Pharm Block 4 - extra practice questions

The client receives ipratropium via inhalation for the treatment of chronic asthma. The nurse plans to do medication education with the client. What will the best plan of the nurse include? Select all that apply. "Wait 1 minute between puffs." "Wait 15 minutes before using any other inhaled medications." "Report any changes in urinary pattern." "Use the medication consistently, not occasionally." "The medication may also be used for acute asthma attacks."

"Wait 1 minute between puffs." "Report any changes in urinary pattern." "Use the medication consistently, not occasionally."

A client is admitted with a fever of 102.8° F (39.3° C), origin unknown. Assessment reveals cloudy, foul-smelling urine that is dark amber in color. New prescriptions have just been written to obtain stat urine and blood cultures and to administer an antibiotic intravenously. The nurse will complete these orders in which sequence? Antibiotic Blood and urine cultures

#1 - Blood and urine cultures #2 - Antibiotic

A drug dose that delivers 750 mg has a half-life of 4 hours. How much drug will remain in the body after one half-life?

375 mg

The nurse is preparing to administer nifedipine to a client. Which actions will the nurse take prior to administering this medication? SATA Ask the client their name and date of birth. Assess heart rate. Assess pulses. Assess potassium level. Assess blood pressure. Assess respirations.

Ask the client their name and date of birth. Assess heart rate. Assess blood pressure.

The nurse is caring for a client taking metoclopramide. Prior to administering the medication, the nurse reviews the client's history to understand why the client is taking this medication. Which conditions found in the client's history would indicate the need for metoclopramide therapy? Select all that apply. Gastroesophageal reflux disease Type 1 diabetes Peptic ulcer disease Constipation Episodes of vomiting

Gastroesophageal reflux disease Type 1 diabetes Episodes of vomiting

The nurse who is administering aminoglycoside therapy must monitor the client closely for signs of toxicity as manifested by which of these conditions? (Select all that apply.) Hearing loss Elevated liver function tests (LFTs) Altered level of consciousness dizziness Rising serum creatinine level

Hearing loss dizziness Rising serum creatinine level

The nursing instructor is teaching pharmacology to student nurses. What will the nursing instructor include as the four major components of pharmacokinetics? Select all that apply. How drugs move from the site of administration to circulating fluids. How drugs change body illnesses and pathogens. How drugs are removed from the body. How drugs are transported throughout the body. How drugs are converted to a form that is easily removed from the body.

How drugs move from the site of administration to circulating fluids. How drugs are removed from the body. How drugs are transported throughout the body. How drugs are converted to a form that is easily removed from the body.

The nurse is planning care for a client who experiences frequent constipation and currently taking docusate sodium. What will the nurse include in the plan of care for this client? SATA Increase dairy products in the diet. Increase daily physical exercise. Increase dietary fiber in the diet. Drink a glass of water every hour. Increase protein in the diet.

Increase daily physical exercise. Increase dietary fiber in the diet.

The nurse is preparing to administer a second dose of morphine to a client. Which assessments will the nurse complete prior to administering morphine? Dietary history Last bowel movement Respiratory rate Allergies Pain level

Respiratory rate Allergies Pain level

The nurse administers omeprazole to a client before breakfast. The client asks the nurse why this medication cannot just be taken with the rest of their medications after breakfast. What is the nurse's best response? a. "If we wait until after breakfast, you could suffer from heart burn before this medication starts to work." b. "This medication interacts with your other medications so it needs to be given before breakfast." c. "The provider wrote the prescription that way, you shouldn't question your provider." d. "This medication will decrease the ability of the other medications to absorb properly causing those medications not to work well."

a. "If we wait until after breakfast, you could suffer from heart burn before this medication starts to work."

The client asks the nurse why she must continue taking her asthma medication even though she has not had an asthma attack in several months. What is the best response by the nurse? a. "The medication is still needed to decrease inflammation in your airways and help prevent an attack." b. "The medication needs to be taken or your lungs will be severely damaged and we will not be able to stop an acute attack." c. "The medication needs to be taken indefinitely according to your health care provider, so you should discuss this with them." d. "The medication needs to be taken for at least a year; then, if you have not had an acute attack, you can stop it."

a. "The medication is still needed to decrease inflammation in your airways and help prevent an attack."

