Pharm ATI Prep Wk 5

A nurse is preparing to administer cefaclor 750 mg PO in 3 divided doses. Cefaclor 500 mg/tablet is available. How many tablets should the nurse administer with each dose?

0.5 tablets

A nurse is preparing to administer dextrose 5% in water (D5W) 1,000 mL for infusion over 10 hr. The drop factor of the manual IV tubing is 15 gtt/mL. The nurse should set the manual IV infusion to deliver how many gtt/min?

25 gtt

A nurse is preparing to administer 150 units/hr of regular insulin to a client. Regular insulin is available at 1,500 units in 0.9% sodium chloride 500 mL. 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 per hour?

500 mL

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

7.5 mL

A nurse is caring for a client who takes warfarin to treat chronic atrial fibrillation and has early manifestations of Alzheimer's disease. The client's partner asks the nurse if the client would benefit from taking ginkgo biloba. Which of the following responses should the nurse make? a. "Ginkgo biloba will likely interfere with the effectiveness of his other medications." b. "You should ask his provider if ginkgo biloba is safe." c. "Ginkgo biloba is most effective in the later stages of Alzheimer's disease." d. "People who have Alzheimer's disease should adhere to the medication regimen their provider prescribes."

a. "Ginkgo biloba will likely interfere with the effectiveness of his other medications." Ginkgo biloba may delay the mental deterioration of Alzheimer's disease if taken in the early stages. Research has not demonstrated this, however. More importantly, ginkgo biloba increase the client's risk of bleeding when taken with warfarin.

A nurse is teaching a client about the adverse effects of omeprazole. Which of the following client statements indicates an understanding of the teaching? a. "If I experience severe diarrhea, I will call my doctor." b. "Pneumonia is associated with long-term use of this medication." c. "I will need to take this medication with food." d. "I should take vitamin B12 while using this medication."

a. "If I experience severe diarrhea, I will call my doctor." Clients who experience diarrhea while taking omeprazole or other proton pump inhibitors (PPIs) should report this finding to the provider immediately. Omeprazole and other PPIs are associated with a dose-related increase in the risk of infection with Clostridium difficile, which is a bacterium that can cause severe diarrhea.

A nurse is planning care for a client who is receiving gentamicin IM and has a new prescription to obtain gentamicin peak and trough levels. At which of the following times should the nurse plan to obtain a blood sample to evaluate the gentamicin peak? a. 1 hour after administering the IM injection b. Just before administering the IM injection c. 12 hours after the last IM injection d. 30 minutes after administering the IM injection

a. 1 hour after administering the IM injection Timing is important when drawing blood samples for aminoglycoside levels. The nurse should obtain blood samples for peak levels 1 hour after administering an IM injection or 30 minutes after completing an IV infusion.

A nurse is administering subcutaneous heparin to a client who is at risk for deep vein thrombosis. Which of the following actions should the nurse take? a. Administer the medication into the client's abdomen b. Inject the medication into a muscle c. Massage the site after administering the medication d. Use a 220gauge needle to administer the medication

a. Administer the medication into the client's abdomen The heparin should be administered into the client's abdomen.

A nurse is teaching a group of nurses about the manifestations of progestin deficiency for clients who take a combination oral contraceptive (OC). Which of the following findings should the nurse include in the teaching as an indication of progestin deficiency? a. Amenorrhea b. Weight gain c. Depression d. Acne

a. Amenorrhea A client who takes a combination OC and has a progestin deficiency can have amenorrhea. Increasing the OC dose of progestin can result in a more regular menstrual cycle.

A nurse is administering brimonidine eye drops to a client who has glaucoma. Which of the following ocular effects should the nurse expect? a. Decreased intraocular pressure b. Blocked growth of new blood vessels c. Paralysis of accommodation d. Mydriasis

a. Decreased intraocular pressure Brimonidine is an alpha-2 adrenergic agonist used for the long-term treatment of open-angle glaucoma. It decreases intraocular pressure by reducing aqueous humor production.

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? a. Hypotension b. Tachycardia c. Decreased level of consciousness d. History of diuretic use

a. Hypotension Diltiazem can be a treatment option of 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.

