pharm final

The health care provider prescribes 1000 mL of normal saline 0.45% for infusion over 8 hours. The drop factor is 10 gtt/mL. At how many drops per minute does the nurse set the flow rate? (Round to the nearest whole number).

21

The health care provider prescribes 2000 mL of 5% dextrose and normal saline 0.45% for infusion over 24 hours. The drop factor is 15 gtt/mL. At how many drops per minute does the nurse set the flow rate? (Round to the nearest whole number).

21

The health care provider prescribes 2000 mL of 5% dextrose and normal saline 0.45% for infusion over 24 hours. The drop factor is 15 gtt/mL. At how many drops per minute does the nurse set the flow rate? (Round to the nearest whole number). __

21

The health care provider prescribes 1000 mL of 5% dextrose in water to be infused over 8 hours. The drop factor is 15 gtt/mL. At how many drops per minute does the nurse set the flow rate? (Round to the nearest whole number).

31

The health care provider prescribes 1000 mL of 5% dextrose in water, to be infused over 24 hours. The drop factor is 60 gtt/mL. At how many drops per minute does the nurse set the flow rate? (Round to the nearest whole number).

42

The health care provider's prescription reads, "Clindamycin phosphate 0.3 g in 50 mL NS, to be administered IV over 30 minutes." The medication label reads, "Clindamycin phosphate 150 mg/mL." How many milliliters of medication does the nurse prepare to ensure that the correct dose is administered?

2

The health care provider prescribes an intramuscular dose of 200,000 units of penicillin G benzathine for an adult client. The label on the 10-mL ampule sent from the pharmacy reads, "Penicillin G benzathine, 300,000 units/mL." How many milliliters of medication does the nurse prepares to ensure administration of the correct dose? (Round to the nearest tenth.)

0.7

Disulfiram is prescribed for a client. Which questions does the nurse make a priority of asking the client before administering this medication? Select all that apply. Select all that apply. A. "Do you have a history of thyroid problems?" B. "Do you have a history of cancer in your family?" C. "When was your last drink of alcohol?" D. "Do you have a history of diabetes insipidus?" E. "When did you have your last full meal?"

A. "Do you have a history of thyroid problems?" C. "When was your last drink of alcohol?"

A nurse provides instructions to a client who will be taking furosemide. Which statement by the client indicates to the nurse that the client needs additional instruction? A. "I should expect to have ringing in my ears." B. "This medication will make me urinate." C. "I need to maintain my fluid intake." D. "I need to sit or stand up slowly."

A. "I should expect to have ringing in my ears."

A client with a thoracic spinal cord injury is receiving dantrolene sodium. Which statement by the client indicates to the nurse that the client is experiencing an adverse effect of the medication? A. "I'm feeling really drowsy." B. "I can't seem to get enough to eat." C. "I urinate about the same amount as I always did." D. "My legs are very relaxed."

A. "I'm feeling really drowsy."

At 1300, the nurse is documenting the receipt of a unit of packed blood cells at the hospital blood bank. The nurse calculates that the transfusion must be started by which time? A. 1330 B. 1400 C. 1345 D. 1315

A. 1330

At 1600 the nurse checks a client's total parenteral nutrition (TPN) infusion bag and notes that the solution is running at a rate of 100 mL/hr. The bag was hung the previous day at 1800. The nurse plans to change the infusion bag and tubing this evening at what time? A. 1800 B. 1700 C. 2100 D. 2000

A. 1800

A nurse is caring for a group of adult clients on an acute care nursing unit. Which clients does the nurse recognize as the most likely candidates for total parenteral nutrition (TPN)? Select all that apply. Select all that apply. A. A client with severe sepsis B. A client with a severe exacerbation of ulcerative colitis C. A client with renal calculi D. A client who has undergone repair of a hiatal hernia E. A client with pancreatitis

A. A client with severe sepsis B. A client with a severe exacerbation of ulcerative colitis E. A client with pancreatitis

An adult client has prescriptions for morphine sulfate 2.5 mg IV every 6 hours and ketorolac (Toradol) 30 mg IV every 6 hours. Which action should the nurse implement? A. Administer both medications according to the prescription. B. Hold the ketorolac to prevent an antagonistic effect. C. Hold the morphine to prevent an additive drug interaction. D. Contact the healthcare provider to clarify the prescription.

A. Administer both medications according to the prescription.

A client with schizophrenia has been taking an antipsychotic medication for 2 months. For which adverse effect should the nurse monitor the client closely? A. Akathisia B. Athetoid limbs C. Protruding tongue D. Pelvic thrusts

A. Akathisia

Risperidone is prescribed for a client with a diagnosis of schizophrenia. Which laboratory study does the nurse expect to see among the health care provider's prescriptions? A. Creatinine level B. Sedimentation rate C. Red blood cell count D. Platelet count

A. Creatinine level

An adult client is given a prescription for a scopolamine patch (Transderm Scop) to prevent motion sickness while on a cruise. Which information should the nurse provide to the client? A. Apply the patch at least 4 hours prior to departure. B. Change the patch every other day while on the cruise. C. Place the patch on a hairless area at the base of the skull. D. Drink no more than 2 alcoholic drinks during the cruise.

A. Apply the patch at least 4 hours prior to departure.

A client is receiving heparin sodium by way of continuous IV infusion. For which adverse effects of the therapy does the nurse assess the client? Select all that apply. A. Bleeding from the gums B. Slowed pulse C. Tinnitus D. Increased blood pressure E. Tarry stools

A. Bleeding from the gums E. Tarry stools

A nurse discontinues an infusion of a unit of blood after the client experiences a transfusion reaction. Once the incident has been documented appropriately, where does the nurse send the blood transfusion bag? A. Blood bank B. Risk management C. Microbiology laboratory D. Infection-control department

A. Blood bank

Following the administration of sublingual nitroglycerin to a client experiencing an acute anginal attack, which assessment finding indicates to the nurse that the desired effect has been achieved? A. Client states chest pain is relieved. B. Client's pulse decreases from 120 to 90. C. Client's systolic blood pressure decreases from 180 to 90. D. Client's SaO2 level increases from 92% to 96%.

