Pharm Exam 2 Practice Questions

The nurse is educating a client about a newly-prescribed calcium channel blocker. Which statement indicates that the client understands the nurse's teaching? - "This medication should be taken with a meal or a glass of grapefruit juice." - "This medication will work right away at its peak levels to decrease my blood pressure." - "This medication may cause headaches or gum changes and irritation." - "This medication may cause a dry, hacking cough that won't go away."

"This medication may cause headaches or gum changes and irritation." This answer is correct because calcium channel blockers may cause headaches, minor gum irritation or bleeding, flushing, or mild nausea. These side effects are common, and clients should continue taking the medication even if these side effects occur.

The nurse is caring for a client who is scheduled to receive a dose of diltiazem for atrial flutter. Which action is most important for the nurse to take prior to administering the medication? - Assess the client's heart rate and blood pressure - Monitor the client for dizziness - Strictly calculate hourly intake and output - Ask the client to rate pain using a numerical scale

- Assess the client's heart rate and blood pressure

The nurse is caring for multiple clients who are each scheduled to receive a dose of propranolol. For which client should the nurse withhold the medication and contact the health care provider? -The client with atrial fibrillation who reports chest discomfort - The client with hypertension who reports dizziness - The client with portal hypertension who reports nausea - The client with asthma who reports increased wheezing

- The client with asthma who reports increased wheezing propranolol is a nonselective beta blocker that acts on the beta 2 receptors in the lungs and can cause bronchoconstriction. Propranolol should not be given to the client with asthma and increased wheezing

A nurse is caring for a client who had a myocardial infarction 2 hours ago and is receiving alteplase. Which of the following findings should the nurse identify as an adverse effect of receiving this medication? A. Bleeding B. Increased clot formation C. Shortness of breath D. Blockage of the central venous catheter

A. Bleeding

A nurse is preparing to administer amlodipine to a client who has hypertension. The nurse should plan to monitor the client for which of the following adverse effects of the medication? (Select all that apply.) A. Dizziness B. Pale appearance C. Palpitations D. Abdominal pain E. Peripheral edema

A. Dizziness C. Palpitations E. Peripheral edema

5. Hydrochlorothiazide may be used to treat _________. A. Hypertension B. End stage kidney failure C. Acute stroke D. Angina

A. Hypertension

A nurse is caring for a 5-year-old client with influenza. The client has symptoms of a fever and muscle aches. Which of the following pharmacological agents is recommended for the client? A Ibuprofen B Morphine C Codeine D Acetaminophen

Acetaminophen

The nurse is caring for a client admitted to the hospital for chest pain. Nitroglycerin sublingual is given one time without relief. The blood pressure drops from 142/94 to 120/72. Which action should the nurse perform next? Administer another dose of NTG sublingually. Administer oxygen at 3L/min per nasal cannula. Notify the health care provider. Lay the client supine.

Administer another dose of NTG sublingually.

Which is a priority nursing intervention for a client receiving IV opioids for pain? A. Assess for signs of respiratory depression B. Teach the client about constipation C. Administer the medication as prescribed D. Monitor for nausea and vomiting

Assess for signs of respiratory depression

A nurse is providing teaching to the guardian of a school-aged child who has ADHD and a new prescription for clonidine. Which of the following statements by the guardian indicates an understanding of the teaching? A. "I will not allow my child to eat anything within 2 hours of taking the medication." B. "I can expect my child to be drowsy while taking this medication." C. "I will give my child a dose of the medication at noon every day." D. "I will cut the tablet in half before giving it to my child."

B. "I can expect my child to be drowsy while taking this medication."

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

Which definition accurately defines a 'beta blocker' medication? A. It enhances the body's responses to catecholamines. B. It antagonizes certain types of adrengeric receptors. C. It dissolves clots in the veins and arteries. D. It alters salt and water absorption in the nephron.

B. It antagonizes certain types of adrengeric receptors.

A nurse is caring for a client who has a prescription for clopidogrel. The nurse should monitor the client for which of the following adverse effects? A. Insomnia B. Hypotension C. Bleeding D. Constipation

C. Bleeding

A nurse is caring for a client who reports crushing chest pain. The nurse reviews the client's ECG results and notes ST changes. Which of the following medications should the nurse administer? A. Simvastatin B. Furosemide C. Nitroglycerin D. Sildenafil

C. Nitroglycerin The nurse should identify the need to administer nitroglycerin, which is used to treat angina. Nitroglycerin acts directly on vascular smooth muscle to promote vasodilation.

