PHARM 5

The nurse is educating a young adult client diagnosed with migraine headaches about the prescribed intranasal Sumatriptan for abortive therapy. Which statement made by the client indicates the need for further clarification? "The intranasal spray will cause irritation to my nose and throat and a bad taste in my mouth." "I will administer 2 sprays into one nostril and repeat every 2 hours if needed." "The onset of the drug is auick and it peaks in 90 minutes so l will take

"I will administer 2 sprays into one nostril and repeat every 2 hours if needed."

ORDERED: Decadron (dexamethasone sodium phosphate) 2.5 mg. IM 12hr for treatment of a brain tumor. AVAILABLE: Multidose vial containing Decadron 20mg/5ml. How many ml of the Decadron should you administer? Round to the nearest tenth. Numerical answer only

0.6

A client with lung cancer has developed a new pulmonary embolism. The nurse monitoring the laboratory values of this client on a Heparin drip and notes the aPTT to be subtherapeutic. Standing orders are as follows: Ordered: 7500 units Heparin now Available: 5000 units/ml How many milliliters will the nurse administer?

1.5

The nurse is caring for a client who has chemo-induced nausea and vomiting. The client has an order for 4mg Ondansetron (Zofran) 30 minutes to 1 hour before the administration of the chemo. Available: 4mg in 2 ml normal saline. How many ml will the nurse administer? Numerical answer only

2

Order: 1000 ml of Ds 1/2 NS is ordered to run for 12 hours with an IV set delivering 15 gtt/ml. What is the rate of flow in gtt/min (Round to the nearest whole number)?

21

A client is on bleeding precautions while taking Anastrozole for post-menopausal breast cancer. The nurse identifies which of the following as a potential bleeding risk? Select all that apply. Aspirin Straight razor Stool softner Electric toothbrush Electric razor

Aspirin Straight razor

A client is admitted to the emergency department with repeated tonic-clonic seizures. Tonic-clonic seizures may be attributed to which of the following drugs? Cocaine • Morphine sulfate • Ciprofloxacin hyrochloride Cimetidine

Cocaine

Match the following seizure medications with their generic and brand names. Diazepam Valium Phenytoin Dilantin Valproic acid Depakote Phenobarbital Phenobarb

Diazepam Valium Phenytoin Dilantin Valproic acid Depakote Phenobarbital Phenobarb

An adult client has recently begun cancer treatment with Methotrexate (MTX). The client begins to complain of nausea, vomiting, and dizziness. When reviewing this client's laboratory work, the nurse should prioritize which of the following? •Obtain Abdominal X-ray • Decrased serum potassium • Obtain Arterial blood gases. • Elevated BUN and creatinine

Elevated BUN and Creatinine

The dialysis nurse is caring for a patient with chronic kidney disease (CKD) awaiting dialysis. After reviewing the patient's lab values, which agent will assist in raising the hemoglobin? Estazolam • Dextromethorphan hydrobromide • Pentoxifylline. Epoetin alfa

Epoetin alfa

Which nervous system is stimulated by cholinergic drugs? Sympathetic nervous system Parasympathetic nervous system

Parasympathetic nervous system

The nurse is monitoring the intravenous (IV) infusion of Doxorubicin, an antineoplastic medication. During the infusion, the client complains of pain at the insertion site. On inspection of the site, the nurse notes redness and swelling and that the infusion of the medication has slowed in rate. The nurse suspects extravasation and would take which actions? Select all that apply. Restart the IV at a distal part of the vein Stop the infusion Notify the primary health care provider (PHCP) Increase the flow rate of the solution to flush the skin and subcutaneous Lissue

Stop the infusion Notify the primary health care provider (PHCP)

The nurse is providing education to a client who has been prescribed Sumatriptan (Imitrex). In order to maximize therapeutic benefit while reducing the risk of adverse effects, the nurse should encourage the client to implement which intervention? •. Take the medication before breakfast each day. • Take the medication on days when migraines may be anticipated. Take the medication as soon as the earliest symptoms of migraine are sensed Take the medication when the pain of a migraine becomes too much to bear.