A. Client states chest pain is relieved.

A client is receiving intravenous bleomycin sulfate. During administration of the chemotherapy, nursing assessment is the priority? A. Lung sounds B. Heart rate C. Peripheral pulses D. Level of consciousness

A. Lung sounds

A client with acute myocardial infarction is admitted to the coronary care unit. Which medication should the nurse administer to lessen the workload of the heart by decreasing the cardiac preload and afterload? A. Nitroglycerin. B. Propranolol (Inderal). C. Morphine. D. Captopril (Capoten).

A. Nitroglycerin.

A client being discharged home is prescribed an antibiotic with a dosage three times higher than it was administered when the client was in the hospital. Which route of administration should the nurse anticipate will be prescribed for the greatest first-pass effect? A. Oral. B. Sublingual. C. Intravenous. D. Subcutaneous.

A. Oral.

A client is admitted to the hospital for a new onset of supraventricular tachycardia (SVT) and is prescribed digoxin. For which laboratory finding should the nurse notify the healthcare provider immediately? A. Potassium level of 3.1 mEq/L. B. Sodium level of 132 mEq/L. C. Calcium level of 8.6 mg/dL. D. Magnesium level of 1.2 mEq/L.

A. Potassium level of 3.1 mEq/L.

A client is prescribed ampicillin sodium (Omnipen) for a sinus infection. The nurse should instruct the client to notify the healthcare provider immediately if which symptom occurs? A. Rash. B. Nausea. C. Headache. D. Dizziness.

A. Rash

Carbamazepine is prescribed for a client with trigeminal neuralgia. Which side/adverse effects does the nurse instruct the client to report to the health care provider? Select all that apply. Select all that apply. A. Sore throat B. Fever C. Mouth sores D. Headache E. Nausea

A. Sore throat B. Fever C. Mouth sores

The nurse is preparing to change the solution bag and intravenous tubing of a client receiving total parenteral nutrition (TPN) through a left subclavian central venous line. Which essential action does the nurse ask the client to perform just before switching the tubing? A. Take a deep breath and hold it B. Turn the head to the left C. Exhale slowly and evenly D. Turn the head to the right

A. Take a deep breath and hold it

After abdominal surgery, a client is prescribed low molecular weight heparin (LMWH). During administration of the medication, the client asks the nurse the reason for the medication. Which is the best response for the nurse to provide the client? A. This medication is given to prevent blood clot formation. B. This medication enhances antibiotics to prevent infection. C. This medication dissolves clots that develop in the legs. D. This medication enhances the healing of wounds.

A. This medication is given to prevent blood clot formation.

A female client with rheumatoid arthritis takes ibuprofen (Motrin) 600 mg PO 4 times a day. To prevent gastrointestinal bleeding, misoprostol (Cytotec) 100 mcg PO is prescribed. Which information is most important for the nurse to include in client teaching? A. Use contraception during intercourse. B. Ensure the Cytotec is taken on an empty stomach. C. Encourage oral fluid intake to prevent constipation. D. Take Cytotec 30 minutes prior to Motrin.

A. Use contraception during intercourse.

The nurse is transcribing a new prescription for spironolactone (Aldactone) for a client who receives an angiotensin-converting enzyme (ACE) inhibitor. Which action should the nurse implement? A. Verify both prescriptions with the healthcare provider. B. Report the medication interactions to the nurse manager. C. Hold the ACE inhibitor and give the new prescription. D. Transcribe and send the prescription to the pharmacy.

A. Verify both prescriptions with the healthcare provider.

The healthcare provider prescribes digitalis (Digoxin) for a client diagnosed with heart failure. Which intervention should the nurse implement prior to administering the digoxin? A. Observe respiratory rate and depth. B. Assess the serum potassium level. C. Obtain the client's blood pressure. D. Monitor the serum glucose level.

B. Assess the serum potassium level.

A 43-year-old female client is prescribed thyroid replacement hormone following a thyroidectomy. Which adverse effects should the nurse instruct the client to report immediately to the healthcare provider? A. Tinnitus and dizziness. B. Tachycardia and chest pain. C. Dry skin and intolerance to cold. D. Weight gain and increased appetite.

B. Tachycardia and chest pain.

A client with heart failure being discharged home will be taking furosemide. Which statement by the client indicates to the nurse that the teaching has been effective? A. "I'll check my ankles every day for swelling." B. "I'll weigh myself every day." C. "I'll measure my urine output." D. "I'll take my pulse every day."

B. "I'll weigh myself every day."

When assessing an adolescent who recently overdosed on acetaminophen (Tylenol), it is most important for the nurse to assess for pain in which area of the body? A. Flank. B. Abdomen. C. Chest. D. Head.

B. Abdomen.

A client is prescribed morphine 1 mg IV per hour basal rate with 1 mg IV every 15 minutes per patient-controlled analgesia (PCA) pump for a total of 5 mg IV maximally per hour. Which nursing action has the highest priority before initiating the PCA pump? A. Assessment of the expiration date on the morphine syringe in the pump. B. Assessment of the rate and depth of the client's respirations. C. Assessment of the type of anesthesia used during the surgical procedure. D. Assessment of the client's subjective and objective signs of pain.

B. Assessment of the rate and depth of the client's respirations.

Which medications should the nurse caution the client about taking while receiving an opioid analgesic? A. Antacids. B. Benzodiazepines. C. Antihypertensives. D. Oral antidiabetics.

B. Benzodiazepines.

While taking a medical history, the client states, "I am allergic to penicillin." What related allergy to another type of antiinfective agent should the nurse ask the client about when taking the nursing history? A. Aminoglycosides. B. Cephalosporins. C. Sulfonamides. D. Tetracyclines.

B. Cephalosporins.

The nurse is preparing an education session for a client prescribed opioids for intractable cancer pain. The nurse should include strategies to help prevent which common side effect associated with long-term use of opioids? A. Sedation. B. Constipation. C. Urinary retention. D. Respiratory depression.

B. Constipation.

A client with heart failure is being discharged with a new prescription for the angiotensin-converting enzyme (ACE) inhibitor captopril (Capoten). The nurse's discharge instructions should include reporting which problem to the healthcare provider? A. Weight loss. B. Dizziness. C. Muscle cramps. D. Dry mucous membranes.

