate the adrenergic receptors, causing blood vessel constriction, which can cause nervousness, headache, blurred vision, and tremors.

A nurse is caring for a client who has a new prescription for aliskiren to treat hypertension. The nurse should monitor the client for which of the following findings as an adverse effect of the drug? (Select all that apply.) A. Hyperkalemia B. Throat swelling C. Constipation D. Cough E. Joint pain

A. Hyperkalemia B. Throat swelling D. Cough

A nurse is administering hydrochlorothiazide to a client who has gouty arthritis. The nurse should monitor the client for which of the following findings that indicates an adverse effect of this drug? A. Hyperuricemia B. Hypernatremia C. Hyperkalemia D. Hypoglycemia

A. Hyperuricemia - Hyperuricemia, or increased uric acid levels, along with gouty arthritis, can occur in clients who have a history of these conditions and are taking hydrochlorothiazide.

A patient is taking bumetanide (Bumex) and spironolactone (Aldactone). You should explain that using the drugs together may reduce the risk of which of the following adverse effects? A. Hypokalemia B. Hyponatremia C. Hyperglycemia D. Hypochloremia

A. Hypokalemia

A nurse is instructing a client who has a new prescription for timolol how to insert eye drops. The nurse should instruct the client to press on which of the following areas to prevent systemic absorptions of this medication? A. Bony orbit B. Nasolacrimal duct C. Conjunctival sac D. Outer canthus

B. Nasolacrimal duct - Pressing on the nasolacrimal duct blocks the lacrimal punctum and prevents systemic absorption of the medication

A nurse is caring for a client who is taking spironolactone to treat hypertension. The nurse should recognize that which of the following client laboratory values requires immediate intervention? A. Sodium 140 mEq/L B. Potassium 5.2 mEq/L C. Chloride 100 mEq/L D. Magnesium 1.9 mEq/L

B. Potassium 5.2 mEq/L

Match the drugs in the left column with the corresponding classification: Amiodarone (Cordarone) A. Beta adrenergic blocker that controls atrial and ventricular tachycardia B. Potassium channel blocker that treats ventricular fibrillation and ventricular tachycardia C. Sodium channel blocker that treats supraventricular and ventricular dysrhythmias D. Calcium channel blocker that treats supraventricular tachycardia and atrial fibrillation or flutter

B. Potassium channel blocker that treats ventricular fibrillation and ventricular tachycardia

A nurse should identify that dextromethorphan can have which of the following effects when combined with morphine? A. Reduced antitussive effect of dextromethorphan B. Potentiation of depression of CNS actions C. Increased renal reabsorption of the dextromethorphan D. Delayed analgesic effect of the opioid

B. Potentiation of depression of CNS actions - Combining dextromethorphan with an opioid, such as morphine, increases the risk for decreased respirations and other depressed CNS responses.

A patient with a new prescription for a HMG-CoA (statin) drug is instructed to take the medication with the evening meal or at bedtime. The patient asks why it must be taken at this time of day. The reason is: A. the medication is better absorbed at this time. B. this timeframe correlates better with the natural diurnal rhythm of cholesterol production. C. there will be fewer adverse effects if taken at night instead of with the morning meal. D. this timing reduces the incidence of myopathy

B. this timeframe correlates better with the natural diurnal rhythm of cholesterol production.

A nurse is caring for a client who will begin using transdermal nitroglycerin to treat angina pectoris. When speaking to the client about the drug, which of the following instructions should the nurse include? (Select all that apply.) A. "Apply a new patch at the onset of anginal pain." B. "Apply the patch to dry skin and cover the area with plastic wrap." C. "Apply the patch to a hairless area and rotate sites." D. "Apply a new patch when you start your day." E. "Remove patches for 10 to 12 hours each day."

C. "Apply the patch to a hairless area and rotate sites." D. "Apply a new patch when you start your day." E. "Remove patches for 10 to 12 hours each day."

A nurse is caring for a client who is having difficulty mobilizing thick respiratory secretions. Which of the following drugs should the nurse expect to administer to the client? A. Ipratropium B. Beclomethasone C. Acetylcysteine D. Azelastine

C. Acetylcysteine - Acetylcysteine is a mucolytic that loosens thick respiratory secretions.

A nurse is completing a nursing history for a client who takes simvastatin. The nurse should identify which of the following disorders as a contraindication to adding ezetimibe to the client's medications? A. History of severe constipation B. History of hypertension C. Active hepatitis C D. Type 2 diabetes mellitus

C. Active hepatitis C

A nurse is caring for a client who has a new prescription for propranolol to treat a tachydysrhythmia. The nurse should instruct the client to avoid taking which of the following types of over-the-counter drugs while taking propranolol? A. Antihistamines B. Potassium supplements C. NSAIDs D. Vitamin C

C. NSAIDs - NSAIDs can interact with propranolol and decrease the anti-hypertensive action because vasoconstriction can occur in some COX-2 inhibitors. The nurse should instruct the client to avoid taking NSAIDs and propranolol at the same time.