The client says to the nurse "My doctor said I have epilepsy and need to take medicine for those seizures I had. Do I really need medicine?" What is the best response by the nurse? a. "Yes, you need to take medication on a continuous basis to control the seizures." b. "Having epilepsy is the same as having a mental illness; the medications are very similar." c. "You will need medicine for a little while to cure the seizures." d. "You might not need medicine; you may be controlled by a ketogenic diet."

a. "Yes, you need to take medication on a continuous basis to control the seizures."

The nurse is reviewing the clients MAR. Nonsteroidal antiinflammatory drugs (NSAIDs) could be given for which therapeutic effect? a. Antipyretic b. Sedative c. Antimicrobial d. Anxiolytic

a. Antipyretic

A client has started to take diphenhydramine. What is most important for the nurse to tell the client regarding diphenhydramine? a. Avoid driving a motor vehicle until stabilized on the medication. b. Nightmares and nervousness are more likely in an adult. c. Limit use to 1 to 2 puffs/prays 4 to 6 times per day to avoid rebound congestion. d. Do not take this medication at bedtime to avoid insomnia.

a. Avoid driving a motor vehicle until stabilized on the medication.

The nurse is reviewing the use of antitussive drugs. Antitussive drugs would be most appropriate for which client? a. Patient who has developed bronchitis 2 days after abdominal surgery. b. A patient who has had a productive cough for 2 weeks. c. A patient who has a tracheostomy and thick mucus secretions. d. A patient who has pneumonia with a productive cough.

a. Patient who has developed bronchitis 2 days after abdominal surgery.

A client who has been taking diazepam for 5 weeks has been instructed to stop the medication. Which instruction will the nurse provide to the client on how to discontinue the medication? a. Plan a gradual reduction in dosage. b. Take the medication every other day for a number of weeks. c. Stop taking the drug immediately. d. Overlap this medication with another medication.

a. Plan a gradual reduction in dosage.

A client has had a recent prosthetic heart valve surgery and is receiving anticoagulant therapy. While monitoring the client's laboratory work, the nurse interprets the INR results. What does an INR of 1.5 indicate? a. The client is not receiving enough warfarin to have a therapeutic effect. b. The client's warfarin dose is at therapeutic levels. c. The client's intravenous heparin dose is dangerously high. d. The client's intravenous heparin dose is at therapeutic levels.

a. The client is not receiving enough warfarin to have a therapeutic effect.

The nurse is caring for a client that has a low serum albumin. The provider has ordered aspirin, a highly protein-bound drug, for the client. Which evaluation by the nurse best describes the effect this will have on the client? a. The client will be at risk to experience toxic effects of the drug. b. The client's serum globulin is more important than serum albumin. c. The client's kidneys will excrete the drug at a faster rate. d . The client will be at risk to experience a decreased effectiveness of the drug.

a. The client will be at risk to experience toxic effects of the drug.

The client injects regular insulin as prescribed, but then gets busy and forgets to eat. What will the best assessment of the nurse reveal? a. The client will have moist skin. b. The client will complain of nausea. c. The client will be very thirsty. d. The client will need to urinate.

a. The client will have moist skin.

A nurse is providing discharge teaching for a client who has a new prescription for warfarin. Which of the following instructions should the nurse include in the teaching? a. Use an electric razor while on this medication. b. If a dose of the medication is missed, double the dose at the next scheduled time. c. Mild nosebleeds are common during initial treatment. d. Increase fiber intake to reduce the adverse effect of constipation.

a. Use an electric razor while on this medication.