B. Dizziness.

The nitrate isosorbide dinitrate is prescribed for a client with angina. Which instruction should the nurse include in this client's discharge teaching plan? A. Quit taking the medication if dizziness occurs. B. Do not get up quickly. Always rise slowly. C. Take the medication with food only. D. Increase your intake of potassium-rich foods.

B. Do not get up quickly. Always rise slowly.

A client is prescribed controlled-release oxycodone. Which dosing schedule is best for the nurse to teach the client? As needed. A. As needed. B. Every 12 hours. C. Every 24 hours. D. Every 4 to 6 hours.

B. Every 12 hours.

A client prescribed atenolol has a blood pressure of 120/68 mmHg, displaying a sinus bradycardia with a rate of 58 beats/minute, and a P-R interval of 0.24. Which action should the nurse take? A. Lower the head of the bed and assess the client for orthostatic vital sign changes. B. Give the medication as prescribed and continue to monitor the client. C. Prepare to administer atropine sulfate IV push. D. Hold the prescribed dose and contact the healthcare provider.

B. Give the medication as prescribed and continue to monitor the client.

A client with osteoarthritis receives a new prescription for celecoxib (Celebrex) orally for symptom management. The nurse notes the client is allergic to sulfa. Which action is most important for the nurse to implement prior to administering the first dose? A. Review the client's hemoglobin results. B. Notify the healthcare provider. C. Inquire about the reaction to sulfa. D. Record the client's vital signs.

B. Notify the healthcare provider.

A client being discharged is prescribed warfarin for the treatment following a pulmonary embolism. Which diagnostic test should the nurse instruct the client to receive once a month? A. Perfusion scan. B. Prothrombin Time (PT). C. Activated partial thromboplastin (aPTT). D. Serum Coumadin level (SCL).

B. Prothrombin Time (PT).

A client with heart failure is prescribed spironolactone (Aldactone). Which information is most important for the nurse to provide to the client about diet modifications? A. Do not add salt to foods during preparation. B. Refrain for eating foods high in potassium. C. Restrict fluid intake to 1000 ml per day. D. Increase intake of milk and milk products.

B. Refrain for eating foods high in potassium.

The healthcare provider prescribes naloxone (Narcan) for a client in the emergency room. Which assessment data would indicate that the naloxone has been effective? A. A client's statement that the chest pain is better. B. Respiratory rate is 16 breaths/minute. C. Seizure activity has stopped temporarily. D. Pupils are constricted bilaterally.

B. Respiratory rate is 16 breaths/minute.

The nurse is providing care for a client prescribed propranolol. Which symptoms should the nurse report to the healthcare provider immediately? A. Headache, hypertension, and blurred vision. B. Wheezing, hypotension, and AV block. C. Vomiting, dilated pupils, and papilledema. D. Tinnitus, muscle weakness, and tachypnea.

B. Wheezing, hypotension, and AV block.

Baclofen is prescribed for a client with a spinal cord injury who is experiencing muscle spasms. While providing instructions to the client, which side effect does the nurse tell the client is possible? A. Increased appetite B. Increased salivation C. Nasal congestion D. Photosensitivity

C. Nasal congestion

A client asks the nurse if glipizide (Glucotrol) is an oral insulin. Which response should the nurse provide? A. "Yes, it is an oral insulin and has the same actions and properties as intermediate insulin." B. "Yes, it is an oral insulin and is distributed, metabolized, and excreted in the same manner as insulin." C. "No, it is not an oral insulin and can be used only when some beta cell function is present." D. "No, it is not an oral insulin, but it is effective for those who are resistant to injectable insulins."

C. "No, it is not an oral insulin and can be used only when some beta cell function is present."

A client has a prescription for a unit of packed red blood cells (RBCs). Which IV solution should the nurse obtain to hang with the blood product at the client's bedside? A. 5% dextrose in 0.9% sodium chloride B. 5% dextrose in water in 0.45% sodium chloride C. 0.9% sodium chloride D. Lactated Ringer's solution (LR)

C. 0.9% sodium chloride

A client is taking hydromorphone (Dilaudid) PO every 4 hours at home. Following surgery, Dilaudid IV every 4 hours PRN and butorphanol tartrate (Stadol) IV every 4 hours PRN are prescribed for pain. The client received a dose of the Dilaudid IV four hours ago, and is again requesting pain medication. Which intervention should the nurse implement? A. Alternate the two medications every 4 hours PRN for pain. B. Alternate the two medications every 2 hours PRN for pain. C. Administer only the Dilaudid every 4 hours PRN for pain. D. Administer only the Stadol every 4 hours PRN for pain.

C. Administer only the Dilaudid every 4 hours PRN for pain.

The healthcare provider prescribes naproxen (Naproxen) twice daily for a client with osteoarthritis of the hands. The client tells the nurse that the drug does not seem to be effective after three weeks. Which is the best response for the nurse to provide? A. The frequency of the dosing is necessary to increase the effectiveness. B. Therapeutic blood levels of this drug are reached in 4 to 6 weeks. C. Another type of nonsteroidal antiinflammatory drug may be indicated. D. Systemic corticosteroids are the next drugs of choice for pain relief.

C. Another type of nonsteroidal antiinflammatory drug may be indicated.

The nurse administers a dose of metoprolol for a client. Which assessment is most important for the nurse to obtain? A. Temperature. B. Lung sounds. C. Blood pressure. D. Urinary output.

C. Blood pressure.

A female client calls the clinic and talks with the nurse to inquire about a possible reaction after taking amoxicillin for 5 days. She reports having vaginal discomfort, itching, and a white discharge. The nurse should discuss which action with the client? A. Discontinue the antibiotic because original symptoms have subsided. B. Continue taking medication until finished until the symptoms subside. C. Consult with healthcare provider about another treatment for this effect. D. Use an over-the-counter (OTC) vaginal wash to flush out the secretions.

C. Consult with healthcare provider about another treatment for this effect.

A postoperative client receiving a continuous IV infusion of meperidine 35 mg/hr for the past four days has become increasingly restless and irritable, and begins to hallucinate. Which action should the nurse take first? A. Administer a PRN dose of the PO lithium. B. Administer naloxone IV push. C. Decrease the IV infusion rate of the meperidine. D. Increase the IV infusion rate of the meperidine.