You are instructing a patient who is taking cetirizine (Zyrtec) how to treat allergic rhinitis. Which of the following information should the provider include? A. Restrict fluids to minimize the drug's adverse effects. B. Take the drug in the morning to reduce adverse effects. C. Take the drug on an empty stomach to increase absorption. D. Administer the drug prophylactically during allergy seasons.

D. Administer the drug prophylactically during allergy seasons.

A nurse is caring for a client who is 1 hr postoperative following an open cholecystectomy with general anesthesia. The nurse should monitor for which of the following findings as an indication of hypoxia? A. Report of incisional pain B. Delayed return of motor function C. Absent bowel sounds D. Cyanotic mucous membranes

D. Cyanotic mucous membranes

While talking with a patient who is taking captopril (Capoten) to treat hypertension, which of the following instructions should you include to help her manage the drug's adverse effects? A. Check your heart rate prior to taking the drug. B. Wear sunscreen and protective clothing while outdoors. D. Do not use salt substitutes to season your food. E. Take the drug on an empty stomach.

D. Do not use salt substitutes to season your food

You should monitor a patient taking dextromethorphan (Robitussin DM and others) due to the potential for which of the following? A. Tachycardia B. Fluid retention C. Blurred vision D. Drug abuse

D. Drug abuse

The nurse is teaching a client who has a prescription for zileuton. Which of the following instructions should the nurse include? A. Check apical pulse before taking the drug. B. Take the drug only as needed before exercising. C. Rinse mouth after using the drug. D. Have laboratory tests performed at regular intervals.

D. Have laboratory tests performed at regular intervals - Zileuton, a leukotriene modifier, can cause liver injury. The nurse should monitor liver function once a month for 3 months, then every 2 to 3 months during the first year of treatment.

A nurse is caring for a client who has a new prescription for verapamil to treat atrial fibrillation. The nurse should instruct the client to avoid drinking grapefruit juice while taking verapamil because it can cause the client to experience which of the following conditions? A. Tachycardia B. Dehydration C. Diarrhea D. Hypotension

D. Hypotension

A nurse is teaching a client who is beginning fluticasone propionate/salmeterol therapy. Which of the following instructions should the nurse include? A. Take the drug as needed for acute asthma B. Follow a low-sodium diet C. Use an alternate-day dosing schedule D. Increase weight-bearing activity.

D. Increase weight-bearing activity - Weight-bearing activity can help minimize bone loss, which is an adverse effect of fluticasone propionate/salmeterol, an inhaled glucocorticoid and inhaled long-acting beta2 agonist (LABA) combination medication.

A nurse is caring for a client who is prescribed isosorbide mononitrate for chronic stable angina and develops reflex tachycardia. Which of the following medications should the nurse expect to administer? A. Furosemide B. Captopril C. Ranolazine D. Metoprolol

D. Metoprolol

nurse is teaching a client about albuterol. The nurse should instruct the client to monitor for and report which of the following as an adverse effect of this drug? A. Fever B. Bruising C. Polyuria D. Palpitations

D. Palpitations - Although not common at therapeutic doses, beta2 agonists can cause cardiac stimulation, resulting in chest pain, palpitations, hypertension, and arrhythmias.

A nurse is teaching a client about montelukast. Which of the following instructions should the nurse include? A. Use a spacer to improve inhalation. B. Take the drug at the onset of bronchospasm. C. Rinse mouth to prevent an oral fungal infection. D. Take the drug once a day in the evening.

D. Take the drug once a day in the evening - Montelukast, a leukotriene modifier, is most effective when taken once per day in the evening.

A nurse is caring for a client who is receiving oxygen at 8 L/min through a simple face mask. The nurse should identify that the client is able to receive which of the following concentrations of oxygen with a simple face mask? A. 36% B. 40% C. 75% D. 95%

B. 40%

You should instruct a patient who is taking zileuton (Zyflo) to report which of the following possible indications of a serious adverse effect of the drug? A. Abdominal pain B. Dysphagia C. Blurred vision D. Bradycardia

A. Abdominal pain

A nurse is providing teaching to a client who is starting simvastin. Which of the following information should the nurse include in the teaching? A. Take this medication in the evening B. Change position slowly when rising from a chair C. Maintain a steady intake of green leafy vegetables D. Consume no more than 1 L/day of fluid

A. Take this medication in the evening

For which of the following reasons should a client attach a spacer to a metered dose inhaler? ​A. To increase the amount of drug delivered to the lungs B. To increase the amount of drug delivered to the oropharynx C. To increase the amount of drug delivered on exhalation D. To increase the speed of drug delivery into the mouth

A. To increase the amount of drug delivered to the lungs - A spacer increases the amount of drug that reaches the lungs.

While instructing a patient about using isosorbide (Isordil) to treat angina, you should advise the patient to avoid A. Milk B. Caffeine C. Alcohol D. grapefruit juice.