The nurse is caring for a client who has been prescribed a diuretic to manage hypertension. The nurse should caution the client about use of which type of over-the-counter medication? Select all that apply. Cold medications Nasal decongestants Ibuprofen Antacids Acetaminophen

Cold medications Nasal decongestants Ibuprofen Antacids Acetaminophen

A nurse applies a fentanyl patch to a client with chronic pain. Which of the following side effects must the nurse educate the client regarding the fentanyl patch? A. Nausea B. Vomiting C. Constipation D. Double vision

Constipation

A nurse is caring for a client with benign prostatic hyperplasia 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 assessing a client who is receiving a continuous morphine IV infusion and finds the client's respiratory rate has decreased from 20/min to 12/min. Which of the following actions should the nurse take? A. Flush the IV line with saline B. Administer flumazenil C. Lower the head of the bed D. Slow the rate of the infusion

D. Slow the rate of the infusion

Which of the following potent analgesics is recommended for chronic, persistent pain that takes up to 17 hours for full effect? A. Naproxen B. Fentanyl C. Morphine D. Oxycodone

Fentanyl

Which treatment(s) are considered standard medical treatment for a client admitted with chest pain associated with myocardial infarction (MI)? Select all that apply. IV morphine IV nitroglycerin PO warfarin IV digoxin Nasal cannula O2

IV morphine IV nitroglycerin Nasal cannula O2 (Morphine to reduce pain, nitroglycerin to vasodilate coronary arteries and increase oxygenation to the myocardium, nasal cannula to improve oxygenation to the myocardium)

A client experiences nausea and vomiting after applying a fentanyl patch for chronic pain. Which of the following nursing priorities should the nurse teach the client about long-term use of a fentanyl patch? A Inform the client that tolerance may develop. B Inform the client that the relief of the fentanyl patch is only temporary. C Inform the client that multiple patches may be applied for severe pain. D Inform the client that there are no long-term side effects of the fentanyl patch.

Inform the client that tolerance may develop.

The nurse is caring for a client that is receiving a dobutamine infusion. When reviewing the client's list of scheduled medication due to be administered in the next hour, the nurse should question which medication? Levocetirizine Simvastatin Metoprolol Pantoprazole

Metoprolol This answer is correct because metoprolol is a beta-adrenergic blocker (antagonist). The client is on a dobutamine infusion, which is a beta-adrenergic agonist. Administering metoprolol could negate the effects of the dobutamine infusion, so the nurse should contact the health care provider and question the client's scheduled dose of metoprolol.

A client suspected of opioid overdose experiences respiratory depression and hypotension. Which of the following antidotes must be given to the client to counteract the toxicity of the analgesic drug? A Atropine B Naloxone C Flumazenil D Acetylcysteine

Naloxone

Which of the following is indicated for clients as pain management after surgery or long-term recovery? A Fentanyl B Oxycodone C Naproxen D Patient-controlled analgesia (PCA) pump

Patient-controlled analgesia (PCA) pump

Before applying a new fentanyl patch, what is the first nursing action? A. Remove the old patch. B. Place the new patch next to the old patch. C. Clean the area. D. Dry the skin where the patch will be applied.

Remove the old patch.

A client is receiving patient-controlled analgesia (PCA). What priority teaching is needed for who is allowed to administer the medication via PCA pump? A. The client is the only one who can push the button to administer medication to himself/herself. B. The nurse is the only one who can push the button to administer medication to the client. C. The doctor is the only one who can push the button to administer medication to the client. D. The client's family can push the button to administer medication to the client.

The client is the only one who can push the button to administer medication to himself/herself.

The nurse is caring for a client who presents with supraventricular tachycardia. The nurse is aware that which medication may be given to treat this arrhythmia? Atropine Valacyclovir Fluoxetine Verapamil

Verapamil verapamil is a calcium channel blocker that may be used as an alternative to adenosine to treat supraventricular tachycardia. Verapamil possesses negative chronotropic, dromotropic, and inotropic effects. Verapamil and diltiazem are both non-dihydropyridines, which are a type of calcium channel blocker bind to calcium channels in the sinoatrial and atrioventricular nodes of the heart (making them useful for managing heart arrhythmias).

The nurse is caring for a client with a prescription for a vasodilator. Which consideration is most important for the nurse to include in the teaching plan? - Weigh daily while wearing the same amount of clothing - Check the radial pulse before taking the medication - Change positions slowly and carefully - Use a backup method if using oral contraceptives

- Change positions slowly and carefully This answer is correct because clients taking vasodilators may experience orthostatic or positional hypotension. To minimize dizziness and prevent falls, clients should understand the importance of changing positions slowly and carefully. Examples of vasodilators include nitroglycerin and hydralazine.