C. Decrease the IV infusion rate of the meperidine.

The healthcare provider prescribes a beta-1 agonist medication to be administered. The nurse should anticipate the medication to be prescribed for a client diagnosed with which condition? A. Glaucoma. B. Hypertension. C. Heart failure. D. Asthma.

C. Heart failure.

The nurse is assessing the effectiveness of high dose aspirin therapy for an 88-year-old client with arthritis. The client reports hearing non-stop ringing in the ears. Which action should the nurse implement? A. Refer the client to an audiologist for evaluation of her hearing. B. Advise the client that this is a common side effect. C. Notify the healthcare provider of the finding immediately. D. Face the client directly and speak in a low, monotone voice.

C. Notify the healthcare provider of the finding immediately.

The nurse is making early morning rounds on a group of clients when a client begins exhibiting symptoms of an acute asthma attack. The nurse administers a PRN prescription for a Beta 2 receptor agonist agent. Which client response should the nurse expect? A. Tachycardia. B. Increased blood pressure. C. Rapid resolution of wheezing. D. Improved pulse oximetry values. E. Reduce fever airway inflammation.

C. Rapid resolution of wheezing. D. Improved pulse oximetry values.

Which client should the nurse identify as being at highest risk for complications during the use of an opioid analgesic? A. An older client with Type 2 diabetes mellitus. B. A client with chronic rheumatoid arthritis. C. A client with a open compound fracture. D. A young adult with inflammatory bowel disease.

D. A young adult with inflammatory bowel disease.

Which change in data indicates to the nurse that the desired effect of the angiotensin II receptor antagonist valsartan has been achieved? A. Dependent edema reduced from +3 to +1. B. Serum HDL increased from 35 to 55 mg/dL. C. Pulse rate reduced from 150 to 90 beats/minute. D. Blood pressure reduced from 160/90 mmHg to 130/80 mmHg.

D. Blood pressure reduced from 160/90 mmHg to 130/80 mmHg.

A client being treated for hyperthyroidism with propylthiouracil (PTU) asks the nurse how the medication works. Which is the best response to give the client? A. It decreases the amount of thyroid-stimulating hormone circulating in the blood. B. It increases the amount of thyroid-stimulating hormone circulating in the blood. C. It enhances the amount of T4 and diminishes the amount of T3 produced by the thyroid. D. It inhibits the synthesis of T3 and T4 by the thyroid gland.

D. It inhibits the synthesis of T3 and T4 by the thyroid gland.

A client with coronary artery disease who is taking digoxin (Lanoxin) receives a new prescription for atorvastatin (Lipitor). Two weeks after initiation of the Lipitor prescription, the nurse assesses the client. Which finding requires the most immediate intervention? A. Heartburn. B. Headache. C. Constipation. D. Vomiting.

D. Vomiting.

A nurse is providing dietary instructions to a client taking spironolactone. The nurse realizes the teaching has been effective if the client selects which food items from the menu? Select all that apply. A. Cereal B. Bananas C. Citrus fruits D. Rice E. Carrots

A. Cereal D. Rice E. Carrots

A client with heart failure is being given furosemide and digoxin. The client calls the nurse and complains of anorexia and nausea. Which action should the nurse take first? A. Check the result of laboratory testing for potassium on the sample drawn 3 hours ago B. Discontinue the morning dose of furosemide C. Administer an antiemetic D. Administer the daily dose of digoxin

A. Check the result of laboratory testing for potassium on the sample drawn 3 hours ago

A nurse has taught a client taking a methylxanthine bronchodilator, theophylline, about beverages that must be avoided. Which beverage choices by the client indicate to the nurse that the client needs further education? Select all that apply. Select all that apply. A. Chocolate milk B. Orange juice C. Lemonade D. Coffee E. Cocoa

A. Chocolate milk D. Coffee E. Cocoa

The health care provider (HCP)prescribes the administration of total parenteral nutrition (TPN), to be started at a rate of 50 mL/hr by way of infusion pump through an established subclavian central line. After the first 2 hours of the TPN infusion, the client suddenly complains of difficulty breathing and chest pain. The nurse should take which immediate action? A. Clamp the TPN infusion line B. Obtain a sample for blood glucose testing C. Obtain an electrocardiogram (ECG) D. Obtain blood for culture

A. Clamp the TPN infusion line

A nurse discontinues an infusion of a unit of packed red blood cells (RBCs) because the client is experiencing a transfusion reaction. After discontinuing the transfusion, which action should the nurse take next? A. Contact the health care provider B. Obtain a culture of the tip of the catheter device removed from the client C. Change the solution to 5% dextrose in water D. Remove the IV catheter

A. Contact the health care provider

A nurse is preparing a plan of care for a client who will be receiving meperidine hydrochloride. Which side/adverse effects does the nurse make a note of needing to be alert to in the plan of care? Select all that apply. Select all that apply. A. Hypotension B. Bradycardia C. Urine retention D. Constipation E. Respiratory depression

A. Hypotension C. Urine retention D. Constipation E. Respiratory depression

A nurse is preparing a client for the insertion of a central intravenous line into the subclavian vein by the health care provider. The nurse gathers the equipment, places it at the bedside, and prepares to assist the health care provider with the procedure. As further preparation for the procedure, the nurse places the client in which position? A. In a slight Trendelenburg position B. Flat on the left side C. In the prone position D. In the supine position

A. In a slight Trendelenburg position

A nurse suspects that a client receiving total parenteral nutrition (TPN) through a central line has an air embolism. The nurse immediately places the client in which position? A. Left side with the head lower than the feet B. Right side with the head lower than the feet C. Right side with the head higher than the feet D. Left side with the head higher than the feet

A. Left side with the head lower than the feet

A nurse has just hung a transfusion of packed red blood cells and stayed with the client for the appropriate amount of time. Before leaving the room, the nurse tells the client that it is most important to immediately report which specific signs if it occurs? Select all that apply. Select all that apply. A. Rash B. Backache C. Tiredness D. Chills E. Fatigue

A. Rash B. Backache D. Chills

The health care provider's prescription reads, "Phenytoin 0.1 g by mouth twice daily." The medication label indicates that the bottle contains 100-mg capsules. How many capsules does the nurse prepare for administration of one dose?