C. Alcohol

A patient has been ordered the powdered form of the bile acid sequestrant colestipol. Which of the following does the nurse identify as true? A. The nurse should have the patient swallow the dose of the colestipol powder one teaspoonful at a time. B. The powder should be dissolved and immediately administered. C. The colestipol should be administered 1 hour before or 4 to 6 hours after any other oral medication. D. The colestipol should be administered with meals.

C. The colestipol should be administered 1 hour before or 4 to 6 hours after any other oral medication.

A nurse is assessing a client who is taking digoxin to treat heart failure. Which of the following findings is a manifestation of digoxin toxicity? A. Bruising B. Report of metallic taste C. Muscle pain D. Report of anorexia

D. Report of anorexia

You are instructing a patient about using cromolyn via inhalation to treat exercise-induced asthma. You should should advise the patient to take the drug? A. 15 min before exercising. B. if needed to stop bronchospasm. C. after strenuous activity. D. once in the evening at bedtime.

A. 15 min before exercising

A nurse is teaching a client who has a new prescription for verapamil to control hypertension. Which of the following instructions should the nurse include? A. Increase the amount of fiber in the diet B. Drink grapefruit juice daily to increase vitamin C intake C. Decrease the amount of calcium in the diet D. Withhold food for 1 hr after the medication is taken

A. Increase the amount of fiber in the diet

You should advise a patient who is taking beclomethasone (QVAR) to monitor for which of the following possible indications of an adverse effect of the drug? A. White coating in the mouth B. Abdominal pain C. Muscle twitching D. Palpitations

A. White coating in the mouth

A nurse is teaching a client who has angina pectoris and is learning how to treat acute anginal attacks. The client asks, "What is my next step if I take one tablet, wait 5 minutes, but still have anginal pain?" Which of the following responses should the nurse make? A."Take two more sublingual tablets at the same time." B. "Call the emergency response team" C. "Take a sustained-release nitroglycerin capsule" D."Wait another 5 minutes then take a second sublingual tablet."

B. "Call the emergency response team"

A nurse is teaching about the use of fluticasone to treat perennial rhinitis. Which of the following statements by the client indicates an understanding of the teaching? A. "I should use the spray every 4 hours while I am awake." B. "It can take as long as 3 weeks before the medication takes a maximum effect." C. "This medication can also be use to treat motion sickness." D. "I can use this medication when my nasal passages are blocked."

B. "It can take as long as 3 weeks before the medication takes a maximum effect."

A nurse is caring for a client who has a new prescription for dobutamine. The nurse should clarify the prescription with the provider if the client is receiving which of the following types of drugs? (Select all that apply.) A. ACE inhibitor B. MAOI C. General anesthetic D. Tricyclic antidepressant E. Beta blocker

B. MAOI C. General anesthetic D. Tricyclic antidepressant E. Beta blocker

A nurse is providing teaching to a client who is taking simvastatin. The nurse should instruct the client to report which of the following manifestations as an indication of a serious adverse reaction that could require discontinuing drug therapy? A. Bronchoconstriction B. Muscle pain C. Lip numbness D. Somnolence B. Muscle pain

B. Muscle pain

A nurse is caring for a client who has been taking phenylephrine nasal drops for the past 10 days for sinusitis. The nurse should assess the client for which of the following manifestations as an adverse effect of this medication? A. Sedation B. Nasal congestion C. Productive cough D. Constipation

B. Nasal congestion

A nurse is teaching a client about using intranasal glucocorticoids. Which of the following instructions should the nurse give? A. Start at a low dose and gradually increase it. B. Take the drug as needed for nasal congestion. C. Allow at least 2 weeks for the full therapeutic effect. D. Use the drug prior to exercise.

C. Allow at least 2 weeks for the full therapeutic effect - It can take 2 or 3 weeks to see the full therapeutic effect of intranasal glucocorticoids.