The nurse is caring for a client that reports muscle pain. Which prescribed medication could be causing the muscle pain? a. atorvastatin b. clonidine c. amiodarone d. isosorbide

a. atorvastatin

A nurse in the emergency department is caring for a client who took 3 nitroglycerin tablets sublingually for chest pain. The client reports relief from the chest pain but now he is experiencing a headache. Which statement will the nurse make? a. "A headache indicates tolerance to the medication, the health care provider will prescribe another medication." b. "A headache is an expected adverse effect from the increased blood flow to the head." c. "A headache is an indication of an allergy to the medication, don't ever take nitroglycerin again." d. "A headache is an unexpected adverse effect, I will get the health care provider."

b. "A headache is an expected adverse effect from the increased blood flow to the head."

A 6-year-old child who has chickenpox also has a fever of 102.9° F (39.4° C). The child's mother asks the nurse if she should use aspirin to reduce the fever. What is the best response by the nurse? a. "You can use aspirin, but be sure to follow the instructions on the bottle." b. "Acetaminophen should be used to reduce the fever, not aspirin." c. "It's best to wait to see if the fever gets worse." d. "You can use the aspirin, but watch for worsening symptoms."

b. "Acetaminophen should be used to reduce the fever, not aspirin."

The nurse follows the Nursing Process when conducting medication education about insulin. The step of evaluation is best demonstrated by which question? a. "What questions do you have about insulin?" b. "Can you tell me four points you remember about how to take your insulin?" c. "Is your abdomen the best place to inject insulin?" d. "Can you recognize when you are experiencing hypoglycemia?"

b. "Can you tell me four points you remember about how to take your insulin?"

A nurse is teaching a client who has a new prescription for clopidogrel. Which instruction will the nurse include? Incorrect answer: a. "Take this medication three times daily." b. "You might have to stop taking this medication 1 week before any planned surgeries." c. "Expect to have black-colored stools while taking this medication." d. "Take this medication on an empty stomach."

b. "You might have to stop taking this medication 1 week before any planned surgeries."

A client is receiving heparin therapy as part of the treatment for a pulmonary embolism. The nurse monitors the results of which laboratory test to check the medication's effectiveness? a. Bleeding times b. Activated partial thromboplastin time (aPTT) c. Vitamin K levels d. Prothrombin time/international normalized ratio (PT/INR)

b. Activated partial thromboplastin time (aPTT)

The nurse assesses a client one hour after lispro was given. The client is diaphoretic and shaky. The nurse evaluates the client's blood sugar and the result is 50. Which is the best nursing action? a. Call the provider for an additional prescription. b. Administer 4 ounces of orange juice. c. Administer glucagon subcutaneous. d. Administer additional insulin according to the sliding scale.

b. Administer 4 ounces of orange juice.

A client is in the recovery room after having a lengthy surgery on their hip. As the client is gradually awakening, they request pain medication. Within 10 minutes after receiving a dose of morphine sulfate, the client is very lethargic and their respirations are shallow, with a rate of 7 per minute. The nurse prepares for which priority action at this time? a. Close observation of signs of opioid tolerance b. Administration of naloxone c. Immediate intubation and artificial ventilation d. Assessment of the patient's pain level

b. Administration of naloxone

A nurse is caring for a client who has congestive heart failure and is taking digoxin daily. The client refused breakfast and is complaining of nausea and weakness. Which of the following actions should the nurse take first? a. Request a prescription for an antiemetic. b. Check the client's vital signs. c. Request a dietitian consult. d. Suggest that the client rests before eating the meal.

b. Check the client's vital signs.

Which is an advantage of over-the-counter (OTC) remedies? Incorrect answer: a. Third-party health insurance payers usually cover the costs. b. Clients can self-treat minor ailments and reduce physician visits. c. There are fewer drug interactions d/ Clients can feel better faster when self-medicating.

b. Clients can self-treat minor ailments and reduce physician visits.

Which is an advantage of over-the-counter (OTC) remedies? a. Third-party health insurance payers usually cover the costs. b. Clients can self-treat minor ailments and reduce physician visits. c. Clients can feel better faster when self-medicating. d. There are fewer drug interactions.

b. Clients can self-treat minor ailments and reduce physician visits.