Which of the following clients must avoid using non-steroidal anti-inflammatory drugs (NSAIDs)? Select all that apply. - A client with asthma. - A client with peptic ulcer disease. - A client with a recent nephrectomy. - A client with rheumatoid arthritis. - A client with gout.

A client with asthma. A client with peptic ulcer disease. A client with a recent nephrectomy. (Rationale: NSAIDs are used to treat gout and arthritis, but cause issues with asthma, ulcers and dysfunctional kidneys)

A client is receiving patient-controlled analgesia (PCA). When is it appropriate to notify the healthcare provider (HCP) for an increase in dosage? A. When pt attempts 2x the dose of medication B. When the pt attempts 3x the dose of medication C. When the pt attempts 5x the dose of medication D. The client's doses are not to be increased after the initial dosage is set.

A. When the client attempts are 2x the dose of the medication given.

A nurse is caring for a client who has bronchitis and a prescription for a mucolytic agent. Which of the following findings should the nurse identify as an adverse effect of this type of medication? A. Fluid overload B. Bronchospasm C. Electrolyte imbalance D. Tachycardia

B. Bronchospasm

A nurse is providing teaching to a client about a new prescription for captopril to treat hypertension. Which of the following client statements indicates an understanding of the teaching? A. "I might have a sore throat that will go away after a few days." B. "I will take this medication with food to avoid getting an upset stomach." C. "I might feel dizzy at times while taking this medication." D. "I will take ibuprofen if I get a fever while taking this medication."

C. "I might feel dizzy at times while taking this medication."

A nurse is teaching a client who has a new prescription for warfarin. Which of the following statements should the nurse identify as an indication that the client understands the instructions? A. "I'll use a safety razor to shave each day." B. "I'll be sure to eat lots of spinach." C. "I'll avoid contact sports like football." D. "I'll take ibuprofen if I get a headache."

C. "I'll avoid contact sports like football."

A nurse is caring for a client who has a prescription for chlorothiazide to treat hypertension. The nurse should plan to monitor the client for which of the following adverse effects? A. Thrombophlebitis B. Hyperactive reflexes C. Muscle weakness D. Hypoglycemia

C. Muscle weakness Chlorothiazide is a thiazide diuretic used to treat hypertension and congestive heart failure. It promotes the excretion of water, sodium, and potassium and can cause hypokalemia. Manifestations of hypokalemia include muscle weakness, muscle cramps, and dysrhythmias.

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? A. Discontinue the medication if a rash develops. B. Expect increased salivation during the first few weeks of therapy. C. Minimize fiber intake to prevent diarrhea. D. Avoid driving until the client's reaction to the medication is known.

D. Avoid driving until the client's reaction to the medication is known.

Which of the following is the most common long-term side effect of opioid use? A constipation B nausea C vomiting D pruritus

constipation

A nurse is providing teaching to a client with hypertension and type 1 diabetes mellitus who has a new prescription for metoprolol. Which of the following statements by the client indicates an understanding of the teaching? A. "I might have difficulty recognizing when my blood sugar is low." B. "I will have a lower risk of developing an infection while I take this medication." C. "I should be concerned about losing excess weight while I take this medication." D. "I could have more problems with high blood sugar while taking this medication."

A. "I might have difficulty recognizing when my blood sugar is low." Metoprolol, a beta-adrenergic blocker, is used to treat hypertension. Because it decreases the 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.

A nurse is providing teaching to a parent of a child who has asthma and a new prescription for a cromolyn sodium metered-dose inhaler. Which of the following statements by the parent indicates the need for further teaching? A. "I will give my child a dose as soon as wheezing starts." B. "My child should rinse out his mouth after using the inhaler." C. "My child should exhale completely before placing the inhaler in his mouth." D. "If my child has difficulty breathing in the dose, a spacer can be used."

A. "I will give my child a dose as soon as wheezing starts." Cromolyn is a mast cell inhibitor that has a slow onset and is given for prophylactic treatment of asthma. It is not a rescue medication.

A nurse is teaching a client about a new prescription for extended-release oxycodone for pain management. Which of the following statements should the nurse include in the teaching? A. "Swallow this medication whole." B. "Take this medication before meals and at bedtime." C. "Constipation decreases with continued use." D. "Avoid taking other supplemental analgesics with this medication."

