Pharm 3.0 Final

A nurse is preparing to administer Digoxin 0.2 mg via IV bolus to a client. The amount available is Digoxin 0.25 mg/1ml. How many ml should the nurse administer?

0.8 ml

A nurse is administering insulin glulisine 10 units subcutaneously at 0720 to an adolescent client who has type 1 diabetes mellitus. The nurse should anticipate onset of action of the insulin at which of the following times?

0745

A nurse is preparing to administer codeine 30 mg PO every 4 hr. PRN to a client for pain. The amount available is codeine oral solution 15 mg/5 ml. How many ml should the nurse plan to administer per does?

10 ml

A nurse is preparing to administer heparin 900 units/hr. via IV infusion. The amount available is heparin 25, 000 units in 500 mL 5% dextrose in water. The nurse should set the IV pump to deliver how many mL/hr.?

18 ml/hr

A nurse is preparing to administer Chlorothiazide 20 mg/kg/day PO divided equally and administered twice daily for a toddler who weighs 28.6 lb. The amount available is Chlorothiazide oral suspension 250 mg/5ml. how many ml should the nurse administer per dose?

2.6 ml

A nurse is preparing to administer ampicillin 500 mg in 50 ml of dextrose 5% in water [D5W] to infuse over 15 minutes. The drop factor of the manual IV tubing is 10 gtt./ml. The nurse should set the manual IV infusion to deliver how many gtt./min?

33 gtt/min

A nurse is preparing to administer dextrose 5& in 0.45% sodium chloride 400 ml IV to an older adult client over 8 hr. The nurse should set the IV pump to deliver how many ml/hr.?

50 ml/hr

A nurse is preparing to administer an IV fluid bolus of 1 L 0.9% sodium chloride over 2 hr. to a client who is dehydrated. The nurse should set the IV pump to deliver how many ml/hr.?

500 ml/hr

A nurse is preparing to administer ampicillin 50 mg/kg/day PO divided into 4 equal doses for a toddler who weighs 33 lbs. available is ampicillin 125 mg/5ml oral solution. How many ml should the nurse administer per dose?

7.5 ml

A nurse is preparing a discharge teaching plan for a 6-year-old client who has asthma and several prescription medications using metered dose inhalers [MDIs]. Which of the following interventions should the nurse include in the plan?

Add a spacer to the MDI

A nurse is preparing to administer iron dextran IV to a client. Which of the following actions should the nurse plan to take?

Administer a small test dose before giving the full dose

A nurse is providing teaching to the parents of a school-age child who has asthma about medications for bronchospasm. Which of the following inhaled medications should the nurse instruct the parents to use to relieve and acute asthma attack?

Albuterol

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

Aspartate Aminotrasnferase [AST] **Isoniazid can be toxic to the liver. Therefore, it is important to monitor liver enzymes, such as AST, during therapy with isoniazid. In addition, the nurse should instruct the client to notify the provider of jaundice, nausea, dark-colored urine or other findings indicating hepatitis.** -Monitoring of thyroid hormones, such as TSH, is not indicated for a client taking isoniazid. -Monitoring potassium levels is not indicated for a client taking isoniazid. -Monitoring sodium levels is not indicated for a client taking isoniazid.

A nurse is planning to administer Diphenhydramine 50 mg via IV bolus to a client who is having an allergic reaction. The client has an IV infusion containing a medication that is incompatible with diphenhydramine in solution. Which of the following actions should the nurse take?

Aspirate to check for IV patency before administering the Diphenhydramine 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 caring for a client and realizes after administering the 0900 medications that she administered digoxin 0.25 mg PO to the client instead of the prescribed digoxin 0.125 mg PO. Which of the following actions should the nurse take first?

Assess the client's apical pulse

A nurse is providing teaching to a client who has hypertension and a new prescription for oral Clonidine. Which of the following instructions should the nurse include in the teaching?

Avoiding driving until the client's reaction to the medication is known **Clonidine can cause drowsiness, weakness, sedation, and other CNS effects. Until the client's response to the medication is known, the nurse should instruct the client to avoid driving or handling other potentially hazardous equipment. Over time, these effects are likely to decrease.** --Clonidine can cause constipation. The nurse should instruct the client to increase fiber intake. --Dry mouth is an expected finding of clonidine therapy, especially during the first few weeks. The nurse should instruct the client to suck hard candy and take sips of water to relieve this manifestation. --Clonidine should not be discontinued abruptly due to the risk of hypertensive crisis. The client should report the rash to the provider.