The provider prescribes medication to a client with diabetes. Which prescription will the nurse validate with the provider? a. Metformin 500 mg PO BID. b. Glargine insulin 20 units subcutaneously BID c. Use lispro insulin for sliding scale coverage. d. Regular insulin 12 units subcutaneously TID.

b. Glargine insulin 20 units subcutaneously BID

The nurse is caring for a client with asthma. The nurse assesses the client's mouth for an adverse effect of which class of medication? a. Mast cell stabilizers b. Glucocorticoids c. Leukotriene modifiers d. Beta-adrenergic agonists

b. Glucocorticoids

The nurse makes a home visit to the client with diabetes mellitus. During the visit, the nurse notes that the client's additional insulin vials are not refrigerated. What is the best action by the nurse at this time? a. Have the client discard the vials. b. Have the client place the insulin vials in the refrigerator. c. Instruct the client to label each vial with the date when opened. d. Tell the client there is no need to keep additional vials.

b. Have the client place the insulin vials in the refrigerator.

A client has been taking omeprazole OTC for 5 years. The nurse is reviewing the client's history. Which finding could be attributed to the omeprazole therapy? a. Chronic dry mouth b. Osteoporosis c. Long-term constipation d. Intestinal obstruction

b. Osteoporosis

A client is receiving a third intravenous dose of penicillin. The client calls the nurse to report that they are feeling "anxious" and having trouble breathing. What will the nurse do first? a. Check for allergies. b. Stop the antibiotic infusion. c. Take the client's vital signs. d. Notify the provider.

b. Stop the antibiotic infusion.

The nurse is monitoring a client who has been on antibiotic therapy for 2 weeks. Today the client tells the nurse that they have had watery diarrhea since the day before and has abdominal cramps. The oral temperature is 101° F (38.3° C). Based on these findings, which conclusion will the nurse draw? a. The client's original infection has not responded to the antibiotic therapy. b. The client needs to be tested for Clostridium difficile infection. c. The client will need to take a different antibiotic. d. The client is showing typical adverse effects of antibiotic therapy.

b. The client needs to be tested for Clostridium difficile infection.

Phenytoin has a narrow therapeutic index. What does the nurse understand about this? a. A very small dosage can result in the desired therapeutic effect. b. The safe and the toxic plasma levels of the medication are very close to each other. c. There is no difference between safe and toxic plasma levels. d. Phenytoin has a low chance of being effective.

b. The safe and the toxic plasma levels of the medication are very close to each other.

A client who has received some traumatic news is panicking and asks for some medication to help settle down. The nurse anticipates giving which drug that is most appropriate for this situation? a. valproic acid b. diazepam c. baclofen d. phenytoin

b. diazepam

The nurse assesses a client taking morphine and finds that the client is unarousable. After taking the appropriate nursing actions, the nurse reviews the MAR to see which other medications could have been the cause if taken with morphine. Which medications could have added to this client's CNS depression? Select all that apply. naloxone butorphanol fluoxetine tramadol alprazolam

butorphanol tramadol alprazolam

The nurse is educating the client about their new prescription for prednisone. The client asks the nurse why this medication cannot be stopped abruptly. What is the best response by the nurse? Incorrect answer: a. "You could have withdrawal symptoms if this medication is stopped abruptly." b. "You won't have enough thyroid hormone available if this medication is not tapered." c. "Adrenal suppression could occur while on this medication." d. "Your body could experience too much stress unless you taper the dose when stopping."

c. "Adrenal suppression could occur while on this medication."

The nurse has completed medication education for the client who takes psyllium. The nurse recognizes that additional teaching is indicated when the client makes which statement? a. "This medication is a lot more natural than other laxatives." b. "This medication takes several days to work." c. "I don't need to drink extra fluids while I take this medication." d. "This medication will make the stool bigger by adding bulk."

c. "I don't need to drink extra fluids while I take this medication."

A client with asthma comes to the clinic and states that they have been using their albuterol inhaler up to 10 times per day and still has shortness of breath. How will the nurse respond? a. "The provider will most likely add another asthma medication." b. "You must not be using the inhaler correctly." c. "This is caused from rebound bronchoconstriction." d. "The metered dose inhaler is almost empty."

c. "This is caused from rebound bronchoconstriction."