Match the drugs in the left column with the corresponding classification: Verapamil (Calan) A. Beta adrenergic blocker that controls atrial and ventricular tachycardia B. Potassium channel blocker that treats ventricular fibrillation and ventricular tachycardia C. Sodium channel blocker that treats supraventricular and ventricular dysrhythmias D. Calcium channel blocker that treats supraventricular tachycardia and atrial fibrillation or flutter

D. Calcium channel blocker that treats supraventricular tachycardia and atrial fibrillation or flutter

A nurse is reviewing the health record of a client who asks about using propranolol to treat hypertension. The nurse should recognize which of the following conditions is a contraindication for taking propranolol? A. Asthma B. Glaucoma C. Hypertension D. Tachycardia

A. Asthma

Match the drugs in the left column with the corresponding classification: Propranolol (Inderal) A. Beta adrenergic blocker that controls atrial and ventricular tachycardia B. Potassium channel blocker that treats ventricular fibrillation and ventricular tachycardia C. Sodium channel blocker that treats supraventricular and ventricular dysrhythmias D. Calcium channel blocker that treats supraventricular tachycardia and atrial fibrillation or flutter

A. Beta adrenergic blocker that controls atrial and ventricular tachycardia

A nurse is caring for a client who received IV verapamil to treat supraventricular tachycardia (SVT). The client's pulse rate is now 98/min and the blood pressure is 74/44 mg Hg. The nurse should expect a prescription for which of the following IV medications? A. Calcium gluconate B. Sodium bicarbonate C. Potassium chloride D. Magnesium sulfate

A. Calcium gluconate

A nurse is teaching a client who has a new prescription for digoxin to treat heart failure. Which of the following instruction should the nurse include in the teaching? A. Contact provider if heart rate is less than 60/min B. Check pulse rate for 30 seconds and multiply results by 2 C. Increase intake of sodium D. Take with food if nausea occurs

A. Contact provider if heart rate is less than 60/min

You are caring for a patient who is taking oral amiodarone (Cordarone) to treat atrial fibrillation. You should advise the patient to watch for and report which of the following? (Select all that apply.) A. Cough B. Blurred vision C. Dizziness D. Sore throat E. Fever

A. Cough B. Blurred vision C. Dizziness E. Fever

A nurse is taking a medication history from a client who has angina and is to begin taking ranolazine. The nurse should report which of the following medications in the client history that can interact with ranolazine? (Select all that apply) A. Digoxin B. Simvastatin C. Verapamil D. Amlodipine E. Nitroglycerin transdermal patch

A. Digoxin B. Simvastatin C. Verapamil

A nurse is teaching a client who has a new prescription for diphenhydramine for allergic rhinitis. The nurse should instruct the client to monitor which of the following manifestations as an adverse effect of this medication? (Select all that apply) A. Dry mouth B. Nonproductive cough C. Skin rash D. Drowsiness E. Urinary hesitation

A. Dry mouth D. Drowsiness E. Urinary hesitation

A nurse is providing teaching to a client who has a new prescription for losartan to treat hypertension. The nurse should instruct the client that which of the following findings could indicate an adverse reaction to the drug and needs to be reported? A. Facial edema B. Sleepiness C. Peripheral edema D. Constipation

A. Facial edema

A nurse is providing teaching to a client who has a new prescription for digoxin. The nurse should instruct the client to monitor and report which of the following adverse effects that is a manifestation digoxin toxicity? (Select all that apply) A. Fatigue B. Constipation C. Anorexia D. Rash E. Blurred vision

A. Fatigue C. Anorexia E. Blurred vision

A nurse is caring for a client who is taking amiodarone to treat atrial fibrillation. Which of the following should the nurse instruct the client to avoid while taking this drug? A. Grapefruit juice B. Milk C. Foods high in vitamin K D. NSAIDs

A. Grapefruit juice - Grapefruit juice, particularly in large amounts, can cause toxicity of potassium channel blockers, such as amiodarone.

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 this drug? A. Headache B. Constipation C. Hypertension D. Hyperglycemia

A. Headache - Adverse effects of nitrates, such as nitroglycerin, include headaches, which can be severe at the beginning of nitrate therapy but decrease in severity with continued exposure to nitrates.

A nurse is assessing a client who is taking a loop diuretic and is experiencing a thready, irregular pulse, orthostatic hypotension, and confusion. The nurse should identify that these manifestations indicate which of the following adverse effects? A. Hypokalemia B. Hypoglycemia C. Hypouricemia D. Hyponatremia

A. Hypokalemia - Manifestations of hypokalemia include a thready, irregular pulse, orthostatic hypotension, anxiety, confusion, skeletal muscle weakness, hypoactive bowel sounds, polyuria, nausea, and vomiting.