*A nurse is planning care for a client with thrombophlebitis who has a prescription to receive heparin via continuous IV infusion. Which of the following actions should the nurse include in the plan of care? a. Infuse the heparin using an electronic IV pump b. Administer vitamin K if the client has indications of hemorrhage c. Adjust the dosage of heparin based on the client's PT levels d. Inform the client that the heparin will dissolve the thrombus

a. Infuse the heparin using an electronic IV pump The nurse should administer heparin using an electronic IV pump, rather than by gravity, to prevent an accidental increase or change in the rate of infusion.

*A nurse is caring for a client who has a prescription for an oral contraceptive to prevent pregnancy. The nurse should identify that which of the following actions is the purpose of this medication? a. Inhibition of ovulation b. Thinning of the endometrial lining c. Inhibition of luteinizing hormone d. Thinning of cervical mucus

a. Inhibition of ovulation The nurse should identify that this medication inhibits ovulation to prevent pregnancy.

*A nurse is assessing a client who was recently admitted and has a history of alcohol use disorder. The client displays ataxia, an altered level of consciousness, and nystagmus. Which of the following medications should the nurse anticipate administering to the client? a. Parenteral thiamine b. Niacin extended-release capsules c. Parenteral pyridoxine d. Riboflavin tablets

a. Parenteral thiamine The nurse should identify that a client who has a history of alcohol use disorder and displays ataxia, an altered level of consciousness, and nystagmus is exhibiting manifestations of Wernicke-Korsakoff syndrome due to a thiamine deficiency. Therefore, the nurse should anticipate administering parenteral thiamine.

*A nurse is caring for a client who received spinal anesthesia 30 minutes ago. The client reports feeling dizzy, and the nurse notes that the client's blood pressure is 84/54 mmHg. Which of the following actions should the nurse take? a. Place the client in the head-down position b. Assess the placement of the catheter c. Prepare to administer an IV reversal agent d. Assist the client in passive range of motion movements

a. Place the client in the head-down position The nurse should identify the client is experiencing an adverse effect from receiving the spinal anesthesia. Hypotension is the common adverse effect of spinal anesthesia due to the loss of venous tone and decreased venous return to the heart. Therefore, the nurse should position the client in a 10 to 15 degree, head-down position to rapidly promote venous return to the heart, which increases the client's blood pressure.

*A nurse is providing teaching to a female client who has a new prescription for pravastatin to treat hyperlipidemia. Which of the following pieces of information should the nurse include in the teaching? a. Pravastatin can be taken with grapefruit juice b. Pravastatin can be continued during pregnancy c. Pravastatin should be taken with the evening meal d. Laboratory testing to monitor the client's WBC count is required

a. Pravastatin can be taken with grapefruit juice Grapefruit juice increases the bioavailability of some medications, but it does not have this effect on pravastatin. It is safe for the client to take the medication with grapefruit juice if desired.

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

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

*A nurse is reviewing the medical record of a client. The medication administration record shows the client is taking clopidogrel. Which of the following events should the nurse expect in the client's medical history? a. Recent myocardial infarction b. History of hemorrhagic stroke c. Current outbreak of psoriasis d. History of hypertension

a. Recent myocardial infarction The nurse should expect the client's medical record to indicate a history of an atherosclerotic event such as myocardial infarction, ischemic stroke, or peripheral vascular disease. Clopidogrel is an anti platelet medication that inhibits the aggregation of platelets to prevent such thrombotic events.

A nurse is providing teaching to a group of new parents about medications. The nurse should include that aspirin is contraindicated for children who have a viral infection due to the risk of developing which of the following adverse effects? a. Reye's syndrome b. Visual disturbances c. Diabetes mellitus d. Wilms' tumor

a. Reye's syndrome Aspirin should not be given to children or adolescents who have a viral infection like chickenpox or influenza due to the risk of developing Reye's syndrome.

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

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

A nurse is teaching a client who has a prescription for chenodiol for the treatment of gallstones. Which of the following client statements indicates an understanding of the teaching? a. "Treatment should last for a couple of months." b. "Liver function tests are required while taking this medication." c. "I should contact my provider if I experience diarrhea." d. "I can continue to take this medication if I become pregnant."

b. "Liver function tests are required while taking this medication." The nurse should identify that chenodiol is hepatotoxic and can injure the liver. Periodic liver function tests are required during treatment. This medication is contraindicated in clients who have preexisting liver condition.