The client is receiving phenytoin, a drug with a narrow TI, and asks the nurse why he has to have blood drawn so often. What is the best response by the nurse? a. "To determine if your body is responding as it should." b. "To be sure the medication is working properly." c. "To be sure you have the correct amount of medication in your system." d. "To detect side effects before they become a problem."

c. "To be sure you have the correct amount of medication in your system."

A nurse is caring for a client who has deep vein thrombosis and has been on heparin continuous infusion for 5 days. The provider prescribes warfarin PO without discontinuing the heparin. The client asks the nurse why both anticoagulants are necessary. Which statement will the nurse make? a. "The IV heparin increases the effectiveness of the warfarin and will decrease your stay." b. "Both heparin and warfarin work together to dissolve the clot." c. "Warfarin takes several days to work, so the IV heparin will be used until the warfarin reaches therapeutic level." d. "I will call the provider to get a prescription for discontinuing the heparin today."

c. "Warfarin takes several days to work, so the IV heparin will be used until the warfarin reaches therapeutic level."

A client has been admitted to the emergency department for an overdose of oral alprazolam. The client is very drowsy but still responsive, with a respiratory rate of 12 breaths/min. Which nursing action will the nurse take next? a. Administer prescribed naloxone b. Prepare for hemodialysis to remove the medication c. Administer prescribed flumazenil d. Prepare for intubation and mechanical ventilation

c. Administer prescribed flumazenil

The nurse is caring for a client on psyllium therapy. Which other medication could be attributing to the need for psyllium therapy? a. Cimetidine b. Ondansetron c. Aluminum hydroxide d. Metoclopramide

c. Aluminum hydroxide

A nurse is teaching a client who has a new prescription for transdermal nitroglycerin. Which instruction should the nurse include in the teaching? a. Apply a new transdermal patch once a week. b. Apply the transdermal patch in the same location as the previous patch. c. Apply the transdermal patch in the morning. d. Apply a new transdermal patch when chest pain is experienced.

c. Apply the transdermal patch in the morning.

At 0900, the nurse is about to give morning medications, and the client has asked for a dose of aluminum hydroxide. Which schedule for the aluminum hydroxide and other oral medications is correct? a. Give the aluminum hydroxide at 0900, and then the other oral medications at 0930. b. Give all the medications at 0900. c. Give the other oral medications at 0900, and then the aluminum hydroxide at 1000. d. Give the other oral medications at 0900, and then the aluminum hydroxide at 0915.

c. Give the other oral medications at 0900, and then the aluminum hydroxide at 1000.

The nurse is administering a vancomycin infusion. Which measure is appropriate for the nurse to implement in order to reduce complications that may occur with this medication's administration? a. Restricting fluids during vancomycin therapy. b. Applying sunscreen when outdoors. c. Infusing the medication over at least 1 hour. d. Monitoring blood pressure for hypertension during the infusion.

c. Infusing the medication over at least 1 hour.

While recovering from surgery, a client started taking bisacodyl to relieve constipation caused by the pain medications. Two weeks later, at the follow-up appointment, the client tells the nurse they like how "regular" the bowel movements are now while taking the laxative. Which teaching principle is appropriate for this client? a. It is important to have a daily bowel movement to promote bowel health. b. Make sure to take this medication with plenty of fluids. c. Long-term use of laxatives may lead to dependency. d. Continue using the bisacodyl to keep having daily bowel movements.

c. Long-term use of laxatives may lead to dependency.

The nurse is caring for a client taking fluoxetine. What nursing action will the nurse take? a. Monitor apical heart rate. b. Advise the client to maintain adequate fluid intake of 2L/day. c. Monitor the client for suicidal tendencies. d. Tell the client that this medication will have an immediate effect.

c. Monitor the client for suicidal tendencies.