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 Epoetin alfa often causes hypertension, which can lead to stroke or other cardiovascular complications. The nurse should monitor the client's blood pressure and notify the provider about increases. The client who receives epoetin alfa frequently requires concurrent use of antihypertensive medication.

A nurse is planning discharge teaching for a client who has Major Depressive Disorder and a new prescription for Phenelzine. Which of the following foods should the nurse include in the plan as safe for the client to consume while taking Phenelzine?

Broiled beef steak **Phenelzine, an MAOI, is an antidepressant. This medication interacts with a variety of foods to produce a hypertensive crisis. Beef steak and other meats that are fresh do not interact with phenelzine and are safe to consume.** --Most cheeses, except for cottage cheese and cream cheese, interact with MAOIs, such as phenelzine, and can cause hypertensive crisis. --Pepperoni, salami, and other dried or cured meats interact with MAOIs, such as phenelzine, and can cause hypertensive crisis. --Fish that has been cured or dried interacts with MAOIs, such as phenelzine, and can cause hypertensive crisis.

A nurse is providing discharge teaching to a client who has venous thrombosis and a prescription for warfarin. Which of the following instructions should the nurse include in the teaching?

Carry a medic alert ID card

A nurse is caring for a client who has congestive heart failure and is taking digoxin. The client reports nausea and refused to eat breakfast. Which of the following actions should the nurse take first

Check the client's 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 caring for a client who has alcohol use disorder and is admitted with lower extremity fractures following a motor-vehicle crash. A few hours after admission, the client develops restlessness and tremors. Which of the following medications should the nurse anticipate administering to the client first?

Chlordiazepoxide 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 administering Ciprofloxacin and Phenazopyridine to a client who has a severe urinary tract infection [UTI]. The client asks why both medications are needed. Which of the following responses should the nurse make?

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.** --The use of phenazopyridine does not affect the dosage of ciprofloxacin hydrochloride. --Phenazopyridine does not potentiate the action of ciprofloxacin hydrochloride and has no antibiotic or antiseptic qualities. --Phenazopyridine has no effect on adverse effects of ciprofloxacin hydrochloride.

A nurse is administering oral hydroxyzine to a client. Which of the following adverse effects should the nurse instruct the client to expect?

Dry mouth

A nurse is administering Adenosine via IV bolus for a client who has developed paroxysmal atrial tachycardia. For which of the following findings should the nurse assess the client during administration of Adenosine?

Dyspnea **Dyspnea can occur during administration of adenosine due to bronchoconstriction. Since adenosine has a very short half-life of about 10 seconds, this effect should be short-lived.**

A nurse is planning to administer Diltiazem via IV bolus to a client who has atrial fibrillation. When assessing the client, the nurse should recognize that which of the following findings is a contraindication to administration of Diltiazem.

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.** --Diltiazem and other calcium channel blockers are contraindicated for use in certain conditions where bradycardia is present, such as second- or third-degree heart block. It is used to treat tachydysrhythmia, such as atrial flutter and fibrillation and supraventricular tachycardia. --A decreased level of consciousness is not a contraindication to diltiazem use. --Diltiazem does not interact with diuretics, and a history of diuretic use is not a contraindication for diltiazem administration.

A nurse is providing discharge teaching to a client who had a kidney transplant and has a prescription for oral cyclosporine. Which of the following statements by the client indicates an understanding of the teaching?

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.** -Cyclosporine and similar medications taken after a kidney transplant must be continued for the rest of the client's life. -Cyclosporine causes some hirsutism (unusual hair growth) in many clients who take it. It does not cause hair loss. -Cyclosporine is an immunosuppressive agent, which prevents rejection of the transplanted kidney.

A nurse is providing discharge teaching about lithium toxicity to a client who has a new prescription for lithium. Which of the following statements by the client indicates an understanding of the teaching?

I can develop lithium toxicity if i experience vomiting or diarrhea **Vomiting or diarrhea can cause electrolyte imbalances. If serum sodium decreases, lithium is retained by the kidneys and the risk for lithium toxicity increases.** --Diuretics decrease kidney excretion of lithium, which causes lithium levels to rise and increases the potential for toxicity. --When sodium levels are low, lithium excretion by the kidneys is increased. Therefore, eating foods with larger amounts of sodium reduces, rather than increases, the risk for lithium toxicity. Increased sodium intake can lead to excretion of lithium and a decrease in the lithium level. It is important for clients to eat normal and consistent amounts of sodium to maintain lithium levels. --NSAIDs, such as naproxen and ibuprofen, increase renal reabsorption of sodium and lithium, which causes an increase in lithium levels and possible toxicity. Acetylsalicylic acid and sulindac are NSAIDS that do not affect lithium levels.