A nurse is teaching a client who has persistent cancer pain about the adverse effects of opioids. Which of the following statements should the nurse include in the teaching? a. "Opioids do not relieve pain without causing severe adverse effects." b. "Physical dependence is not the same as addiction." c. "Tolerance typically means that the medication will no longer be effective." d. "The most common adverse effect is respiratory depression with prolonged use."

b. "Physical dependence is not the same as addiction." The nurse should explain that physical dependence can occur in all clients who take opioids, and the client may develop abstinence syndrome if the opioid is abruptly withdrawn. Physical dependence is not the same as addiction, but it can result in addiction. Addiction results when the opioid is continued despite physical and psychological harm.

A nurse is teaching the guardian of an infant about the DTaP vaccine. Which of the following pieces of information should the nurse include in the teaching? a. "Routine immunization for DTaP consists of 3 injections." b. "The first immunization for DTaP in the series is given at 2 months." c. "DTaP immunization has been replaced with DTP." d. "This immunization is administered subcutaneously."

b. "The first immunization for DTaP in the series is given at 2 months." The nurse should tell the guardian that the first immunization of DTaP is given at 2 months, with the rest of the vaccinations occurring at 4 months, 6 months, 15 to 18 months, and 4 to 6 years of age.

*A nurse is administering insulin glulisine 10 units subcutaneously at 0730 to an adolescent client who has type 1 diabetes mellitus. The nurse should anticipate the onset of action of the insulin at which of the following times? a. 0800 b. 0745 c. 0900 d. 1030

b. 0745 Insulin glulisine has a very short onset of action of 15 minutes. The nurse should expect the onset of action around 0745 and ensure the client eats breakfast immediately following the administration of the insulin.

A nurse is reviewing the medication history of a client who has mild intermittent asthma. The nurse should anticipate a prescription for which of the following inhalers for the client? a. Ipratropium b. Albuterol sulfate c. Tiotropium d. Budesonide

b. Albuterol sulfate The nurse should anticipate a client who has had mild intermittent asthma to be prescribed albuterol sulfate. Albuterol sulfate is a short-acting beta2-agonist that activates beta2-receptors in the smooth muscle of the lung, allowing the client's airway and lungs to dilate, thereby relieving bronchospasm and allowing the client to breathe.

A nurse is caring for a client who is receiving IV famotidine. Which of the following adverse effects should the nurse report to the provider immediately? a. Nausea b. Bloody stools c. Drowsiness d. Headache

b. Bloody stools When using the urgent vs nonurgent approach to client care, the nurse should determine that the priority finding is bloody stools because adverse effects of treatment with famotidine might include dyscrasias (e.g. thrombocytopenia), which can lead to bleeding. This finding should be reported to the provider immediately.

A nurse is reviewing the laboratory data for a client who has Alzheimer's disease and a new prescription for memantine. The nurse should identify that which of the following findings increases the client's risk for reduced clearance of the medication? a. ALT 60 international units/L b. Creatinine clearance 35 mL/min c. HbA1c 5% d. BMI 31

b. Creatinine clearance 35 mL/min Creatinine clearance is an estimate of the GFR and the kidneys' ability to filter waste. A creatinine clearance of 35 mL/min is below the expected reference range of 87 to 139 mL/min and indicates moderate renal impairment. Memantine is excreted by the kidneys, and decreased clearance occurs with moderate renal impairment.

*A nurse is monitoring a client who has asthma, takes albuterol, and recently stated taking propranolol to treat a cardiovascular disorder. The client reports that the albuterol has been less effective. Which of the following factors should the nurse identify as a possible explanation for this change? a. Potentiative interaction b. Detrimental inhibitory interaction c. Increased adverse reaction d. Toxicity-reducing inhibitory interaction

b. Detrimental inhibitory interaction A detrimental inhibitory interaction can occur with the concurrent use of propranolol and albuterol. When a client takes propranolol and albuterol together, propranolol can interfere with albuterol's therapeutic effects.

*A nurse is caring for a client who has atrial fibrillation and is scheduled for cardioversion. The nurse should anticipate a prescription from the provider for which of the following medications for this procedure? a. Amlodipine b. Diltiazem c. Nifedipine d. Lidocaine

b. Diltiazem The nurse should anticipate a prescription for diltiazem, which blocks calcium channels in the heart and blood vessels, thereby lowering blood pressure. Also, it is an antiarrhythmic medication that is used during cardioversion to treat atrial fibrillation.