The nurse administers medications by various routes of delivery. The nurse recognizes which route of administration as requiring higher dosages of drugs to achieve a therapeutic effect? a. Sublingual route b. Intravenous route c. Oral route d. Rectal route

c. Oral route

The nurse is caring for several clients taking opioid analgesics. The nurse assesses each of these clients for adverse effects of opioid analgesics. Which assessment finding will the nurse address immediately? a. Inability to void b. A drowsy client c. Respiratory rate of 8 breaths per minute d. No bowel movement for 3 days

c. Respiratory rate of 8 breaths per minute

Which statement most accurately indicates that a therapeutic range for a medication had been reached? a. No serious adverse effects are experienced following administration. b. The medication was effective, but the patient experienced a lethal dysrhythmia. c. The indication for administration was achieved without serious side effects. d. A pre-specified amount (in milligrams) was administered.

c. The indication for administration was achieved without serious side effects.

A client will be receiving alteplase for an acute myocrdial infarction. The nurse explains to the client that this medication is used for which purpose? a. To relieve chest pain. b. To control bleeding in the coronary vessel. c. To dissolve the clot in the coronary artery. d. To prevent further clot formation.

c. To dissolve the clot in the coronary artery.

The nurse assesses the client's vital signs prior to administering metoprolol. The assessment findings reveal a blood pressure of 110/78, pulse rate of 58 beats/min, and respirations of 16 breaths/min. What action will the nurse take next? a. Assess for other signs of toxicity. b. Administer the metoprolol. c. Withhold the metoprolol. d. Assist the client to a supine position.

c. Withhold the metoprolol.

A pregnant client calls the clinic and tells the nurse that she has a headache and doesn't know the best over-the-counter (OTC) medication to take. Which medication will the nurse advise the client to take for the headache? a. ibuprofen b. morphine c. acetaminophen d. aspirin

c. acetaminophen

A client tells the nurse that they have some sexual dysfunction after starting several new medications. Which medication will the nurse conclude could be the cause of the sexual dysfunction? a. alprazolam b. amitriptyline c. fluoxetine d. phenytoin

c. fluoxetine

A client has been diagnosed with absence seizures. Which medication would be appropriate for the nurse to administer? a. diazepam b. phenytoin c. valproic acid d. alprazolam

c. valproic acid

The nurse has given medication instruction to a client receiving phenytoin. Which statement by the client indicates that the client has an adequate understanding? a. "I will be able to stop taking this medication once the seizures stop." b. "I can go out for a beer while on this medication." c. "I can skip doses if the adverse effects bother me." d. "I will need to take extra care of my teeth and gums while on this medication."

d. "I will need to take extra care of my teeth and gums while on this medication."

The nurse is educating the client about starting metformin, which instruction will the nurse include? a. "Take the medication on an empty stomach 1 hour before meals." b. "Take metformin if your blood glucose level is above 150 mg/dL." c. "Take this 60 minutes after breakfast." d. "Take the medication with food to reduce gastrointestinal (GI) effects."

d. "Take the medication with food to reduce gastrointestinal (GI) effects."

The nurse is caring for a client that has a new prescription for montelukast. The nurse has completed medication education and evaluates learning has occurred when the client makes which statement? a. "This medication is good when I have an acute attack of asthma." b. "This medication dilates my airways so I can breathe better." c. "This medication activates my fight-or-flight response." d. "This medication decreases the inflammation in my lungs."

d. "This medication decreases the inflammation in my lungs."

The nurse is educating the client on anticoagulant therapy about adverse effects. Which adverse effect of anticoagulant therapy is the most serious? a. Severe headache b. Electrolyte depletion c. Cardiac arrhythmia d. Abnormal hemorrhage

d. Abnormal hemorrhage

The nurse is assessing a client on cimetidine therapy. Which assessment finding indicates to the nurse the medication is effective? a. Absence of nausea. b. Formed, soft stool. c. Regular bowel movements d. Absence of heart burn.

d. Absence of heart burn.