1

A client is taking a folic acid supplement. Which laboratory parameter does the nurse use to evaluate the effectiveness of this therapy? Select all that apply. A. Magnesium B. Blood glucose C. Alkaline phosphatase D. Hemoglobin E. Hematocrit

D. Hemoglobin E. Hematocrit

The health care provider's prescription for an adult client reads, "Potassium chloride 15 mEq by mouth." The label on the medication bottle reads, "20 mEq potassium chloride/15 mL." How many milliliters of KCl does the nurse prepare to ensure administration of the correct dose of medication? (Round to the nearest whole number.)

11

A nurse is caring for a client with histoplasmosis who is receiving intravenous amphotericin B . Which is the most critical observation for the nurse to make while the medication is being administered? A. Monitor the client's urine output B. Monitor the client for hypothermia C. Check the client's blood glucose level D. Check the client's neurological status

A. Monitor the client's urine output

A client is receiving total parenteral nutrition (TPN) with fat emulsion (lipids) piggybacked to the TPN solution. For which signs of an adverse reaction to the fat emulsion should the nurse monitor the client? Select all that apply. Select all that apply. A. Nausea and vomiting B. Pallor C. Subnormal temperature D. Chills E. Headache F. Chest and back pain

A. Nausea and vomiting D. Chills E. Headache F. Chest and back pain

A nurse is monitoring a client who is receiving total parenteral nutrition (TPN). Which signs and symptoms causes the nurse to suspect that the client is experiencing hyperglycemia as a complication? A. Nausea, thirst, and increased urine output B. Sweating, chills, and decreased urine output C. Nausea, vomiting, and oliguria D. Pallor, weak pulse, and anuria

A. Nausea, thirst, and increased urine output

Phenelzine sulfate is being administered to a client with depression. The client suddenly complains of a severe frontally radiating occipital headache, neck stiffness and soreness, and vomiting. On further assessment, the client exhibits signs of hypertensive crisis. Which medication should the nurse prepare to administer, anticipating that it will be prescribed as the antidote to treat phenelzine-induced hypertensive crisis? A. Phentolamine B. Protamine sulfate C. Calcium gluconate D. Acetylcysteine

A. Phentolamine

A nurse is assessing a peripheral intravenous (IV) site and notes blanching, coolness, and edema at the insertion site. What should the nurse do first? A. Remove the IV B. Check for blood return C. Measure the area of infiltration D. Apply a warm compress

A. Remove the IV

The client rings the call bell and complains of pain at the site of an IV infusion. The nurse assesses the site and determines that phlebitis has developed. Which actions should the nurse take? Select all that apply. Select all that apply. A. Removing the IV catheter at that site B. Applying warm, moist compresses to the IV site C. Notifying the health care provider about the finding D. Starting a new IV line in a proximal portion of the same vein E. Encouraging the client to scrub the site while in the shower

A. Removing the IV catheter at that site B. Applying warm, moist compresses to the IV site C. Notifying the health care provider about the finding

A nurse is monitoring a client who is receiving a continuous intravenous infusion of morphine sulfate. Which finding should cause the nurse to contact the health care provider? A. Respiratory rate of 10 breaths/min B. Urine output of 30 mL/hr C. Blood pressure of 100/60 mm Hg D. Temperature of 97.6° F (36.4°C)

A. Respiratory rate of 10 breaths/min

A nurse hangs a 500-mL bag of intravenous (IV) fluid for an assigned client. One hour later the client complains of chest tightness, is dyspneic and apprehensive, and has an irregular pulse. The IV bag has 100 mL remaining. Which action should the nurse take first? A. Shut off the IV infusion B. Sit the client up in bed C. Slow the rate of infusion D. Remove the IV

A. Shut off the IV infusion

A client taking metronidazole for the treatment of trichomoniasis vaginalis calls the clinic nurse to express concern because her urine has turned dark in color. The nurse should provide which information to the client? A. That darkening of the urine is a harmless side effect B. To discontinue the medication C. To report to the clinic to see the health care provider D. To increase her fluid intake

A. That darkening of the urine is a harmless side effect

A home care nurse has been assigned a client who has been discharged home with a prescription for total parenteral nutrition (TPN). Which parameters does the nurse plan to check at each visit as a means of identifying complications of the TPN therapy? Select all that apply. Select all that apply. A. Weight B. Glucose test C. Temperature D. Hemoglobin and hematocrit E. Peripheral pulses

A. Weight B. Glucose test C. Temperature

A young female client with schizophrenia says to the nurse, "Since I started on olanzapine last year, I'm doing well in school and all, but I've gained so much weight, and it's really bothering me. What can I do about this?" Which response by the nurse would be therapeutic? A. Weight gain can be a side effect of the medication, so you need to watch your diet and exercise. How much weight have you gained?" B. "That medication isn't any more likely to cause weight gain than the others you're taking. Perhaps we could go over your diet and exercise habits." C. "Well, I think you're overreacting. Today people think they should be skinny-minnies, even though it's not healthy." D. "I want you to stop taking this medication immediately, and I'm calling the doctor, because this is a very serious side effect and you may need dialysis."

A. Weight gain can be a side effect of the medication, so you need to watch your diet and exercise. How much weight have you gained?"

A nurse is assessing a client who is being hospitalized with a diagnosis of pneumonia. The client's husband tells the nurse that the client is taking donepezil hydrochloride. The nurse should ask the husband about the client's history of which disorder? A. Diabetes mellitus B. Dementia C. Seizure disorder D. Posttraumatic stress disorder

B. Dementia

A client who needs to receive a blood transfusion has experienced a pruritic rash during previous transfusions. The client asks the nurse whether it is safe to receive the transfusion. Which medication does the nurse anticipate will most likely be prescribed before the transfusion? A. Ibuprofen B. Diphenhydramine C. Acetaminophen D. Acetylsalicylic acid

B. Diphenhydramine

A nurse is caring for a client with a diagnosis of chronic kidney disease who is receiving dialysis. Epoetin alfa, to be administered subcutaneously, has been prescribed, and the nurse is drawing the medication from a single-use vial. What should the nurse do to prepare the medication? A. Shake the vial before drawing up the medication B. Draw up the medication and discard the unused portion C. Mix the medication with 0.1 mL of heparin before administration to prevent clotting D. Obtain the medication from the medication freezer and allow it to thaw