A nurse is caring for a client who has acute glomerulonephritis and a prescription for furosemide. The nurse should monitor the client for which of the following therapeutic effects of this medication? a. Hypotension b. Diuresis c. Increased blood glucose level d. Weight gain

b. Diuresis The nurse should identify that furosemide is a high-ceiling loop diuretic indicated for the treatment of clients who have severe renal impairment such as acute glomerulonephritis. Furosemide blocks the reabsorption of sodium and chloride, thereby preventing the reabsorption of water. Diuresis is a therapeutic response to the administration of furosemide.

A nurse is reviewing the medical record of a client with rheumatoid arthritis who has a prescription for infliximab. Which of the following findings should the nurse identify as a contraindication to the client receiving this medication? a. Psoriatic arthritis b. Hepatitis B virus c. Ulcerative colitis d. Ankylosing spondylitis

b. Hepatitis B virus The nurse should identify that infliximab is a tumor necrosis factor (TNF) antibody medication that is used to reduce the disease manifestations and to delay disease progression. Infliximab has immunosuppressant properties that can increase the risk of infection. Clients who have an active or chronic infection such as hepatitis B virus should not take infliximab.

A nurse is teaching a client who had a kidney transplant surgery about immunosuppressive medications. Which of the following adverse effects of those medications should the nurse include in the teaching? a. Increased urinary output b. Increased susceptibility to infection c. Increased hair loss d. Increased risk of autoimmune disorders

b. Increased susceptibility to infection Immunosuppressive medications such as cyclosporine increase the risk of infection. As the medication classification indicates, these medications impair immunity and adversely affect the client's ability to resist and fight infection.

A nurse is administering a medication to a client. The nurse should identify that which of the following medication distribution factors facilitates the effective passage of the medication across the client's cell membranes? a. Protein-binding ability b. Lipid solubility c. Hepatic metabolism d. Slow dissolution

b. Lipid solubility A medication being lipid soluble and the presence of a transport system both facilitate the ability of the medication to cross cell membranes that separate the medication from the blood.

A nurse is caring for a client who has a new prescription for ergotamine. The nurse should recognize that ergotamine is administered to treat which of the following conditions? a. Raynaud's phenomenon b. Migraine headaches c. Ulcerative colitis d. Anemia

b. Migraine headaches Ergotamine prevents or stops a migraine headache by blocking alpha-adrenergic receptors in the cranial peripheral vascular smooth muscle, which cause vasoconstriction of dilated cerebral blood vessels.

*A nurse is reinforcing teaching with a newly licensed nurse about contraindications to vaccines. Which of the following examples should the nurse provide as a true contraindication for all vaccines? a. Previous local reaction to an injectable vaccine b. Moderate illness without a fever c. Recent exposure to an infectious disease d. Family history of an allergy to penicillin

b. Moderate illness without a fever The nurse should identify that a client who has a moderate or severe illness with or without a fever has a true contraindication to receiving a vaccine. The nurse should postpone the immunization until the client has recovered from the illness.

*A nurse is caring for a client who has rheumatoid arthritis and a new prescription for etanercept. Which of the following values should the nurse review prior to the administration of the medication? a. Ability to swallow b. Results of last purified protein derivative (PPD) test c. Serum creatinine level d. Blood glucose level

b. Results of last purified protein derivative (PPD) test The nurses should identify that a client who is taking etanercept is at risk for infections such as tuberculosis (TB). To reduce this risk, the client should be tested for latent TB; if the test is positive, the client should undergo TB treatment before receiving etanercept. During treatment with etanercept, the client should be monitored closely for the development of TB.

*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 3 times per day, to the client for restlessness and anxiety over the past few days. For which of the following adverse effect should the nurse assess the client? a. Low-grade fever b. Sedation c. Diuresis d. Tonic-clonic seizures

b. Sedation Lorazepam is a benzodiazepine with anti-anxiety and sedative effects. Older adult clients are especially 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.

*A nurse is preparing to administer an IM injection for a client. Which of the following factors should the nurse identify as a potential contraindication to administering the medication via the IM route? a. The medication is a depot preparation b. The client is taking an anticoagulant c. The medication is a particulate suspension d. The client has been vomiting

b. The client is taking an anticoagulant Because of the risk of bleeding from the injection site, anticoagulant therapy (e.g. warfarin) is a contraindication to receiving medications via the MI route.