A. "Swallow this medication whole."

A nurse is caring for a client who is undergoing conservative treatment for deep-vein thrombosis. The client asks the nurse what will happen to the clot. Which of the following responses should the nurse make? A. "Your body has a process called fibrinolysis that will eventually dissolve the clot." B. "Your body has a mechanism that will keep the clot stable in its present location." C. "The clot will break into tiny fragments and float harmlessly in your bloodstream." D. "Treatment with heparin will dissolve the clot and keep other clots from forming."

A. "Your body has a process called fibrinolysis that will eventually dissolve the clot."

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 22-gauge needle to administer the medication

A. Administer the medication into the client's abdomen

A nurse is caring for a client who has a prescription for a QT interval medication. Which of the following conditions should the nurse identify as an adverse effect of this medication? A. Bradycardia B. Jaundice C. Low blood pressure D. Dark urine

A. Bradycardia The nurse should identify that an adverse effect of a QT interval medication is bradycardia. This medication should be used with caution for clients who have hypotension or heart failure, older adult clients, or clients who have low potassium or magnesium levels.

A nurse is teaching a client who has chemotherapy-induced anemia and a prescription for epoetin alfa. The nurse should instruct the client to report which of the following findings as an adverse effect of epoetin alpha? A. Hypertension B. Leukocytosis C. Bone pain D. Neutropenia

A. Hypertension The nurse should instruct the client to report hypertension, which is an adverse effect of epoetin alfa. Other adverse effects can include headaches, seizures, heart failure, and thromboembolic events related to increased hemoglobin levels.

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 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.

Adverse effects of calcium channel blockers include which of the following? A. Hypotension and AV block B. Rapid heart rate C. Hunger D. Elevated blood pressure

A. Hypotension and AV block

The intravenous administration of atropine, 0.5 mg (an antimuscarinic agent), would have which of the following effects. A. Increases the heart rate. B. Increases respiratory secretions. C. Reduces the heart rate. D. Causes diarrhea.

A. Increases the heart rate.

A charge nurse is teaching a newly licensed nurse about a client who has severe allergy-related asthma and a new prescription for omalizumab. Which of the following pieces of information should the charge nurse include to describe the medication's mechanism of action? A. It reduces the number of immunoglobulin E (IgE) molecules on mast cells. B. It stabilizes the cellular membrane of mast cells. C. It decreases the synthesis and release of inflammatory mediators. D. It relaxes the smooth muscles by blocking adenosine receptors.

A. It reduces the number of immunoglobulin E (IgE) molecules on mast cells.

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 antiplatelet medication that inhibits the aggregation of platelets to prevent such thrombotic events.

A nurse is caring for a client who received naloxone for a suspected opioid overdose. Which of the following findings should the nurse identify as an adverse effect of this medication? A. Report of pain B. Respiratory rate 8/min C. Report of numbness D. Report of abdominal cramping and diarrhea

A. Report of pain The nurse should identify that naloxone is used to reverse the effects of an opioid overdose administered for pain, sedation euphoria, and respiratory depression. Excess doses of naloxone can cause the return of pain but can improve the client's respiratory rate.

A nurse is caring for a client who has asthma and requires long-term treatment. The nurse should identify that which of the following medications used for long-term treatment places the client at an increased risk of asthma-related death? A. Salmeterol B. Fluticasone C. Budesonide D. Theophylline

A. Salmeterol The nurse should identify that salmeterol is a long-acting beta2-agonist. When this medication is used alone for the long-term treatment of asthma, this class of medication increases the client's risk of asthma-related death. To decrease this risk, the client should be prescribed both a long-acting beta2-agonist along with an inhaled corticosteroid.

A nurse is providing teaching to a client who has a new prescription for lisinopril. Which of the following should the nurse include in the teaching as an adverse effect of lisinopril? A. Tongue swelling B. Low potassium level C. Runny nose D. Bruising

A. Tongue swelling Angioedema is a fatal response that occurs in about 1% of clients who use ACE inhibitors such as lisinopril. Manifestations of angioedema include swelling of the tongue, lips, or pharynx.

A nurse in a community health clinic is assessing a new client who has prescriptions for isoniazid and rifampin. Which of the following disorders should the nurse expect the client to have? A. Tuberculosis B. Hypertension C. Diabetes D. Cirrhosis

A. Tuberculosis Isoniazid and rifampin are first-line antitubercular medications used to treat active tuberculosis. The medications are used in combination therapy.