B. Draw up the medication and discard the unused portion

Metoprolol has been prescribed for a client with hypertension. For which common side effects of the medication does the nurse monitor the client? Select all that apply. A. Nightmares B. Weakness C. Dry eyes D. Fatigue E. Erectile dysfunction

B. Weakness D. Fatigue E. Erectile dysfunction

A home health nurse provides instructions to a client who is taking allopurinol for the treatment of gout. The nurse realizes the instructions have been effective if the client verbalizes the importance of which teaching point? A. Place an ice pack on the lips if they swell B. Drink at least 8 glasses of fluid every day C. Take the medication on an empty stomach 2 hours before meals D. Use an over-the-counter (OTC) antihistamine lotion if a rash develops

B. Drink at least 8 glasses of fluid every day

A client with tuberculosis is being started on isoniazid and the nurse stresses the importance of returning to the clinic for follow-up blood testing. The nurse realizes the client understands the instructions if the client verbalizes the need to return to the clinic for which blood test? A. Blood urea nitrogen B. Liver enzymes C. Red blood cell count D. Serum creatinine

B. Liver enzymes

A nurse is providing instruction to a client who is taking codeine sulfate for severe back pain. Which instruction should the nurse provide to the client? A. Avoid all exercise to help prevent lightheadedness B. Maintain a high-fiber diet C. Decrease fluid intake D. Avoid the use of stool softeners to help prevent diarrhea

B. Maintain a high-fiber diet

A nurse notes that the site of a client's peripheral IV catheter is reddened, warm, painful, and slightly edematous in the area of the insertion site. After taking appropriate steps to care for the client, the nurse documents in the medical record that the client has experienced which problem? A. Infiltration of the IV line B. Phlebitis of the vein C. An allergic reaction to the IV catheter material D. Hypersensitivity to the IV solution

B. Phlebitis of the vein

Packed red blood cells have been prescribed for a client with low hemoglobin and hematocrit values. The nurse takes the client's temperature orally before hanging the blood transfusion and notes that it is 100.0° F (37.7 C). What should the nurse do next? A. Begin the transfusion as prescribed B. Administer an antihistamine and begin the transfusion C. Call the health care provider D. Administer 2 tablets of acetaminophen and begin the transfusion

C. Call the health care provider

A nurse notes that the site of a client's peripheral intravenous (IV) catheter is reddened, warm, painful, and slightly edematous near the insertion point of the catheter. On the basis of this assessment, the nurse should take which action first? A. Check for loose catheter connections B. Remove the IV catheter C. Slow the rate of infusion D. Notify the health care provider

B. Remove the IV catheter

A client who is taking bupropion in an attempt to stop smoking tells a nurse that he has been doubling the daily dose to make it easier to resist smoking. The nurse warns the client that doubling the daily dosage is dangerous. Of which adverse effect of the medication does the nurse warn the client? A. Orthostatic hypotension B. Seizures C. Weight gain D. Insomnia

B. Seizures

A nurse is to administer a dose of digoxin to a client with atrial fibrillation and notes that the client has a potassium level of 4.6 mEq/L (4.6 mmol/L). The nurse determines which about the administration of the dose? A. Should be withheld and the health care provider notified B. Should be administered as prescribed C. Should be preceded with a dose of potassium D. Should be withheld that day

B. Should be administered as prescribed

A pregnant client is receiving magnesium sulfate for the management of preeclampsia. Which assessment finding indicates to the nurse that the client is experiencing magnesium toxicity? A. Proteinuria of +3 B. Sudden drop in fetal heart rate C. Serum magnesium level of 2.5 mEq/L (1.25 mmol/L) D. Presence of deep tendon reflexes

B. Sudden drop in fetal heart rate

A client who has undergone adrenalectomy is prescribed prednisone. Which finding indicates that the client is experiencing an adverse effect of the medication? A. Dry mouth B. Tarry stools C. Hypotension D. Hypoglycemia

B. Tarry stools

A nurse is preparing a plan of care for a pregnant client who will be given oxytocin to induce labor. Which occurrence does the nurse include in the plan of care as a reason for immediate discontinuation of the oxytocin infusion? A. Severe drowsiness B. Uterine hyperstimulation C. Early decelerations of the fetal heart rate D. Uterine atony

B. Uterine hyperstimulation

A nurse has just received a prescription to transfuse a unit of packed red blood cells for an assigned client. For how long does the nurse plan to stay with the client after the unit of blood is hung? A. 60 minutes B. 5 minutes C. 15 minutes D. 45 minutes

C. 15 minutes

A nurse is making initial rounds on a group of assigned clients. Which client should the nurse see first? A. A client receiving total parenteral nutrition (TPN) at a rate of 50 mL/hr for the last 24 hours B. A client receiving TPN at a rate of 50 mL/hr whose temp was 99° F (37.2°C) on the previous shift C. A client whose TPN solution was decreased to a rate of 25 mL/hr who is now complaining of weakness, headache, and sweating D. A client receiving TPN at a rate of 100 mL/hr who has complained of needing frequent trips to the bathroom to void

C. A client whose TPN solution was decreased to a rate of 25 mL/hr who is now complaining of weakness, headache, and sweating

A nurse is reviewing the laboratory results of a client receiving intravenous chemotherapy. Which laboratory finding prompts the nurse to initiate neutropenic precautions? A. A clotting time of 10 minutes B. An ammonia level of 20 mcg N/dL (14.6 μmol N/L) C. A white blood cell (WBC) count of 2.0 × 103/μL (2.0 × 109/L). D. A platelet count of 100 × 103/μL (100× 109/L).

C. A white blood cell (WBC) count of 2.0 × 103/μL (2.0 × 109/L).

The emergency department staff prepares for the arrival of a child who has ingested a bottle of acetaminophen. Which medication does the nurse ensure is available? A. Phytonadione B. Pancreatin C. Acetylcysteine D. Protamine sulfate

C. Acetylcysteine

A client has been given a prescription to begin using nitroglycerin transdermal patches for the management of angina pectoris. What should the nurse tell the client about the medication? A. Place the patch in the area of a skin fold to promote adherence B. Alternate daily dose times between the morning and the evening to prevent the development of tolerance to the medication C. Apply the patch at the same time each day and leave it in place for 12 to 16 hours as directed D. If the patch becomes dislodged, do not reapply and wait until the next day to apply a new patch.