A nurse is providing teaching to a client who has hypertension and type 1 diabetes mellitus and a new prescription for metoprolol. Which of the following statements by the client indicates an understanding of the teaching?

I might have difficulty recognizing when my blood sugar is low **Metoprolol, a beta-adrenergic blocker, is used to treat hypertension. Because it decreases heart rate, this common manifestation of hypoglycemia can be masked and hypoglycemia might become more difficult to recognize. The client should be taught to recognize hypoglycemia by other manifestations, such as hunger, nausea, and sweating.** --Metoprolol does not decrease the risk for an infection. --Metoprolol does not cause weight loss, although it can cause weight gain due to fluid retention. The client should be taught to report unexpected weight gain, edema, and cough while taking beta-adrenergic blockers. --Metoprolol does not extend or increase the risk for hyperglycemia. However, hypoglycemia can be prolonged while taking this medication.

A nurse is providing discharge teaching to a client who has been hospitalized for major depressive disorder and has a prescription or Amitriptyline. Which of the following statements by the client indicates an understanding of the teaching?

I will move slowly when I stand up because amitriptyline can cause my blood pressure to decrease **Amitriptyline can cause orthostatic hypotension. The nurse should instruct the client to take precautions to prevent injury due to falls while taking amitriptyline.** --Amitriptyline is a tricyclic antidepressant that has a sedative effect. This medication is often prescribed three times daily until a therapeutic dose has been achieved and then the entire dose is prescribed at bedtime to help the client sleep at night and prevent daytime drowsiness. --Amitriptyline should not be taken with other CNS depressants, such as alcohol and sedatives, because these substances can enhance the adverse effects of amitriptyline. --Amitriptyline and other tricyclic antidepressants have an anticholinergic action and can cause severe constipation as well as adverse effects such as dry mouth, blurred vision, and urinary retention.

A nurse is providing teaching to a client who has postmenopausal osteoporosis and a new prescription for intranasal calcitonin-salmon. Which of the following statements by the client indicates an understanding of the teaching?

I will need to depress the side arms to activate the pump

A nurse is providing teaching to a client who has heart failure and is taking Spironolactone. Which of the following statements by the client indicates an understanding of the teaching?

I will watch for increased breast tissue growth while taking this medication Spironolactone, which is derived from steroids, can cause adverse endocrine effects, such as gynecomastia, impotence in men and irregular menses and hirsutism in women. The nurse should instruct the client that these changes can occur.

A nurse is caring for a client who is in preterm labor and has a new prescription for Nifedipine. The client states she is concerned because her father takes Nifedipine for his angina pectoris. The nurse should explain to the client that Nifedipine works for clients who are pregnant by which of the following mechanisms?

It inhibits uterine contractions by blocking entry of calcium into uterine cells **Nifedipine, a calcium channel blocker, causes uterine relaxation by blocking the flow of calcium to the myometrial cells of the uterus.** --This describes the mechanism of action that occurs when antibiotics are administered to prevent preterm labor. --Nifedipine does not work by decreasing the activity of the CNS. --This describes the mechanism of terbutaline to suppress preterm labor. Terbutaline has more adverse effects affecting the health of the client than nifedipine.

A nurse is providing teaching to a client who has type 2 Diabetes Mellitus and a new prescription for Metformin. Which of the following adverse effects of Metformin should the nurse instruct the client to watch for and report to the provider?

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.** --Weight loss, rather than weight gain, is a common finding when beginning metformin. The sulfonylurea medications for type 2 diabetes, such as glipizide and tolbutamide, are very likely to cause weight gain. --Although metformin lowers blood sugar, taking it in prescribed doses as the sole medication for diabetes does not cause hypoglycemia. Other medications for type 2 diabetes, such as sulfonylureas and glitazones, can cause severe hypoglycemia, and when used in combination with metformin might cause this adverse effect. --Metformin can cause nausea, vomiting, and diarrhea. Constipation is not an adverse effect of metformin.

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

Oral Oxycodone **The client's current pain regimen consists of a nonopioid analgesic, naproxen, and an adjuvant medication for neuropathic pain, gabapentin. According to the WHO analgesic ladder for cancer pain management, the next addition to the pain regimen is an opioid for moderate pain. Oxycodone is an oral opioid that relieves moderate to moderately severe pain; therefore, it is an appropriate choice to add to the client's pain regimen.** --Diazepam has no analgesic effects and can cause sedation, which will interfere with the client's daily activities. --Naloxone is an opioid antagonist, which is not indicated for a client who has cancer pain and is not taking opioids. Naloxone is administered to clients who have opioid overdose. --Meperidine, an opioid analgesic, is not indicated for cancer pain because it can cause severe toxic effects when given for more than a few doses.