Which of the following analgesics is the preferred choice for breastfeeding women? A. Naproxen B. Naloxone C. Acetaminophen D. Ibuprofen

Acetaminophen Rationale: This answer is correct because acetaminophen is the first-choice analgesic for breastfeeding women. Acetaminophen is an analgesic that can be given to children to treat fever and reduces the risk of children developing Reye's Syndrome. Reye's Syndrome occurs in the presence of NSAIDs used to treat fever or viral infection, which causes multiple organ failure.

A nurse is caring for a client who has been taking isoniazid and rifampin for 3 weeks for the treatment of active pulmonary tuberculosis (TB). The client reports his urine is an orange color. Which of the following statements should the nurse make? A. "Stop taking the isoniazid for 3 days, and the discoloration should go away." B. "Rifampin can turn body fluids orange." C. "I'll make an appointment for you to see the provider this afternoon." D. "Isoniazid can cause bladder irritation."

B. "Rifampin can turn body fluids orange." Rifampin can cause body fluids, such as tears, sweat, saliva, and urine, to turn a reddish-orange color. The nurse should inform the client that this effect does not cause harm.

A nurse is teaching a client who has asthma and a prescription for a fluticasone dry powder inhaler (DPI). Which of the following instructions should the nurse include in the teaching? A. "This medication should be taken at the start of your symptoms." B. "Rinse your mouth after administering this medication." C. "Shake the canister prior to administering this medication." D. "This medication relaxes your airways to decrease your symptoms."

B. "Rinse your mouth after administering this medication." Oral corticosteroids increase the risk of the development of oral candidiasis, also known as thrush. In order to prevent this effect, the nurse should advise the client to rinse the mouth after the administration of this medication.

A nurse is teaching a client with chronic asthma who has a new prescription for cromolyn. Which of the following instructions should the nurse include in the teaching? A. "Use the inhaler just before exercise." B. "The medication's therapeutic effects can take up to several weeks to develop." C. "You will shake the medication container for 3 seconds." D. "You will need to exhale slowly after you inhale."

B. "The medication's therapeutic effects can take up to several weeks to develop."

A nurse is teaching a client who has allergic rhinitis about a new prescription for brompheniramine. Which of the following pieces of information should the nurse include in the teaching? A. "Report gastrointestinal disturbances immediately." B. "You might find that you develop a dry mouth." C. "You should not experience any central nervous system alterations." D. "Increased urinary frequency is an expected effect."

B. "You might find that you develop a dry mouth."

A nurse is caring for a child who is in the emergency department after ingesting a bottle of acetaminophen. Which of the following medications should the nurse plan to administer? A. Digoxin immune fab B. Acetylcysteine C. Naloxone D. Vitamin K

B. Acetylcysteine

A nurse is assessing a client who is experiencing chest pain. Which of the following medications should the nurse expect to administer to suppress the aggregation of platelets? A. Nitroglycerin B. Aspirin C. Morphine D. Metoprolol

B. Aspirin Aspirin suppresses platelet aggregation, producing an immediate antithrombotic effect. The client should chew the first dose of aspirin to allow rapid absorption.

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? A. Take ibuprofen as needed for headaches or other minor pains B. Carry a medical alert ID card C. Report to the laboratory weekly to have blood drawn for aPTT D. Increase intake of dark green vegetables

B. Carry a medical alert ID card

A nurse is monitoring a client who has asthma, takes albuterol, and recently started 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 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 admitting a client who has atrial fibrillation with a heart rate of 155/min. The nurse should anticipate a prescription from the provider for which of the following medications? A. Atropine B. Diltiazem C. Epinephrine D. Vasopressin

B. Diltiazem The nurse should anticipate the provider to prescribe diltiazem for a client who is experiencing atrial fibrillation. Diltiazem is an antiarrhythmic agent that reduces the ventricular rate in atrial fibrillation.

A nurse is reviewing the laboratory results for a client who has a prescription for filgrastim. An increase in which of the following values indicates a therapeutic effect of this medication? A. Erythrocyte count B. Neutrophil count C. Lymphocyte count D. Thrombocyte count

B. Neutrophil count

A nurse is reviewing the laboratory values of a client who is receiving a continuous IV heparin infusion and has an aPTT of 90 sec. Which of the following actions should the nurse prepare to take? A. Administer vitamin K B. Reduce the infusion rate C. Give the client a low-dose aspirin D. Request an INR

B. Reduce the infusion rate An aPTT of 90 seconds is outside the expected reference range of 60 to 80 seconds, which can cause anticoagulation. The nurse should contact the provider, reduce the infusion rate, and assess the client for bleeding.