A nurse is preparing to administer warfarin to a client who has a new onset of atrial fibrillation. The client asks the nurse, "What should this medication do?" Which of the following responses should the nurse make? a. "It helps your heart return to a normal rhythm." b. "It dissolves blood clots." c. "It can reduce your risk of having a stroke." d. "It helps to prevent bleeding in atrial fibrillation."

c. "It can reduce your risk of having a stroke." The nurse should identify that atrial fibrillation increases the client's risk of having a stroke due to clot formation in the atrium. Warfarin can prevent clot formation when used long-term, which will reduce the client's risk of having a stroke.

*A nurse is teaching a client who is experiencing age-related vaginal atrophy and has a prescription for estradiol cream. Which of the following statements should the nurse include in the teaching? a. "This medication should be used daily." b. "This medication should be applied externally." c. "This medication has fewer systemic effects than oral estrogen." d. "This medication can increase your risk of bone loss."

c. "This medication has fewer systemic effects than oral estrogen." The nurse should instruct the client that intravaginal estradiol cream has few systemic side effects because it is applied topically. However, oral estrogen can cause serious systemic effects.

A nurse is providing teaching to a client who has a prescription for ranitidine to treat a gastric ulcer. Which of the following statements should the nurse include in the teaching? a. "This medication is more effective when taken on an empty stomach." b. "You should take this medication with an antacid for pain control." c. "This medication is less effective for people who smoke." d. "You should expect to experience dizziness when taking this medication."

c. "This medication is less effective for people who smoke." The nurse should explain that smoking interferes with the effectiveness of ranitidine. If a client taking ranitidine smokes, the nurse should encourage the client to quit smoking or to avoid smoking after the last dose of the day.

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

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

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

c. Black cohosh Black cohosh is an herb that is used for the treatment of menopausal symptoms such as hot flashes, vaginal dryness, irritability, and sleep disturbance.

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 the administration of adenosine? a. Seizures b. Cinchonism c. Dyspnea d. Transient pallor of the face

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

*A nurse is teaching the parent of a child who has severe reactive airway disease about glucocorticoid therapy. The parent asks why her child has to inhale the medication instead of taking it orally. Which of the following pieces of information should the nurse provide to the parent? a. Inhaled glucocorticoids are less likely to cause thrush b. Oral glucocorticoids are hazardous during times of stress c. Oral glucocorticoids are more likely to slow linear growth in children d. Inhaled glucocorticoids are more effective for acute bronchospasm

c. Oral glucocorticoids are more likely to slow linear growth in children The chronic use of oral glucocorticoids in high doses by children can result in decreased linear growth. Inhaled glucocorticoids deliver the anti-inflammatory agent directly to the local target area (the client's airways), resulting in a decreased risk for adrenal suppression.

A nurse is assessing a client who has heart failure and is receiving digoxin. Which of the following findings should indicate to the nurse that the client is experiencing digoxin toxicity? a. Suppression of dysrhythmias b. Increased AV conduction c. Visual disturbances d. Weight gain

c. Visual disturbances The nurse should recognize that nausea, vomiting, abdominal discomfort, fatigue, and visual disturbances are common manifestations that can indicate that the client is experiencing digoxin toxicity.

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? a. "I will increase my intake of citrus fruits, bananas, and potatoes." b. "I will use salt substitutes on my food." c. "I will drink as much water as I can while taking this medication." d. "I will watch for increased breast tissue growth while taking this medication."

d. "I will watch for increased breast tissue growth while taking this medication." Spironolactone, which is derives 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 providing teaching to a client who has multiple sclerosis and a new prescription for baclofen PO. Which of the following pieces of information should the nurse include? a. "You should take the medication on an empty stomach to increase absorption." b. "You can stop taking the medication once your back spasms disappear." c. "You can expect to experience urinary frequency when you first start taking this medication." d. "You should change positions slowly while taking this medication."

d. "You should change positions slowly while taking this medication." The nurse should teach the client that dizziness and hypotension are adverse effects of this medication. The client should change positions slowly to minimize orthostatic hypotension.

A nurse is caring for a client who is taking diphenhydramine for allergies. The client reports, "I feel sleep during the day." Which of the following responses should the nurse make? a. "You will find that all antihistamines cause sedation." b. "You should avoid taking the antihistamine with food." c. "The effects of sedation will occur with each dose." d. "You should try antihistamines with non-sedative effects."

d. "You should try antihistamines with non-sedative effects." The nurse should tell the client to try second-generation antihistamines that have no sedative effect, as these are large molecules with low lipid solubility that cannot cross the blood-brain barrier. Diphenhydramine is a first-generation antihistamine and has a common adverse effect of sedation.