The nurse is assessing a client prior to administering amiodarone. Which assessment finding will require the nurse to withhold the medication? a. Blood pressure of 150/98 b. Pulse rate of 100 beats/min c. blue-grey discoloration of skin d. Adventitious breath sounds

d. Adventitious breath sounds

The nurse is preparing to administer glargine insulin to a client. When will the nurse administer this medication? a. Fifteen minutes before meals. b. When the sliding scale indicates. c. When the client is eating. d. At bedtime.

d. At bedtime.

When reviewing the allergy history of a client, the nurse notes that the client is allergic to penicillin. Based on this finding, the nurse would question a prescription for which class of antibiotics? a. Fluoroquinolones b. Sulfonamides c. Tetracyclines d. Cephalosporins

d. Cephalosporins

A nurse is caring for a client who is taking captopril. Which of the following outcomes indicates a therapeutic effect of the medication? a. Decreased angina b. Decrease of HDL cholesterol c. Decreased heart rate d. Decreased blood pressure

d. Decreased blood pressure

The nurse is monitoring for therapeutic results of antibiotic therapy in a client with an infection. Which laboratory value would indicate therapeutic effectiveness of this therapy? a. Increased hemoglobin level b. Increased red blood cell count c. Decreased platelet count d. Decreased white blood cell count

d. Decreased white blood cell count

The nurse is caring for a client on insulin therapy. Which lab value would suggest that insulin therapy is working? a. Finger stick glucose 220 b. Hgb (Hemoglobin) A1C 9.2% c. Finger stick glucose 150 d. Hgb (Hemoglobin) A1C 5.5%

d. Hgb (Hemoglobin) A1C 5.5%

The nurse checks the client's laboratory work prior to administering a dose of vancomycin and finds that the trough vancomycin level is too low. What will the nurse do next? a. Double the dose of vancomycin. b. Administer the vancomycin as prescribed. c. Wait for the peak vancomycin level before administering. d. Hold the medication and notify the prescriber.

d. Hold the medication and notify the prescriber.

A client will be discharged with a 1-week supply of an opioid analgesic for pain management after abdominal surgery. The nurse will include which information in the teaching plan? a. Importance of taking the drug on an empty stomach. b. How to prevent dehydration due to diarrhea. c. Importance of taking the drug only when the pain becomes severe. d. How to prevent constipation.

d. How to prevent constipation.

The client is prescribed the decongestant phenylephrine nasal spray. What will the nurse teach the client? a. Don't take this medication if you have high blood pressure. b. This drug may be used in maintenance treatment for asthma. c. Take this drug at bedtime as a sleep aid. d. Limit the drug to 5 days of use to prevent rebound nasal congestion.

d. Limit the drug to 5 days of use to prevent rebound nasal congestion.

The nurse is caring for a client taking montelukast. The nurse understands that this medication is given for which purpose? a. Treatment of inflammation in chronic bronchitis. b. Treatment of an acute asthma attack. c. Reversing bronchospasm associated with asthma. d. Maintenance treatment of asthma.

d. Maintenance treatment of asthma.

The nurse is assessing a client before administering medications. The client's blood pressure is 180/98. Which medication will the nurse withhold? a. Nasal phenylephrine b. diphenhydramine c. dextromethorphan d. Oral phenylephrine

d. Oral phenylephrine

The nurse is preparing to administer tetracycline to a client. With which assessment finding will the nurse withhold the medication and notify the provider? a. Recent sunburn b. Tinnitus c. Pain in the achilles tendon d. Positive pregnancy test.

d. Positive pregnancy test.

The nurse is assessing the client for possible evidence of digitalis toxicity. The nurse acknowledges that which is included in the signs and symptoms for digitalis toxicity? a. Pulse rate of 130 beats/min with irregular rate b. Pulse rate of 100 beats/min c. Pulse rate of 72 beats/min with irregular rate d. Pulse rate below 60 beats/min

d. Pulse rate below 60 beats/min

The nurse is educating the client about insulin therapy. The nurse will include which teaching about the action of regular insulin? a. Regular insulin stimulates the pancreas to secrete more insulin. b. Regular insulin promotes the entry of glucose into the bloodstream. c. Regular insulin stimulates the pancreas to produce insulin. d. Regular insulin promotes the entry of glucose into the cells.

d. Regular insulin promotes the entry of glucose into the cells.