A nurse is caring for a client who has asthma and is prescribed a short-acting beta2-agonist. Which of the following should the nurse identify as the expected outcome of this medication? A. Reduces the frequency of attacks B. Reverses bronchospasm C. Prevents inflammation D. Decreases chronic manifestations

B. Reverses bronchospasm

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 providing education about continuous heparin therapy for a client who is 18 hours postpartum and has developed a deep vein thrombosis (DVT). Which of the following statements should the nurse include in the teaching? A. "An adverse effect of this medication is drowsiness." B. "This medication will require frequent monitoring of WBC levels." C. "Use a soft toothbrush to brush your teeth gently." D. "Avoid taking acetaminophen while receiving this medication."

C. "Use a soft toothbrush to brush your teeth gently."

A nurse is providing teaching to a client with a new diagnosis of heart failure who has a prescription for furosemide. Which of the following statements should the nurse include in the teaching? A. "You can take ibuprofen for headaches while taking this medication." B. "You may experience increased swelling in your lower extremities while taking this medication." C. "You should eat foods that are high in potassium while taking this medication." D. "You should take this medication at bedtime."

C. "You should eat foods that are high in potassium while taking this medication." The nurse should instruct this client who has a prescription for furosemide to consume foods that are high in potassium. Furosemide is a high-ceiling loop diuretic that depletes potassium, sodium, chloride, magnesium, and water.

A nurse is performing medication reconciliation for a newly admitted client who has rheumatoid arthritis (RA). Which of the following medications should the nurse identify as the treatment for this condition? A. Misoprostol B. Dantrolene C. Celecoxib D. Colchicine

C. Celecoxib Celecoxib is a type of NSAID known as cyclooxygenase-2 (COX-2) inhibitors that are used to relieve some of the manifestations caused by RA in adults. The nurse should identify that the medication is also prescribed for osteoarthritis, spondylitis, and painful menstruation.

A patient will receive a maintenance dose of digoxin (0.125 mg tablet). What should the nurse do before administering this drug? A. Insert an 18g intravenous catheter to infuse the medication. B. Obtain a urine sample. C. Check and document the patient heart rate. D. Provide a high-sodium meal.

C. Check and document the patient heart rate.

A nurse is reviewing the medical record of a client who is receiving hydrochlorothiazide (HCTZ). The nurse should expect to find an improvement in which of the following conditions as a result of this medication? A. Gouty arthritis B. Dehydration C. Diabetes insipidus D. Hypokalemia

C. Diabetes insipidus A thiazide diuretic such as HCTZ is administered to treat diabetes insipidus. Diabetes insipidus is a condition in which there is an overproduction of urine. Thiazides reduce urine production by 30% to 50%.

A nurse is providing teaching to a client who has chronic kidney failure with an AV fistula for hemodialysis and a new prescription for epoetin alfa. Which of the following therapeutic effects of epoetin alfa should the nurse include in the teaching? A. Reduces blood pressure B. Inhibits clotting of fistula C. Promotes RBC production D. Stimulates growth of neutrophils

C. Promotes RBC production

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? A. Nasal congestion B. Tremors C. Tinnitus D. Frontal headache

C. 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 heart failure and is receiving digoxin. Which of the following findings should indicate to the nurse the client is experiencing digoxin toxicity? A. Suppression of dysrhythmias B. Increased atrioventricular (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 caring for a client who takes warfarin 2.5 mg PO daily and has an INR of 6.2. The nurse should anticipate a prescription from the provider for which of the following medications? A. Protamine sulfate B. Fondaparinux C. Vitamin K D. Bivalirudin

C. Vitamin K The nurse should anticipate the provider to prescribe vitamin K for a client who has an INR of 6.2. Vitamin K antagonizes warfarin's actions, which can reverse warfarin-induced inhibition of clotting factor synthesis.

A nurse is caring for a client who has severe asthma and allergic rhinitis. The client is taking theophylline. Which of the following medications should the nurse identify as being incompatible with theophylline? A. Cromolyn B. Albuterol C. Zafirlukast D. Methylprednisolone

C. Zafirlukast

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? A. "I know that blurred vision is expected to happen while I'm taking digoxin." B. "I will measure my urine output each day and document it in my diary." C. "I will skip a dose of my digoxin if my resting heart rate is below 72 beats per minute." D. "I will eat fruits and vegetables that have a high potassium content every day."