You should instruct a patient using phenylephrine (Neo-Synephrine) spray for nasal congestion to do which of the following to avoid rebound congestion? (Select all that apply.) A. Limit the drug's use to 3 to 5 days. B. Add an intranasal glucocorticoid. C. Taper the dose prior to discontinuation. D. Restrict the drug's use to one nostril at a time. E. Add a beta2 adrenergic agonist.

A. Limit the drug's use to 3 to 5 days. B. Add an intranasal glucocorticoid. C. Taper the dose prior to discontinuation. D. Restrict the drug's use to one nostril at a time.

A nurse is teaching a client who has a new prescription for quinidine. Which of the following statements should the nurse include? A. Monitor your pulse rate and report changes." B. "Remain upright for 30 minutes after taking this medication." C. "This medication can decrease digoxin levels." D. "This medication can cause urinary incontinence."

A. Monitor your pulse rate and report changes." - Sodium channel blockers, like quinidine, can worsen dysrhythmias, or cause new ones. The nurse should teach the client to monitor their pulse rate and report changes from prescribed parameters. It can be helpful to instruct the client to keep a written record of their pulse rate for the provider.

A nurse is caring for a client who is taking atorvastatin and has a new prescription for gemfibrozil. The nurse should recognize that this drug combination places the client at an increased risk for which of the following adverse effects? A. Myopathy B. Hypoglycemia C. Irregular pulse D. Kidney failure

A. Myopathy - When taking a statin drug, it is important to know that concurrent use of fibric acid derivatives, such as gemfibrozil, or other drugs to lower cholesterol, can increase the risk for myopathy.

For which of the following reasons should a nurse instruct a client to avoid guaifenesin with combination over the counter products? A. Over-the-counter cold products can also contain guaifenesin. B. Blood glucose levels are increased. C. Rebound congestion is likely. D. Drug tolerance is likely.

A. Over-the-counter cold products can also contain guaifenesin. - Many combination over-the-counter cold products contain guaifenesin. A client taking both might be taking excessive amounts of the drug. Combination products also contain multiple drugs to treat different manifestations, some of which the client might not have. All drugs have potential adverse effects, so the client should use only those drugs required to treat existing symptoms and only in the recommended amounts.

A nurse is caring for a client who is taking a diuretic. The nurse should instruct the client to include which of the following foods in their diet to increase potassium intake? A. Raisins B. Cabbage C. Cheese D. Eggs

A. Raisins - Diuretics can deplete the body of potassium, so the nurse should instruct the client to include potassium-rich foods in their diet, such as raisins and other dried fruits.

A nurse is caring for a client who is about to begin captopril therapy. Which of the following adverse effects should the nurse instruct the client to report because it can indicate a need to discontinue drug therapy? (Select all that apply.) A. Rash B. Distorted taste C. Swelling of the tongue D. Photosensitivity E Dry cough

A. Rash B. Distorted taste C. Swelling of the tongue E. Dry cough

A nurse is teaching a client who has a new prescription for nitroglycerin transdermal patch for angina pectoris. Which of the following instructions should the nurse include? A. Remove the patch each evening B. Cut each patch in half if angina attacks are under control C. Take off the nitroglycerin patch for 30 min if a headache occurs D. Apply a new patch every 48 hr

A. Remove the patch each evening

A nurse is caring for a client who has a depressive disorder and requires a prescription drug to treat hypertension. The nurse should recognize that which of the following antihypertensive drugs is contraindicated for this client? A. Reserpine B. Captopril D. Hydralazine E. Eplerenone

A. Reserpine - Severe depression and an increased risk for suicide are adverse effects of adrenergic neuron blockers, such as reserpine. These adverse effects develop because of the depletion of serotonin and norepinephrine and can persist after clients discontinue taking the drug.

A nurse is reviewing new prescriptions with a client who has heart disease. The nurse should instruct the client that which of the following drugs is prescribed to treat hypercholesterolemia? A. Simvastatin B. Furosemide C. Losartan D. Nitroglycerin

A. Simvastatin - Simvastatin is an HMG-CoA reductase inhibitor. It blocks synthesis of cholesterol by the body to help lower cholesterol levels.

A nurse is teaching a client who has a prescription for long-term use of oral prednisone for treatment of chronic asthma. The nurse should instruct the client to monitor for which of the following manifestations as an adverse effect of this medication? A. Weight gain B. Nervousness C. Bradycardia D. Constipation

A. Weight gain

A nurse is providing instructions to a client who has a new prescription for albuterol, PO. Which of the following instructions should the nurse include? A. "You can take this medication to abort an acute asthma attack." B. "Tremors are an adverse effect of this medication." C. "Prolonged use of this medication can cause hyperglycemia." D. "This medication can slow skeletal growth rate."