A nurse is providing teaching to a client who is taking warfarin about monitoring the therapeutic effects. Which explanation should the nurse provide about the international normalized ratio (INR) test? a. You will only need the test twice per month. b. The INR is the only test available for anticoagulant therapy monitoring. c. The INR also monitors heparin therapy if the provider switches the medication prescription. d. The INR is a standardized test that eliminates the variations between laboratory reports in prothrombin times.

d. The INR is a standardized test that eliminates the variations between laboratory reports in prothrombin times.

The client is admitted to the hospital in chronic renal failure, and is on several medications. What best describes the nurse's assessment of this client? a. The client's liver may compensate for renal failure; the drugs may be effective. b. The client may have decreased effectiveness of the drugs. c. The client may have drug toxicity only if the drugs are excreted by the kidneys. d. The client may have drug toxicity from all the drugs.

d. The client may have drug toxicity from all the drugs.

The nurse is caring for a client receiving iodine-131. What will the best evaluation by the nurse reveal? a. The client will need to report tachycardia to the provider. b. The client needs to taper the dosage when stopping treatment. c. The client could safely become pregnant while receiving this treatment. d. The client will most likely require thyroid replacement therapy.

d. The client will most likely require thyroid replacement therapy.

The nurse is caring for a female client receiving an antibiotic for pneumonia. The client has developed a vaginal suprainfection. How will the nurse best explain to the client the cause of the suprainfection? a. This is an allergic reaction to the antibiotics. b. The pneumonia-causing bacteria have developed resistance to the antibiotic. c. The infection has spread from your lungs to your vagina. d. The large doses of antibiotics have killed the normal flora.

d. The large doses of antibiotics have killed the normal flora.

The nurse notes in the client's medication prescriptions that the client will be starting heparin therapy followed by warfarin. What is the primary goal of heparin and warfarin therapy? a. To dissolve an existing thrombus. b. To stabilize an existing thrombus. c. To dilate the vessel around a clot. d. To prevent further thrombus formation.

d. To prevent further thrombus formation.

The nurse is caring for a client who is taking levothyroxine. Which adverse effect, associated with too much medication, will the nurse assess the client for? a. Bradycardia b. Headache c. Excessive fluid overload d. Weight loss

d. Weight loss

A nurse is receiving a client who is immediately postoperative following hip arthroplasty. Which medication should the nurse plan to administer for DVT prophylaxis? a. aspirin PO b. heparin infusion c. warfarin PO d. enoxaparin subcutaneous

d. enoxaparin subcutaneous

During assessment of a client with osteoarthritis pain, the nurse knows that which condition is a contraindication to the use of nonsteroidal antiinflammatory drugs (NSAIDs)? a. Rheumatoid arthritis b. Headaches c. Diabetes mellitus d. Renal disease

d. renal disease

The nurse is monitoring potassium levels for several clients. Which medications require the nurse to monitor potassium levels? Select all that apply. digoxin clonidine spironolactone atenolol furosemide hydrochlorothiazide losartan

digoxin spironolactone furosemide hydrochlorothiazide

Which drugs would be affected by the first-pass effect? Select all that apply. sublingual nitroglycerin tablets transdermal nicotine patches penicillin given by IV piggyback infusion levothyroxine tablets omeprazole capsules morphine given by IV push injection diphenhydramine elixir

levothyroxine tablets omeprazole capsules diphenhydramine elixir

The nurse is caring for a client on medication therapy. The nurse assesses the client for therapeutic and adverse effects. Upon assessment, the nurse notes that the client has not had a bowel movement for 3 days, reports no heart burn despite suffering from GERD for 2 years, and no nausea or vomiting following surgery. Which medications found on the MAR will the nurse withhold? Select all that apply. psyllium ondansetron omeprazole loperamide diphenoxylate with atropine

ondansetron loperamide diphenoxylate with atropine