Pharm Final
A nurse is preparing to give a patient diphenoxylate/atropine (Lomotil) for diarrhea. The nurse will teach the patient that they might experience which of the following
A feeling of euphoria
A client is receiving an intravenous heparin drip. Which laboratory value will require immediate action by the nurse?
Activated partial thromboplastin time (aPTT) of 150 seconds.
Hydrocortisone is prescribed for a client with diabetes mellitus who is taking Humulin NPH insulin daily. Which prescription change does the nurse anticipate during therapy with the hydrocortisone?
An increased amount of daily Humulin NPH insulin
A nurse is preparing to give medications to a patient with a peptic ulcer. The nurse would expect to give which of the following types of medication? Select all that apply
Antibiotic Proton Pump Inhibitor GI Protectant
The nurse who is caring for a patient with gastroesophageal reflux disease (GERD) should question the order for which drug?
Antibiotics.
Which pulse should you monitor when a patient takes digoxin?
Apical
When a nurse is assessing a patient experiencing constipation, which possible serious condition is a consideration?
Bowel obstruction
Ondansetron (Zofran) has been ordered prior to chemotherapy for a patient receiving treatment for lymphoma. Prior to administering this drug, the nurse will review the patient's past medical history for what condition?
Cardiac dysrhythmias.
The nurse is administering digoxin (Lanoxin) to a client diagnosed with congestive heart failure. Which intervention should the nurse implement? Select all that Apply.
Check the client's current potassium level. Ask the client if he or she is seeing a yellow haze around objects.
What should the nurse teach a patient who is newly diagnosed with hypothyroidism and will take levothyroxine (Synthyroid)?
Check with a provider before accepting a generic form of this medication
Medications like AlternaGel (aluminum hydroxide) have an expected side effect of
Constipation
A client who has been taking beclomethasone (medication in the hydrocortisone family), two inhalations a day, for treatment of asthma. The nurse knows that based on the generic name of this medication, that it is part of which class of medications?
Corticosteroid class
The nurse associates which effect with long-term glucocorticoid therapy?
Decreased production of ACTH.
Which of the following assessment findings would the nurse expect to observe in an adult patient experiencing therapeutic effects from levothyroxine (Synthyroid)? Select all that apply
Decreased reports of fatigue Pulse rate between 60 and 100 beats/minute
The nurse should caution the client with Type 2 Diabetes Mellitus who is taking glyburide, a sulfonylurea, that alcoholic beverages should be avoided while taking these drugs because they can cause which of the following?
Disulfiram (Antabuse)-like symptoms.
The most immediate initial concern the nurse has about a patient experiencing diarrhea is
Electrolyte imbalance
Oral antidiabetic medications commonly cause which of the following undesired effect?
GI upset
A client complains of feeling light headed and shaky. The patient's blood glucose reading is 60. The nurse should:
Give the patient 6 oz of orange juice
A patient is diagnosed with a peptic ulcer. The nurse would expect to look for lab work to evaluate
H. Pylori
H2 receptors are found where?
Heart, CNS and stomach
A client with diabetes mellitus visits a health care clinic. The client's diabetes mellitus previously had been well controlled with metformin daily, but recently the fasting blood glucose level has been 180 to 200 mg/dL. Which medication, if added to the client's regimen, may have contributed to the hyperglycemia?
Hydrocortisone
Exophthalmos, weight loss and nervousness are signs of
Hyperthyroidism.
A daily dose of prednisone (same family as hydrocortisone) is prescribed for a client. The nurse provides instructions to the client regarding administration of the medication and should instruct the client that which time is best to take this medication?
In the morning
The nurse will the teach the patient which of the following strategies to prevent constipation
Increasing fluid intake Increasing dietary fiber Exercising
The nurse is discussing levothyroxine (Synthroid) with a client diagnosed with hypothyroidism. Which intervention should be included in the client teaching?
Instruct the client to take the medication in the morning.
The nurse explains the benefit of using the long-acting insulin glargine (Lantus) over other insulins. What will the nurse tell the patient about this insulin?
It has no definite peak but maintains a steady state of insulin in the body
A patient is scheduled for an imaging procedure that involves the use of IV radiographic contrast. The nurse would contact the provider to hold which medication?
Metformin (glucophage)
Omeprazole (Prilosec) is prescribed for a patient with gastroesophageal reflux disease (GERD). The nurse would monitor a reduction in which symptoms to determine if the drug therapy is effective? (Select all that apply).
Nausea Dyspepsia Belching Dysphagia
A patient who has duodenal ulcers is receiving long-term therapy with rantidine (Zantac). The nurse includes in the care plan that the patient should be monitored for which adverse effect?
Neutropenia and thrombocytopenia
What is the mechanism of action of ondansetron (Zofran)?
Ondansetron acts in the central nervous system at the vomiting center to decrease vomiting
A nurse caring for a patient who is receiving a proton pump inhibitors (PPIs) is aware of which of the following about this drug?
PPI's may increase the Ph of the stomach
In the administration of a drug such as levothyroxine (Synthroid), the nurse must teach the client. (Select all that apply).
Periodic lab test that includes T3-T4 are required. . Report weight loss, anxiety, insomnia, and palpitations.