B. "Tremors are an adverse effect of this medication."

A nurse is providing instructions for a client who has a new prescription for albuterol and beclomethanone inhalers for the control of asthma. Which of the following instruction should the nurse include in the teaching? A. Take the albuterol at the same time each day B. Administer the albuterol inhaler prior to using the beclomethasone if experiencing an acute episode C. Use beclomethasone if experiencing acute episode D. Avoid shaking the beclomethasone before use

B. Administer the albuterol inhaler prior to using the beclomethasone if experiencing an acute episode

A nurse is teaching an adult client about diphenhydramine. The nurse should inform the client to expect which of the following adverse effects while taking this drug? A. Muscle tremors B. Drowsiness C. Excitation D. Insomnia

B. Drowsiness - The most common adverse effect of diphenhydramine, a first-generation antihistamine, is drowsiness.

Legal restrictions apply to the purchase of pseudoephedrine (Sudafed) because of which of the following risks? A. Respiratory depression B. Drug abuse C. Drug tolerance D. Rebound congestion

B. Drug abuse - Because it is possible to alter pseudoephedrine and epinephrine into methamphetamine, a commonly abused drug, the law restricts the drugs' purchase.

A patient taking losartan (Cozaar) for hypertension asks about stopping contraception and starting a family. You should inform the patient that losartan is unsafe to take during pregnancy due to which of the following risks? A. Macrosomia B. Fetal injury C. Gestational diabetes D. Thromboembolic disease

B. Fetal injury

A nurse is planning to administer a first dose of captopril to a client who has hypertension. Which of the following medications can intensify first dose hypotension? (Select all that apply?) A. Simvastatin B. Hydrochlorothiazide C. Phenytoin D. Clonidine E. Aliskiren

B. Hydrochlorothiazide D. Phenytoin E. Aliskiren

A patient is about to begin taking hydrochlorothiazide (Microzide) for hypertension. To assess for adverse effects of the drug, you should monitor for which of the following? (Select all that apply.) A. Ototoxicity B. Hyponatremia C. Hypokalemia D. Dehydration E. Hypoglycemia

B. Hyponatremia C. Hypokalemia D. Dehydration

A nurse is providing teaching to a client who is taking simvastatin. The nurse should instruct the client to report which of the following manifestations as an indication of a serious adverse reaction that could require discontinuing drug therapy? A. Bronochonstriction B. Muscle pain C. Lip Numbness D. Somnolence

B. Muscle pain - Simvastatin, an HMG-CoA reductase inhibitor (statin), can cause myopathy or pain in muscles and joints that can progress to rhabdomyolysis. With this rare but serious adverse effect, muscle protein breaks down and is excreted, resulting in kidney damage.

A nurse should identify that which of the following drugs is used only for the short-term treatment of a cardiac dysrhythmia because of the serious adverse effects associated with long-term use? A. Quinidine B. Procainamide C. Nitroglycerin D. Verapamil

B. Procainamide - Procainamide is a sodium channel blocker and a broad-spectrum antidysrhythmic. It should not be used for long-term treatment of dysrhythmias because of its risk for serious adverse effects, including cardiotoxicity and arterial embolism.

A nurse is teaching a client about the use of an expectorant to treat a cough. The nurse should include that an expectorant has which of the following therapeutic effects? A. Suppresses the cough stimulus B. Reduces surface tension C. Reduces inflammation D. Dries mucous membranes

B. Reduces surface tensions - Expectorants act by reducing the surface tension and viscosity of respiratory secretions. This results in thinning thick mucus, making it easier to cough out of the lungs and drain out of the nose and sinuses.

A nurse is teaching a client who has a new prescription for gemfibrozil. Which of the following instructions should the nurse include? (Select all that apply.) A. Take the drug with food. B. Report any new intolerance to fried foods. C. Report muscle tenderness. D. Expect periodic liver function testing. E. Take the drug once each day.

B. Report any new intolerance to fried foods. C. Report muscle tenderness. D. Expect periodic liver function testing.

A nurse is teaching a client about ipratropium. The nurse should include that this drug has which of the following adverse effects. (Select all that apply) A. Muscle tremors B. Urinary retention C. Dry mouth D. Insomnia E. Tachycardia

B. Urinary retention C. Dry mouth - Urinary retention can occur with ipratropium, an inhaled anticholinergic. - Ipratropium can dry oral secretions.