Take the medication as soon as the earliest symptoms of migraine are sensed

The nurse has been educating the client about the self-administration of Phenytoin (Dilantin). Which statement by the client demonstrates an understanding of the medication? • "I should not change brands without checking with my health care provider." • "I will take aspirin for a headache." • "I can purchase whichever brand is cheapest each month." • "All brands of phenytoin are equal in strength and action."

• "I should not change brands without checking with my health care provider."

The nurse is monitoring the laboratory results of a client receiving an antineoplastic medication by the intravenous route. The nurse plans to initiate bleeding precautions if which laboratory result is noted? • A white blood cell count of 5000 mm • An ammonia level of 10 mcg/di • A clotting time of 1 minute • A platelet count of 50,000

• A platelet count of 50,000

The nurse caring for a client with Alzheimer's dementia identifies which of the following neurotransmitters as a leading cause of this condition? • Norepinephrine • Serotinin • Acetylcholine • Dopamine

• Acetylcholine

The nurse is monitoring the client who received Neostigmine for Myasthenia Gravis. Upon assessment, the client's blood pressure is 150/80 and the heart rate is 45 BPM after the administration. Which medication should the nurse administer to treat the bradycardia?

• Bethanechol • Propranolol. • Pseudoephedrine • Atropine

A client suffering from migraine headaches is prescribed Sumatriptan (Imitrex). What is the action of the drug? • Interrupting the calcium intake in the neuron • Binding to serotonin to produce vasoconstriction • Reducing inflammation in the temporal arteries • Binding to phospholipids to diminish anxiety

• Binding to serotonin to produce vasoconstriction

A client who is receiving Levodopa-Carbidopa for Parkinson's disease is complaining of lightheadedness. Which action by the nurse is the priority to help prevent complications? • Cut the next dose in half • Assess the client's respiratory rate • Check the client's blood pressure • Notify the provider

• Check the client's blood pressure

The nurse is caring for a client prescribed Phenytoin (Dilantin) admitted for breakthrough seizures. Which of the following interventions should the nurse anticipate to help prevent future seizures? • Pad the siderails • Discontinue the Phenytoin • Assess the client's level of consciousness • Check the serum drug level

• Check the serum drug level

The nurse admits a client to the medical-surgical floor for an Edrophonium test. Shortly after the administration of the medication, the client reports that the muscle strength is significantly weaker than before the test. The nurse who is caring for the client recognizes that this finding is listed of what diagnosis? • Alzheimer's disease • Anticholinergic crisis • Myasthenia gravis • Cholinergic crisis

• Cholinergic crisis

The nurse is planning the care of a client with Parkinson disease. The nurse should be aware that treatment will focus on what pathophysiologic phenomenon? • Premature degradation of acetylcholine • Insufficient synthesis of epinephrine • Delayed reuptake of serotonin • Decreased availability of dopamine

• Decreased availability of dopamine

What medication may be administered intravenously (IV) to assist in reducing status epilepticus seizure activity? • Meperidine • Insulin • Diazepam • Ethosuximide

• Diazepam

The clinic nurse caring for a client with Parkinson disease notes that the client has been taking Levodopa and Carbidopa (Sinemet) for 7 years. For what common side effect would the nurse assess this client? • Pruritus • Dyskinesia • Diarrhea • Lactose intolerance.

• Dyskinesia

The nurse is caring for a client taking Cisplatin for treatment of ovarian cancer. The nurse educates the client that which of the following foods can have an adverse effect with this medication? Orange juice • Wheat toast • Fish oil • Grapefruit juice

• Grapefruit juice

A client undergoes the Tensilon test using Edrophonium to confirm the diagnosis of Myasthenia Gravis. When assessing the client, the nurse anticipates a positive diagnosis if which of the following is observed after Endrophonium administration? • Decreased muscle spasms. • Improved breathing • Increased urinary output • Decreased fatigue

• Improved breathing

An older adult client has been diagnosed with early-stage Alzheimer's disease and has begun treatment with Donepezil (Aricept). When providing health education to the client and the client's spouse, the nurse should identify what goal of treatment? • Remission of Alzheimer's disease • Resolution of memory and cognitive deficits • Improvement of cognition and function • Cure of Alzheimer's disease

• Improvement of cognition and function

The nurse identified which of the following as an expected outcome of administering Epoetin Alpha (Epogen)? • Increased red blood cell production • Improved renal function • Decreased bleeding • Increased white blood cell production

• Increased red blood cell production

A client diagnosed with migraines has been prescribed Verapamil. When providing client teaching, how will the nurse explain the role of the drug in treatment? • It prevents migraines from occurring. • It reduces the intensity of menstrual migraines.