A nurse is caring for a client who was brought to the emergency department by friends who report the client has overdosed on heroin. Which of the following findings should the nurse expect to assess?

Pinpoint pupils

A nurse is monitoring laboratory values for a male client who has leukemia and is receiving weekly chemotherapy with methotrexate via IV infusion. Which of the following laboratory values should the nurse report to the provider?

Platelets 78,000/mm **The nurse should monitor the platelet count of a client who is taking methotrexate because the medication can cause thrombocytopenia. This client's platelet count is very low and puts the client at risk for severe bleeding. The nurse should report this finding promptly to the provider.** --The nurse should monitor the BUN of a client who is taking methotrexate because the medication can cause kidney injury. This client's BUN is within the expected reference range and does not need to be reported to the provider at this time. --The nurse should monitor the hemoglobin of a client who is taking methotrexate because the medication can cause bone marrow suppression. This client's hemoglobin is within the expected reference range and does not need to be reported to the provider at this time. --The nurse should monitor the AST of a client who is taking methotrexate because the medication can cause liver damage. This client's AST is within the expected reference range and does not need to be reported to the provider at this time.

A nurse is preparing a discharge teaching plan for a client who is to being long-term oral prednisone for asthma. Which of the following instructions should the nurse include in the plan?

Schedule the medication on alternate days to decrease adverse effects **Some of the adverse effects caused by long-term glucocorticoid therapy, such as suppression of the adrenal gland, can be avoided by using alternate-day therapy. -Glucocorticoids, such as prednisone, can cause significant gastrointestinal distress and lead to ulcer formation. The client should not take steroids on an empty stomach. -Rash is not an expected adverse effect of oral glucocorticoids, such as prednisone. A client should not stop taking prednisone or other glucocorticoids abruptly if taking prednisone for more than 10 days. The dosage should be decreased gradually to prevent withdrawal syndrome during long-term therapy. -Oral glucocorticoids, such as prednisone, are not used as rescue medications. The client might need a short-acting bronchodilator if acute distress occurs.

A home health nurse is visiting an older adult client who has Alzheimer's disease. His caregiver tells the nurse she has been administering prescribed Lorazepam, 1 mg three times per day, to the client for restlessness and anxiety during the past few days. For which of the following adverse effects should the nurse assess the client?

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.** -Low-grade fever is not an adverse effect caused by lorazepam. -Diuresis is not an adverse effect caused by lorazepam. -Lorazepam is a benzodiazepine with antiseizure effects.

A nurse is teaching a client who has chronic stable angina pectoris and a prescription for sublingual nitroglycerin tablets. Identify the sequence of instructions that the nurse should tell the client to use if he experiences chest pain?

Stop activity, place a tablet under the tongue, wait 5 minutes, call 911 if the pain is not relieved

A nurse is planning care for a female client who has severe irritable bowel syndrome with diarrhea [IBS-D] and a new prescription for Alosetron. Which of the following interventions should the nurse include in the plan of care?

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.** --The client should be taught to notify the provider and stop the medication if diarrhea is not controlled after 1 month of starting alosetron. --The client should notify the provider about tachydysrhythmia, which is an adverse effect of alosetron. --Alosetron has few medication interactions and does not interact with oral contraceptives

A nurse is providing teaching to a client who is to start taking Hydrochlorothiazide for hypertension. The nurse instructs the client to eat foods rich in potassium. Which of the following statements by the client indicates an understanding of the teaching?

This medication can cause a loss of potassium **Hydrochlorothiazide can result in hypokalemia caused by excessive potassium excretion by the kidneys. The client should supplement his diet with potassium-rich foods to avoid the occurrence of hypokalemia. Foods that are high in potassium include bananas, raisins, baked potatoes, pumpkins, and milk.** --Potassium does not have an antihypertensive effect. --Potassium does not have a synergistic effect when taken with hydrochlorothiazide. It will not increase the therapeutic effect of an antihypertensive medication. --Potassium does not influence the effectiveness of hydrochlorothiazide.

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 if it occurs?

Tinnitus

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 if it occurs?

Tinnitus 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 has oral Theophylline for relief of chronic bronchitis. The nurse should recognize that which of the following findings indicates toxicity to Theophylline?