You are obtaining a health history from a patient who is to start using a new ipratropium (Atrovent) inhaler. Which of the following information from the patient's history should alert you to take further action? (Select all that apply.) A. Seizure disorder B. Urinary retention C. Depression treated with a monoamine oxidase inhibitor (MAOI) D. Hypothyroidism treated with synthetic thyroid hormone E. Glaucoma

B. Urinary retention E. Glaucoma

Which of the following information should you include when teaching a patient about using an albuterol (Proventil) inhaler for asthma? A. Use it every 12 hr. B. Use it periodically to prevent exercise-induced asthma. C. Store the drug canister in the refrigerator. D. Monitor for an oral yeast infection.

B. Use it periodically to prevent exercise-induced asthma.

A nurse is caring for a client who has a new prescription for alirocumab to reduce cholesterol. The nurse should monitor for which of the following findings as an adverse effect of alirocumab (Select all that apply) A. Muscle aches B. Vasculitis C. Hearing loss D. Urticaria E. Jaundice

B. Vasculitis D. Urticaria E. Jaundice

A nurse is teaching a client about ipratropium. Which of the following instructions should the nurse include? A. Do not drink anything for 30 min after using the drug. B. Wait 5 min between using the drug and another inhaled drug. C. This drug is used to thin respiratory secretions. D. Check pulse rate after inhaling the drug.

B. Wait 5 min between using the drug and another inhaled drug - Ipratropium, an inhaled anticholinergic, requires a 5-min wait between its administration and that of another inhaled drug to allow for bronchodilation to take effect.

A nurse is teaching a family of a child who has cystic fibrosis and a new presciption for acetylcysteine. Which of the following information should the nurse include in the instructions? A. "Expect this medication to suppress your child's cough" B. "Expect this medication to cause euphoria." C. "Expect this medication to smell like rotten eggs." D. "Expect this medication to turn your child's urine orange."

C. "Expect this medication to small like rotten eggs."

A nurse is caring for a client who is taking digoxin and develops changes on their ECG tracing and other manifestations that indicate the client has severe digoxin toxicity. Which of the following drugs should the nurse expect to administer to treat this complication? A. Acetylcysteine B. Flumazenil C. Antigen-binding fragments D. Deferoxamine

C. Antigen-binding fragments - Antigen-binding fragments, also called digoxin immune Fab, binds to digoxin and blocks its action. The nurse should prepare to administer this antidote IV to clients who have severe digoxin toxicity.

A nurse is preparing to administer propranolol to a client who has a dysrhymia. Which of the following actions should the nurse plan to take? A. Hold propanolol for an apical pulse greater than 100/min B. Administer propranolol to increase the client's blood pressure C. Assist the client when sitting up or standing after taking this medication D. Check for hypokalemia frequently due to the risk for propranolol toxicity

C. Assist the client when sitting up or standing after taking this medication

A nurse is teaching a client about the use of beclomethasone to treat asthma. The nurse should explain that the drug has which of the following therapeutic effects? A. Thins mucus B. Relaxes bronchial smooth muscle C. Decreases inflammation D. Increases the cough threshold

C. Decreases inflammation - Beclomethasone, an intranasal glucocorticoid, treats asthma by reducing inflammation.

A nurse in an acute care facility is caring for a client who is receiving IV nitroprusside for hypertensive crisis. Which of the following conditions should the nurse monitor the client for as an adverse effect of this medication? A. Intestinal ileus B. Neutropenia C. Delirium D. Hyperthermia

C. Delirium

A patient is about to begin taking aliskiren (Tekturna) to treat hypertension. Which of the following should you tell the patient to avoid to ensure optimal absorption of this drug? A. Soy sauce B. Green, leafy vegetables C. Fatty foods D. Foods high in carbohydrates

C. Fatty foods

A nurse is collecting data from a client who is taking gemfibrozil. Which of the following assessment findings should the nurse identify as an adverse effect of this medication? A. Mental status changes B. Tremor C. Jaundice D. Pneumonia

C. Jaundice

A nurse is caring for a client who has a new prescription for captopril for hypertension. Which of the following instructions should the nurse include? A. Hypokalemia B. Hypernatremia C. Neutropenia D. Bradycardia

C. Neutropenia

A nurse in a provider's office is monitoring blood electrolytes for four clients who take digoxin. Which of the following electrolyte values increase a client's risk for digoxin toxicity? A. Calcium 9.2 mg/dL B. Calcium 10.2 mg/dL C. Potassium 3.4 mEq/L D. Potassium 4.8 mEq/L

C. Potassium 3.4 mEq/L

A nurse is teaching a client about the use of antihistamines to treat allergic rhinitis. The nurse should explain that these drugs are effective because they perform which of the following actions? A. Decrease viscosity of nasal secretions B. Block H2 receptors C. Prevent histamine from binding to receptors D. Reduce nasal congestion

C. Prevent histamine from binding to receptors - Antihistamines treat allergic rhinitis and reduce swelling by blocking histamine from binding to the receptor sites.