C. Apply the patch at the same time each day and leave it in place for 12 to 16 hours as directed

The serum theophylline level of a client who is taking the medication (Theo-24) is 16 mcg/mL. On the basis of this result, the nurse should take which action initially? A. Call the health care provider immediately B. Call the rapid response team to help with the emergency C. Document the normal value on the chart D. Call the pharmacy to alert the pharmacist regarding the client's theophylline level

C. Document the normal value on the chart

The first bag of total parenteral nutrition (TPN) solution has arrived on the clinical unit for a client beginning this nutritional therapy. The solution is to be infused by way of a central line. Which essential piece of equipment should the nurse obtain before hanging the solution? A. Noninvasive blood pressure monitor B. Blood glucose meter C. Electronic infusion device D. Pulse oximeter

C. Electronic infusion device

A nurse answers a call bell and finds that the total parenteral nutrition (TPN) solution bag of an assigned client is empty. The new prescription was written for a new bag at the beginning of the shift, but it has not yet arrived from the pharmacy. Which action should the nurse take first? A. Hang a solution of 5% dextrose in 0.9% sodium chloride B. Call the pharmacy for further instructions C. Hang a solution of 10% dextrose in water D. Call the health care provider

C. Hang a solution of 10% dextrose in water

A client taking hydrochlorothiazide reports to the clinic for follow-up blood tests. For which side/adverse effect of the medication does the nurse monitor the client's laboratory results? A. Hypocalcemia B. Hypernatremia C. Hypermagnesemia D. Hypokalemia

C. Hypermagnesemia

A nurse is caring for a client who has been taking acetazolamide for glaucoma. Which, if documented in the assessment data, indicates to the nurse that the client may be experiencing an adverse effect of the medication? A. No change in peripheral vision B. Tinnitus C. Jaundice D. Pupillary constriction in response to light

C. Jaundice

A nurse is developing a plan of care for a client, hospitalized with heart failure, who has a history of Parkinson disease and is taking benztropine mesylate daily. Which intervention does the nurse identify as a priority in the plan? A. Checking the client's hemoglobin level daily B. Placing the client in a right side-lying position C. Monitoring intake and output D. Monitoring the client's pupillary response

C. Monitoring intake and output

A nurse is preparing a plan of care for a client with a diagnosis of cancer who is receiving morphine sulfate for pain. Which action does the nurse identify as a priority in the plan of care for this client? A. Encouraging increased fluids B. Monitoring the client's temperature C. Monitoring the client's respiratory rate D. Monitoring urine output

C. Monitoring the client's respiratory rate

A nurse is reading the medical record of a client receiving haloperidol. The nurse notes that the health care provider has documented that the client is experiencing signs of akathisia. On the basis of the health care provider's note, which clinical manifestation would the nurse expect to find during assessment of the client? A. Puffing of the cheeks B. Puckering of the mouth C. Motor restlessness D. Protrusion of the tongue

C. Motor restlessness

Methylergonovine intramuscularly is prescribed for a postpartum client. Before administering the medication, the nurse explains to the client that the medication will promote which effect? A. Maintain a normal blood pressure B. Decrease the strength of uterine contractions C. Prevent postpartum bleeding D. Reduce lochial drainage

C. Prevent postpartum bleeding

A client has been taking metoprolol. Which finding indicates to the nurse that the medication is effective? A. The client's weight has increased. B. The client has wheezes in the lower lobes of the lungs. C. The client's blood pressure has decreased. D. The client's ankles are swollen.

C. The client's blood pressure has decreased.

A client who has been taking lisinopril complains to the nurse of a persistent dry cough. What should the nurse tell the client? A. He probably has an upper respiratory infection B. A chest x-ray is required because the cough is a sign of heart failure C. This is a side effect of therapy D. He needs to have his blood counts checked

C. This is a side effect of therapy

A client with newly diagnosed angina pectoris has taken 2 sublingual nitroglycerin tablets for chest pain. The chest pain is relieved, but the client complains of a headache. What should the nurse tell the client? A. This is an indication that the medication should not be used again B. Headache indicates medication tolerance, and the dosage must be increased C. This is an expected side effect of the nitroglycerin, and the client can relieve it by taking acetaminophen D. This may be an allergic reaction to the nitroglycerin, and the health care provider must be notified

C. This is an expected side effect of the nitroglycerin, and the client can relieve it by taking acetaminophen

A nurse is changing the central line dressing of a client receiving total parenteral nutrition (TPN). The nurse notes moisture under the dressing covering the catheter insertion site. What should the nurse assess next? A. Expiration date on the infusion bag B. Time of the last dressing change C. Tightness of the tubing connections D. Temperature

C. Tightness of the tubing connections

Cyclophosphamide has been prescribed for a client with a diagnosis of breast cancer, and the nurse is providing instructions to the client. The nurse realizes the instructions have been effective if the client makes the statement she will change which aspect of care? A. To drink at least 2 glasses of orange juice every day B. That it is best to take the medication with food C. To increase fluid intake to 2000 mL to 3000 mL/day D. To avoid salt while taking this medication

C. To increase fluid intake to 2000 mL to 3000 mL/day

A nurse is providing instructions to a client regarding quinapril hydrochloride. The nurse should teach the client to implement which measure? A. To take the medication with meals B. That a therapeutic effect will be felt immediately C. To rise slowly from a lying to a sitting position D. To discontinue the medication if nausea occurs

C. To rise slowly from a lying to a sitting position

A client with rheumatoid arthritis is taking high doses of acetylsalicylic acid. While assessing the client for aspirin toxicity, which question should the nurse ask the client? A. "Are you constipated?" B. "Are you having any diarrhea?" C. "Do you have any double vision?" D. "Do you have any ringing in the ears?"

D. "Do you have any ringing in the ears?"

A nurse instructs a client with hypothyroidism about the dosage, method of administration, and side effects of levothyroxine sodium. Which statement by the client indicates an understanding of the nurse's instructions? A. "I should take the medication in the evening." B. "I can expect diarrhea, insomnia, and excessive sweating." C. "If I feel nervous or have tremors, I should only take half the dose." D. "I need to report any episodes of palpitations, chest pain, or dyspnea."