Tremors **Theophylline is a xanthine derivative bronchodilator. An early manifestation of toxicity is CNS stimulation, often seen as tremors. Seizures can occur if blood levels continue to rise.** --Diarrhea, rather than constipation, is a manifestation of theophylline toxicity. --Theophylline is a CNS stimulant. An increase in the blood level of theophylline causes restlessness and irritability, but not fatigue. Lethargy is more indicative of CNS depression. --Tachycardia, rather than bradycardia, is an adverse effect associated with theophylline toxicity.

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 **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.** -Echinacea is a popular herb widely used in the U.S. primarily to reduce the manifestations and duration of colds and flu-like illnesses, although its effectiveness has not been proven. -Ginkgo biloba has become a widely used dietary supplement in the United States for increasing cognitive functions in elderly people, although this effect has not been proven. Ginkgo has been shown to improve leg pain of intermittent claudication and other peripheral arterial disorders. -Ginger root is sometimes used to prevent and treat nausea caused by motion sickness, seasickness, and other causes.

A nurse in an outpatient facility is assessing a client who is prescribed furosemide 40 mg daily, but the client reports that she has been taking extra doses to promote weight loss. Which of the following findings should indicate to the nurse that the client is dehydrated?

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.** --Distended neck veins are indicators of fluid volume excess, not dehydration or fluid volume deficit. --Elevations in laboratory values such as BUN, hematocrit, and others, can be seen in a client who is dehydrated. A BUN of 18 mg/dL is within the expected reference range. --Full, bounding radial pulses are an indicator of fluid volume excess, not dehydration or fluid volume deficit.

A nurse is providing discharge teaching to a client who had a bleeding duodenal ulcer and is prescribed Omeprazole. Which of the following statements should the nurse include in the teaching?

You should take this medication before breakfast every day **Clients who have active duodenal ulcer or gastric reflux disease should take omeprazole once daily before a meal (usually breakfast) because the medication is less effective when taken with food --Omeprazole increases the risk of acquiring pneumonia, both in acute care health facilities and at home during the first few days of use. --Omeprazole should be used for no more than 1 to 2 months due to long-term adverse effects, which include increased risk for fractures and hypomagnesemia. --When used as prescribed, adverse effects of omeprazole are infrequent, including diarrhea, nausea/vomiting and headache. The nurse should instruct the client to report severe diarrhea to the provider.

A nurse is providing discharge teaching to a client who has heart failure and a prescription for Digoxin 0.125 mg PO daily and Furosemide 20 mg PO daily. Which of the following statements by the client indicates an understanding of the teaching?

i will eat fruits and vegetables that high potassium content every day **Hypokalemia is an adverse effect of diuretic therapy. Because the client is taking digoxin, it is important to maintain the potassium level between 3.5 to 5.0 mg/dL to avoid digoxin toxicity.** -Clients are instructed to withhold digoxin if their heart rate is below 60/min. The client should report a heart rate of less than 60/min, which can signify digoxin toxicity. -For home care, the nurse should instruct the client to weigh herself daily at the same time, record the weight, and report weight gain or loss to the provider. Measurement of I&O is done in acute care facilities but is not necessary in the home setting. -Visual disturbances, such as blurred vision or yellow vision, are findings that can occur with digoxin toxicity. The client should report changes in vision to the provider immediately.

A nurse is preparing to administer oxytocin to a client who is at 41 weeks of gestation and is experiencing ineffective labor. Which of the following actions should the nurse plan to take?

increase the dose of Oxytocin to obtain uterine contractions that occur every 2-3 minutes **Effective uterine contractions should occur every 2 to 3 min. --The goal during oxytocin therapy is for the client to experience contractions that last from 45 to 60 seconds. If prolonged contractions occur, administration should be stopped. --The client's blood pressure and pulse should be continually monitored during labor induction with oxytocin. --Oxytocin is administered via IV infusion when used for labor induction. Some other medications used for cervical ripening prior to oxytocin administration (dinoprostone and misoprostol) are administered vaginally. Oxytocin can be administered IM to decrease postpartum bleeding.

A nurse is assessing a client who has hypothyroidism and takes Levothyroxine. Which of the following findings should alert the nurse that the client is experiencing acute Levothyroxine overdose?

tremors **Tremor and anxiety are expected findings in acute levothyroxine overdose. These findings are similar to those seen in hyperthyroidism.** --Tachycardia, rather than bradycardia, is an expected finding in acute levothyroxine overdose. --Heat intolerance, rather than cold intolerance, is an expected finding in acute levothyroxine overdose. --Hyperthermia, rather than hypothermia, is an expected finding in acute levothyroxine overdose.