• It prevents migraines from occurring.

What response by the nurse demonstrates understanding when administering a vesicant antineoplastic drug? It causes minor skin irritation. • It requires administration with a corticosteroid. • It requires administration through a central line. • It requires deep intramuscular injection if diluted with normal saline.

• It requires administration with a corticosteroid.

The nurse has started intravenous infusion of Levetiracetam (Keppra) for seizure management. Which of the following finding would be expected during the postictal state? • Heart rate 120 and Temperature 99.1 • Body rigidity and convulsions • Lethargy and disorientation to place • Nausea and vomiting

• Lethargy and disorientation to place

A client is being admitted to the neurologic ICU following an acute head injury that has resulted in cerebral edema. The nurse observes the client have a tonic-clonic seizure lasting 10 seconds. After administering intravenous Lorazepam (Ativan) to abort the seizure, which of the following should the nurse assess first? • Pain rating • Oxygen saturation • Heart rate • Level of consciousness

• Oxygen saturation

The nurse caring for a client admitted to the hospital performs a head-to-toe assessment and notes this image after inspecting the oral cavity. After reviewing the client's medication list, the nurse suspects this presentation to be a result of which medication? • Phenytoin (Dilantin) • Depakote (Valproic acid) • Levothyroxine (Synthroid) • Amiodarone (Pacerone)

• Phenytoin (Dilantin)

The nurse admits a client with a past medical history of Myasthenia Gravis. Which of the following medications used to manage this condition should the nurse expect to administer? • Pyridostigmine (Mestinon) • Atropine • Diphenhydramine (Benadryl) • Donepazil (Aricept)

• Pyridostigmine (Mestinon)

A client in the late stages of Alzheimer's disease is admitted due to malnutrition from decreased oral intake. The nurse performs a bedside swallow assessment and determines the client has impaired swallowing. Which of the following medications is best for management of Alzheimer's symptoms in this client? • Donepazil (Aricept) • Memantine (Namenda) • Rivastigmine (Exelon) • Galantamine (Razadyne).

• Rivastigmine (Exelon)

A client diagnosed with migraines expresses interest in taking an over-the-counter Acetaminophen, Aspirin, and Caffeine combination drug. Which information presented in the client's history should prompt the nurse to discourage the client from taking the drug? • The client has a chronic venous ulcer on the lower leg. • The client has not adhered to previous treatment regimens. • The client is a smoker. • The client has a diagnosis of liver cirrhosis.

• The client has a diagnosis of liver cirrhosis.

A 32-year-old female client is being treated with a cytotoxic antineoplastic agent. The oncology nurse understands the most important instruction related to the potential for teratogenicity includes which of the following? • The client will not get pregnant due to the elimination of ova. • The client should protect against infections by taking trimethoprim and sulfamethoxazole. • The medication will be completely eliminated 24 hours after the administration. • The client should not become pregnant for several months.

• The client should not become pregnant for several months.

The home health nurse provides education to family members to ensure accurate medication administration for the client with Alzheimer's disease. Which of the following are concerns when allowing the client to self-manage their medications? Select all that apply. • Underdose of the medications. • Not eating food when taking the medication. • Overdose of the medications. • Going to sleep after taking the medication.

• Underdose of the medications. • Overdose of the medications.

The nurse is caring for a client has been prescribed an anticholinergic agent for the treatment of Parkinson-related symptoms. What client education should the nurse provide to help avoid anticholinergic effects? • Enroll in an exercise class at the senior center. • Move to a warm climate to decrease symptoms. • Take only over-the-counter sleep aids. • Void before taking the medication.

• Void before taking the medication.

A nurse is admitting a client has completed chemo for colorectal cancer. The client is on neutropenia precautions and started on Filgrastim (Neupogen) to prevent infection. Which laboratory finding indicates therapy is working? • WBC 6,500 • Hemoglobin 12 • Platelet 200,000 • Hematocrit 38

• WBC 6,500