A client is prescribed with Omeprazole (Prilosec). The nurse determines that the client is receiving its therapeutic effect if which of the following is stated by the client:
Relief from GERD
Ondansetron is classified as a which type of drug?
Serotonin receptor antagonist
A patient who requires insulin injections is admitted to the hospital. During the patient's hospitalization, the nurse will
Share with the patient the nurses will use injection sites that the patient usually does not use to prevent lipodystrophy
Lomotil (diphenoxylate/atropine) has which mechanism of action?
Slowing of intestinal movement
A patient will be treated with propylthiouracil (PTU) for hyperthyroidism. While the patient is taking this drug, which symptoms will the nurse teach the patient to report to the healthcare provider?
Sore throat, low-grade fever, and chills
A patient is scheduled for a colonoscopy. The patient would likely be prescribed which type of laxative for this procedure?
Stimulant laxative
A nurse caring for a patient who is receiving a proton pump inhibitor should teach the patient to
Swallow the capsules whole
When administering a bulk laxative to a patient, the nurse will encourage the patient to
Take the laxative with a full glass of water
The nurse in the healthcare provider's office is completing as assessment on a client who has been prescribed the cardiac glycoside digoxin (Lanoxin) for congestive heart failure. Which data indicates the medication has been effective?
The client has clear breath sounds bilaterally.
A client is taking Humulin NPH insulin and regular insulin every morning. The nurse should provide which instructions to the client? (Select all that apply).
The insulin should be administered at room temperature. Hypoglycemia may be experienced around dinner time.
A patient's wife asks the nurse why her husband did not receive the clot busting medication alteplase (tPA) she has been reading about. Her husband is diagnosed with a hemorrhagic stroke. What should the nurse respond?
The medication you are talking about dissolves clots and could cause more bleeding in your husband's head.
Constipation is defined as:
The passing of hard stool with decreased frequency
The patient on replacement therapy with levothyroxine (Synthroid) reports feeling nervous and is having occasional palpitations and tremors. The nurse recognizes that these symptoms may indicate what effect is occurring?
The patient is experiencing symptoms of hyperthyroidism and the drug dosage may need to be decreased.
A patient with Type 1 diabetes will use a combination insulin which includes NPH and regular insulins. The nurse is teaching the patient about peak times. Why is this important for the patient to know?
The risk for a hypoglycemic reaction is greatest around the peak insulin activity
A patient was started on metformin (Glucophage) for type 2 diabetes. He tells the nurse that he is not sure why he was prescribed this medication to help control his blood sugars. What is the nurse's best response?
This medication reduces fasting and postprandial glucose levels and does not cause hypoglycemia."
The nurse is monitoring a client who was diagnosed with type 1 diabetes mellitus and is being treated with NPH and regular insulin. Which client complaint(s) would alert the nurse to the presence of a possible hypoglycemic reaction? (Select all that apply).
Tremors. Irritability. Nervousness.
The nurse determines that the patient understands an important principle in self-administration of nifedipine (Procardia) when the patient makes which statement?
"Grapefruit juice may enhance the absorption of nifedipine."
The community health nurse visits a client at home. Hydrocortisone, 10 mg orally daily, has been prescribed for the client and the nurse teaches the client about the medication. Which statement, if made by the client, indicates that further teaching is necessary?
"I can take ibuprofen and aspirin if I need it."
Mira is managing her hypertension with an ACE inhibitor. Which of the following statements stated by her indicates a need for further instruction?
"I need to increase my intake of potassium enriched foods including: orange juice, bananas, and green vegetables."
The home health nurse visits a client with a diagnosis of type 1 diabetes mellitus. The client relates a history of vomiting and diarrhea and tells the nurse that no food has been consumed for the last 24 hours. Which additional statement by the client indicates a need for further teaching?
"I need to stop my insulin."
Which statement made by the client indicates understanding about discharge instructions on antihyperlipidemic medications?
"I will continue my exercise program to help increase my high-density lipoprotein (HDL) serum levels."
The community health nurse visits a patient who has been prescribed atorvastatin (Lipitor). Which statement, if made by the patient, indicates that further teaching is necessary concerning this drug therapy?
"I will take my drug with beverages that contain grapefruit juice."
A patient has been taking hydrocotisone for long-term treatment of Addison's Disease and asks the nurse, "why are you checking my blood sugar when I don't have diabetes?" What is the nurse's best response:
"Long-term corticosteroid therapy can cause hyperglycemia."
The nurse is interviewing a client with type 2 diabetes mellitus. Which statement by the client indicates an understanding of the treatment for this disorder?
"The medications I'm taking help release the insulin I already make."
The nurse is scheduling the patient's daily medication. When would the most appropriate time for the patient to receive proton pump inhibitors?
. About 1/2 hour before a meal
Before administering a morning lispro insulin (Humalog) injection, which activity should the nurse perform? (Select all that apply).
. Assess for symptoms of hypoglycemia. Ensure that breakfast trays are present on the unit and the patient may eat. Check the patient's fingerstick glucose level.
The nurse is caring for a patient receiving gemfibrozil (Lopid) for hyperlipidemia. The nurse would validate the order with the prescriber if the patient reported a history of which of the following? (Select all that apply).
. Gallbladder disease Chronic kidney disease Diabetes
A nurse should question the order for pancrelipase (Creon) for which patient?
. The patient with an allergy to pork products.