D. "I need to report any episodes of palpitations, chest pain, or dyspnea."

A client with schizophrenia who has been taking an antipsychotic medication calls the clinic nurse and says, "I need to cancel my appointment with the psychiatrist again, because I still have this awful sore throat. It's so bad that my mouth has a sore." How does the nurse respond to the client? A. "Do you remember when you started this medication? Your psychiatrist told you how important it is to keep your appointments with him." B. "You probably have a simple flu, but it might help if you gargle with some antiseptic mouthwash every 2 hours or so and drink plenty of water." C. "I wouldn't be upset. It happens when you aren't drinking enough water." D. "I think you need to come in for blood work today, because this may be an adverse effect of your medicine."

D. "I think you need to come in for blood work today, because this may be an adverse effect of your medicine."

Warfarin sodium has been prescribed, and the nurse teaches the client about the medication. Which statement by the client indicates that further teaching is necessary? A. "I'll buy one of those medication alert tags that tells people I'm taking an anticoagulant." B. "I'll use an electric shaver until the doctor stops the Coumadin prescription." C. "I won't play football anymore." D. "I won't take any over-the-counter medications except aspirin."

D. "I won't take any over-the-counter medications except aspirin."

A nurse is caring for a client with myasthenia gravis who is exhibiting signs of cholinergic crisis. Which medication does the nurse ensure is available to treat this crisis? A. Protamine sulfate B. Pyridostigmine bromide C. Acetylcysteine D. Atropine sulfate

D. Atropine sulfate

A client has a prescription for short-term therapy with enoxaparin . The nurse explains to the client that this medication is being prescribed for which purpose? A. Prevent pain B. Relieve back spasms C. Increase the client's energy level D. Reduce the risk of deep vein thrombosis

D. Reduce the risk of deep vein thrombosis

A client with HIV infection has been started on therapy with zidovudine. The nurse tells the client to report to the laboratory in 3 months for testing to detect adverse effects of the therapy. Which laboratory test is most important to monitor for this client? A. Serum potassium B. Creatinine C. Blood urea nitrogen (BUN) D. Complete blood count (CBC)

D. Complete blood count (CBC)

A nurse is teaching a client how to mix regular and NPH insulin in the same syringe. The nurse should provide the client with which information about the insulin? A. Remove all of the air from the bottle before mixing the two types B. Keep insulin refrigerated at all times C. Shake the NPH insulin bottle before mixing the two types D. Draw the regular insulin into the syringe first

D. Draw the regular insulin into the syringe first

Betaxolol eye drops have been prescribed for the treatment of a client's glaucoma. The nurse tells the client to return to the clinic for follow-up for which purpose? A. To give a sample for urinalysis B. To have weight checked C. To have the blood glucose level checked D. For measurement of blood pressure and apical pulse

D. For measurement of blood pressure and apical pulse

Fluoxetine hydrochloride is prescribed for a client, and the nurse provides instruction regarding the use of the medication. The nurse tells the client that it is best to take the medication at what time? A. At lunchtime B. With the evening meal C. Midafternoon, with an antacid D. In the morning

D. In the morning

A nurse has taught a client who is taking lithium carbonate about the medication. The nurse determines that the client needs additional teaching if the client makes which comment to the nurse? A. The medication should be taken with meals B. The lithium blood levels must be monitored very closely C. The health care provider must be called if excessive diarrhea, vomiting, or diaphoresis occurs D. It is important to decrease fluid intake while taking the medication to avoid nausea

D. It is important to decrease fluid intake while taking the medication to avoid nausea

Erythromycin is prescribed for a client with a respiratory tract infection. The nurse provides instructions to the client regarding the administration of the oral medication and tells the client that it is best to take the medication in which way? A. With a meal B. At bedtime, with a snack C. With juice D. On an empty stomach

D. On an empty stomach

A client has just undergone insertion of a central venous catheter by the health care provider at the bedside. Which result would the nurse be sure to check before initiating infusion of the IV solution that the health care provider has prescribed? A. Intake and output record B. Serum osmolality C. Serum electrolytes D. Portable chest x-ray

D. Portable chest x-ray

A client with a peripheral intravenous (IV) line in place has a new prescription for infusion of total parenteral nutrition (TPN), a solution containing 25% glucose. Which action should be taken by the nurse? A. Diluting the solution with sterile water to half-strength B. Hanging the IV solution as prescribed C. Hanging the IV solution but setting the infusion at just half the prescribed rate D. Questioning the health care provider about the prescription

D. Questioning the health care provider about the prescription

A client receiving total parenteral nutrition (TPN) requires fat emulsion (lipids), which will be piggybacked to the TPN solution. On obtaining a bottle of fat emulsion, the nurse notes that fat globules are floating at the top of the solution. Which action should the nurse take? A. Shake the bottle vigorously B. Rotate the bottle gently back and forth to mix the globules C. Run the bottle under warm water until the globules disappear D. Request a new bottle from the pharmacy

D. Request a new bottle from the pharmacy

The nurse is caring for a client who has taken atenolol for 2 years. The healthcare provider recently changed the medication to enalapril to manage the client's blood pressure. Which instruction should the nurse provide the client regarding the new medication? A. Take the medication at bedtime. B. Report presence of increased bruising. C. Check pulse before taking medication. D. Rise slowly when getting out of bed or chair.

D. Rise slowly when getting out of bed or chair.

A nurse has a written prescription to remove an intravenous (IV) line. Which item should the nurse obtain from the unit supply area for use in applying pressure to the site after removing the IV catheter? A. Alcohol swab B. Adhesive bandage C. Povidone-iodine (Betadine) swab D. Sterile 2 × 2 gauze

D. Sterile 2 × 2 gauze

Intravenous tobramycin sulfate is prescribed for a client with a respiratory tract infection. For which of the following symptoms, indicative of an adverse effect, does the nurse monitor the client? A. Hypotension B. Nausea C. Vomiting D. Vertigo

D. Vertigo

A nurse has obtained a unit of blood from the blood bank and properly checked the blood bag with another nurse. Which parameter should the nurse assess just before hanging the transfusion? A. Latest platelet count B. Urine output over the last 24 hours C. Skin color D. Vital signs

D. Vital signs