D. "I will eat fruits and vegetables that have a high potassium content every day." Hypokalemia is an adverse effect of diuretic therapy. Because the client is taking digoxin, it is important to maintain a potassium level between 3.5 to 5.0 mg/dL to avoid 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 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 providing teaching to a client who has a new prescription for hydrochlorothiazide 50 mg PO daily to treat hypertension. Which of the following instructions should the nurse include in the teaching? A. "Take hydrochlorothiazide as needed for edema." B. "Check your weight once each week." C. "Take hydrochlorothiazide on an empty stomach." D. "Take hydrochlorothiazide in the morning."

D. "Take hydrochlorothiazide in the morning." The client should take hydrochlorothiazide in the morning to allow for diuresis during the day and to prevent nocturia.

A nurse is providing teaching to a client who is scheduled to start taking hydrochlorothiazide for hypertension. The nurse instructs the client to eat foods that are rich in potassium. Which of the following statements by the client indicates an understanding of the teaching? A. "This medication will not work unless I have enough potassium." B. "Potassium will increase the therapeutic effect of my blood pressure medication." C. "Potassium will lower my blood pressure." D. "This medication can cause a loss of potassium."

D. "This medication can cause a loss of potassium."

A nurse is caring for a client who has congestive heart failure and is taking digoxin. The client reports nausea and refuses to eat breakfast. Which of the following actions should the nurse take first? A. Encourage the client to eat the toast on the breakfast tray B. Administer an antiemetic C. Inform the client's provider D. Check the client's apical pulse

D. 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. Assessing will provide the nurse with the knowledge to make an appropriate decision.

A nurse is providing discharge teaching to a client who is postoperative and has a new prescription for an oral opioid analgesic. Which of the following pieces of information should the nurse include as a rationale for increasing the client's daily intake of fiber? A. Fiber binds with the medication to relieve pain. B. Dietary fiber prevents nausea caused by opioids. C. Fiber promotes the absorption of opioids. D. Dietary fiber helps prevent constipation.

D. Dietary fiber helps prevent constipation.

A nurse is caring for a client who is 12 hours postoperative following a total hip arthroplasty. Which of following medications should the nurse anticipate administering to this client to prevent deep vein thrombosis (DVT)? A. Aspirin B. Warfarin C. Ticagrelor D. Enoxaparin

D. Enoxaparin The nurse should anticipate the administration of enoxaparin for a client who is 12 hours postoperative following surgery. Enoxaparin is low-molecular-weight (LMW) heparin that is used to prevent a DVT by inhibiting the effects of antithrombin and thrombin.

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 nurse is caring for a client who has heart failure and is prescribed dobutamine hydrochloride by continuous IV infusion. The nurse should identify that which of the following is the therapeutic effect of this medication? A. Improves oxygen saturation rate B. Decreases elevated blood pressure C. Reduces heart rate D. Improves cardiac output

D. Improves cardiac output The nurse should identify that dobutamine is a vasopressor that improves cardiac output and hemodynamic status in clients

A nurse is providing teaching to a client with asthma who has a new prescription for a short-acting beta-2 agonist (SABA) bronchodilator. Which of the following pieces of information should the nurse share? A. The SABA will provide prolonged control of asthma attacks. B. SABAs are also available in an oral form. C. The SABA will have to be taken with an inhaled glucocorticoid. D. Notify the provider if the SABA is needed more than twice per week.

D. Notify the provider if the SABA is needed more than twice per week. SABA bronchodilators are used as a PRN rescue medication to stop an ongoing asthma attack. If the client requires the SABA more than twice per week, the provider should be notified because a prescription for a long-acting beta-2 agonist (LABA) might be required. Using a SABA more than twice per week can lead to serious adverse effects.

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-agonist 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 client with rheumatoid arthritis is educated to take ibuprofen to relieve the symptoms. Which of the following must the nurse educate the client on the safety of the analgesic drug? Select all that apply. - Do not take on an empty stomach. - May be taken with asthma drugs. - Do not take vitamin E supplements. - Do not take ginkgo supplements. - May be taken with omega-3 supplements.

Do not take on an empty stomach. Do not take vitamin E supplements. Do not take ginkgo supplements.

The nurse is caring for a client receiving clonidine. Based on its mechanism of action, the nurse should monitor the client for which potential side effects? - Dry mouth, dizziness, and drowsiness - Nausea, diarrhea, and headache - Tinnitus and heartburn - Increased urination and muscle cramps

Dry mouth, dizziness, and drowsiness This answer is correct because clonidine is a centrally-acting alpha 2 agonist that is used to treat hypertension. Clonidine decreases the sympathetic response from the central nervous system inside the brainstem to the peripheral vessels (which decreases peripheral vascular resistance and vasodilation). This mechanism of action may result in dry mouth, dizziness, and drowsiness.