A nurse is assessing a client who is taking amiodarone to treat atrial fibrillation. Which of the following findings is a manifestation of amiodarone toxicity? A. Light yellow urine B. Report of tinnitus C. Productive cough D. Blue-gray skin discoloration

C. Productive cough

A nurse is caring for a client who is taking codeine. The nurse should identify that which of the following assessments is priority to make? A. Blood pressure B. Apical heart rate C. Respirations D. Level of consciousness

C. Respirations -The greatest risk to clients who are taking codeine, an opioid agonist, is severe respiratory depression. Therefore, the respiratory rate is the priority assessment

A nurse is caring for a client who has a new prescription for verapamil. The nurse should clarify the prescription with the provider if the client has a history of which of the following conditions? A. Migraine headaches B. Pancreatitis C. Second-degree AV block D. Angina pectoris

C. Second-degree AV block

A nurse is teaching a client who has a new prescription for dextromethorphan to suppress a cough. The nurse should instruct the client to monitor for which. of the following manifestation as adverse effect of this medication? A. Diarrhea B. Anxiety C. Sedation D. Palpitations

C. Sedation

Match the drugs in the left column with the corresponding classification: Quinidine A. Beta adrenergic blocker that controls atrial and ventricular tachycardia B. Potassium channel blocker that treats ventricular fibrillation and ventricular tachycardia C. Sodium channel blocker that treats supraventricular and ventricular dysrhythmias D. Calcium channel blocker that treats supraventricular tachycardia and atrial fibrillation or flutter

C. Sodium channel blocker that treats supraventricular and ventricular dysrhythmias

A nurse is teaching a client about the use of a mucolytic to treat a cough. The nurse should include that a mucolytic has which of the following therapeutic effects? A. Suppresses the cough stimulus B. Reduces inflammation C. Thins and loosens mucus D. Dries secretions

C. Thins and loosens mucus - Mucolytics make mucus less viscous to increase a cough's productivity.

A nurse should recognize that using pseudoeephdrine to treat allergic rhinitis requires cautious use with clients who have. which of the following conditions? A. Peptic ulcer disease B. A seizure disorder C. Anemia D. Coronary artery disease

D. Coronary artery disease - Because pseudoephedrine, an oral sympathomimetic, can cause systemic vasoconstriction, it requires cautious use with clients who have severe hypertension or coronary artery disease.

A patient who began drug therapy reports palpitations the following day. His ECG indicates frequent premature ventricular contractions. The provider prescribes a stat dose of lidocaine (Xylocaine) 50 mg via IV bolus. You should monitor the patient for which of the following adverse reactions? A. Metabolic alkalosis B. Hypertension C. Tachycardia D. Paresthesias

D. Paresthesia

A nurse is teaching a client about the use of cromolyn sodium to prevent bronchospasm. The nurse should explain that the drug has which of the following therapeutic effects? A. Increases leukocyte activity B. Blocks muscarinic receptors C. Causes bronchodilation D. Reduces inflammation

D. Reduces inflammation - Cromolyn sodium, a mast cell stabilizer, reduces inflammation by inhibiting the inflammatory response.

You are reviewing the history of a patient who is about to begin doxazosin (Cardura) therapy to treat hypertension. Which of the following drugs the patient takes require further action? A. Cimetidine (Tagamet) B. Zolpidem (Ambien) C. Ibuprofen (Motrin) D. Sildenafil (Viagra)

D. Sildenafil (Viagra)

A nurse is caring for a client who has a glomerular filtration rate of 10 mL/min and a reduced urine output. The nurse should clarify a prescription for hydrochlorothiazide for this client because of which of the following characteristics of the drug? A. The drug can cause hypoglycemia in clients who have a low urine output. B. The drug does not reduce blood pressure for clients who have a low urine output. C. The drug can increase the risk of pulmonary edema for clients who have renal insufficiency. D. The drug does not promote diuresis for clients who have renal insufficiency.

D. The drug does not promote diuresis for clients who have renal insufficiency. - Adequate kidney function is essential for clients who take hydrochlorothiazide, a thiazide diuretic, to promote urine production and effective excretion.

A nurse is teaching a client about preventing otitis externa. Which of the following instructions should the nurse include? A. Clean the ear with cotton-tipped swab daily B. Place earplugs in the ears when sleeping at night C. Use a cool water irrigation solution to remove earwax D. Tip the head to the side to remove water from the ears after showering.

D. Tip the head to the side to remove water from the ears after showering. - The client should remove water from the ear after showering or swimming to reduce the risk for otitis externa