*A nurse is caring for a client who has a dry nonoproductive cough. Which of the following types of medication should the nurse recommend? a. Expectorant b. Mucolytic c. Bronchodilator d. Antitussive

d. Antitussive Antitussives suppress the cough reflex.

A nurse is preparing to administer raloxifene to a client. Which of the following conditions is a contraindication for the administration of this medication? a. Osteoporosis b. Hyperthyroidism c. Myocardial infarction d. DVT

d. DVT The nurse should identify that raloxifene, like estrogen, increases the risk of deep-vein thrombosis, pulmonary embolism, and stroke. Raloxifene is contraindicate for clients who have a history of venous thrombotic events.

A nurse is caring for a client who is taking budesonide to treat Crohn's disease. Which of the following findings should indicate to the nurse that the treatment is effective? a. Decreased blood glucose b. Increased potassium c. Increased prostaglandin synthesis d. Decreased inflammation

d. Decreased inflammation For a client who has Crohn's disease, a decrease in inflammation of the gastrointestinal lining of the client's large intestine is a therapeutic effect of taking budesonide. Budesonide is a glucocorticoid that works by suppressing the immune system. Glucocorticoids inhibit the actions of prostaglandins and leukotrienes.

A nurse is caring for a client with BPH who has a new prescription for doxazosin. Which of the following manifestations should the nurse monitor for as an adverse effect of doxazosin? a. Seizures b. Tachycardia c. Bronchodilation d. Hypotension

d. Hypotension Nonselective alpha1-adrenergic antagonists like doxazosin block sympathetic receptors in the blood vessels as well as receptors in the bladder. These agents promote vasodilation, which can cause decreased blood pressure.

A nurse is reviewing the laboratory reports of a client who has been taking warfarin for atrial fibrillation. Which of the following results should the nurse report to the provider immediately? a. PT 18 seconds b. Platelet count 160,000/mm^3 c. Hct 43% d. INR 5.5

d. INR 5.5 When using the urgent vs nonurgent approach to client care, the nurse should determine that the priority laboratory result is an INR of 5.5. A client who is taking warfarin for the treatment of atrial fibrillation is expected to have an INR in the range of 2 to 3. A level of 5.5 is considered a critical value and places the client at risk of bleeding; therefore, the nurse should report this result to the provider immediately.

A charge nurse is monitoring a newly licensed nurse who is caring for a postoperative client who is receiving morphine through a PCA pump. Which of the following actions by the newly licensed nurse requires intervention? a. Instructing the client to administer a PCA dose prior to a dressing change b. Providing increased fluids while the client is using the PCA pump c. Informing the client's partner that only the client should administer the PCA doses d. Maintaining the client on bed rest while the PCA pump is in use

d. Maintaining the client on bed rest while the PCA pump is in use Use of a PCA pump does not prevent ambulation following surgery. Early ambulation should be encouraged. The nurse should instruct the client to sit at the side of the bed prior to standing to reduce the risks of orthostatic hypotension and falls.

*A nurse is caring for a client who is experiencing an acute asthma exacerbation. Which of the following medications should the nurse identify as being contraindicated for this client? a. Dextromethorphan b. Montelukast c. Ciprofloxacin d. Propranolol

d. Propranolol The nurse should identify that a client who is experiencing an acute asthma exacerbation requires the use of a beta2-agonits to alleviate bronchospasm and relax the client's airway. Therefore, propranolol is contraindicated for this client. Propranolol is a beta-blocker that is used to treat cardiac conditions, including hypertension. Blocking the beta receptors prevents the action of beta2-agonists such as albuterol.

A nurse is caring for a client who has cancer involving the lumbar vertebrae and has been prescribed gabapentin. Which of the following therapeutic effects should the nurse identify for the client when taking this medication? a. Reduced cancer-related bone pain b. Decreased anxiety and insomnia c. Decreased inflammatory response to cancer tumors d. Reduced cramping, aching, and burning neuropathic pain

d. Reduced cramping, aching, and burning neuropathic pain The nurse should identify that gabapentin is administered to treat neuropathic pain that is sharp and darting. The medication can also decreases cramping, aching, and burning pain and suppress spontaneous neuronal firing that causes pain.

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

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