The nurse is caring for a client with cardiogenic shock. The health care provider orders that the client be placed on a dobutamine drip. The nurse understands that the goal of this medication is to produce which outcome? - Resolution of atrial fibrillation - Increased cardiac output - Return to normal sinus rhythm - Decreased heart rate and blood pressure

Increased cardiac output

The nurse is caring for a client with uncontrolled hypertension who develops atrial fibrillation with rapid ventricular response. The nurse anticipates that the health care provider will order which medication? Lisinopril Metoprolol Digoxin Apixaban

Metoprolol This answer is correct because the nurse recognizes that the health care provider will most likely select a medication that can help address both of the client's problems (uncontrolled hypertension and atrial fibrillation with rapid ventricular response). Metoprolol is a beta blocker that will block the action of beta 1 receptors in the heart. As a result, this medication will lower both the client's heart rate and blood pressure. Digoxin is not correct because the nurse recognizes that the health care provider will most likely select a medication that can help address both of the client's problems (uncontrolled hypertension and atrial fibrillation with rapid ventricular response). Digoxin will only address the client's atrial fibrillation with rapid ventricular response, but will not lower the blood pressure.

A client with colorectal cancer undergoes bowel resection surgery. Which of the following medications is recommended to treat the client's postoperative pain? A. Naproxen B. Fentanyl C. Morphine D. Oxycodone

Morphine Rationale: This answer is correct because morphine is recommended for severe, acute pain that acts immediately. Morphine is recommended postoperatively. Morphine is administered intravenously for greater bioavailability, not oral. Opioid analgesic drugs act on the CNS by binding to the CNS opioid receptors in the brain where it sedates the body.

A client with a recent diagnosis of gout is seeking effective treatment for pain. Which of the following analgesic drugs is most appropriate for the client? A. Naproxen B Acetaminophen C Morphine D Fentanyl

Naproxen Rationale: This answer is correct because naproxen is an NSAID that is indicative of anti-inflammatory and antipyretic (fever reducer) effects and is commonly given to clients with arthritis and gout to relieve pain symptoms. Gout is indicative of inflammation. Therefore, NSAIDs such as naproxen or ibuprofen may be used for inflammation and pain management.

The nurse is preparing to administer a dose of digoxin to multiple clients. For which client should the nurse withhold the medication and contact the health care provider? - The client with a history of systolic heart failure and an ejection fraction of 32% - The client with a history of atrial fibrillation with a blood pressure of 110/60 mmHg - The client with a history of atrial flutter with a heart rate of 52 beats/minute - The client with a history of paroxysmal atrial tachycardia with a creatinine of 1.1

The client with a history of atrial flutter with a heart rate of 52 beats/minute digoxin's negative chronotropic activity makes this medication useful in managing atrial flutter, it will further decrease the client's heart rate. Since the heart rate is 52 bpm, the medication should be withheld. The nurse should contact the health care provider.

A nurse is reviewing the medical record of a client who is requesting a prescription for sildenafil citrate. Which of the following data in the client's record should the nurse identify as a contraindication to the use of this medication? A. Diabetes mellitus B. Current use of isosorbide to treat heart failure C. Eyeglasses for presbyopia D. Osteoarthritis

b. Current use of isosorbide to treat heart failure Rationale: Taking any nitrates such as isosorbide and nitroglycerin is a contraindication for sildenafil, a medication that treats erectile dysfunction. Taking it concurrently with nitrates can cause life-threatening hypotension.

A client is experiencing toxicity to acetaminophen. Which of the following antidotes must be given to the client to counteract the toxicity of the analgesic drug? A atropine B Naloxone C Flumazenil D Acetylcysteine

d. Acetylcysteine

What is the priority action of the nurse caring for a client receiving opioid analgesic medication via patient-controlled analgesic (PCA) pump? A. Pain assessment B. Intervention C. Administration of medication D. Reassessment

A. Pain Assessment

A nurse is assessing a female client who reports severe joint pain. The nurse should identify that which of the following factors places the client at risk for gout? A. Perimenopause B. Migraine headaches C. Diuretic use D. Irritable bowel syndrome

C. Diuretic use

A nurse is caring for a client who is taking warfarin. Which of the following laboratory values should the nurse recognize as an effective response to the medication? A. Hct 45% B. Hgb 15 g/dL C. aPTT 35 seconds D. INR 3.0

D. INR 3.0