Pharm Final Prep U

A nurse is caring for a 64-year-old female patient who is receiving IV heparin and reports bleeding from her gums. The nurse checks the patient's laboratory test results and finds that she has a very high aPTT. The nurse anticipates that which drug may be ordered?

Protamine sulfate

Which of the following would a nurse expect to administer for a heparin overdose?

Protamine sulfate

A nurse is caring for a patient who is going home on warfarin (Coumadin). The nurse will schedule the patient for what laboratory test to help evaluate therapeutic effects of the drug?

Prothrombin time (PT) and international normalized ratio (INR)

A person is seen wandering the streets and talking to people who are not there. From what disorder do you suspect the person is suffering?

Psychosis

Psyllium (Metamucil) is a bulk-forming laxative available over-the-counter and frequently used. The nurse knows that which of these statements regarding use of psyllium is correct?

Psyllium is useful in critically ill patients who experience constipation.

A patient is receiving an intravenous infusion of amiodarone for treatment of ventricular fibrillation. Which is the most serious adverse effect of the medication?

Pulmonary toxicity

Before administering a beta-adrenergic blocker, the nurse should be aware of what information about the patient?

Pulse and blood pressure

A geriatric client received a narcotic analgesic before leaving the post-anesthesia care unit to return to the regular unit. What is the priority nursing intervention for the nurse receiving the client on the regular unit?

Put side rails up and place bed in low position

Which of the following is an important assessment for the nurse to make before administering a laxative?

Question the client regarding the type and intensity of symptoms to provide a baseline evaluation.

A patient is diagnosed with erectile dysfunction. He asks what effect sildenafil (Viagra) has because he is taking nitroglycerin for chest pain. What is the best explanation for why nitrates are contraindicated with sildenafil (Viagra).

"Nitroglycerine and Viagra cause a severe decrease in blood pressure."

A nurse should review a client's medical conditions prior to administering a phenytoin (Dilantin) because its use is contraindicated in some clients. In what clients would its use be contraindicated? (Select all that apply.)

Pregnancy Sinus bradycardia

Laxatives and cathartics are used in a wide variety of ways. The nurse knows that which of the following are appropriate uses for these drugs? Select all that apply.

Preparation for colonoscopy Hepatic encephalopathy Following myocardial infarction With opioid analgesics

A male patient is receiving heparin by continuous intravenous infusion. The nurse will instruct the patient and family members to report what should it occur?

Presence of blood in urine or stools

After the nurse makes an initial assessment of patients, the nurse reviews their medications. What medication order should the nurse question for a diabetic patient who takes insulin to control their diabetes?

Propranolol (Inderal) 10 mg PO t.i.d.

A patient who has been taking valproic acid (sodium valproate) for a seizure disorder is asking the nurse about getting pregnant. Why is pregnancy discouraged in women who are being treated for seizure disorders?

Antiepilepsy drugs are teratogenic

A client reports a hacking cough. The client asks if taking an antihistamine would be helpful. The nurse's best response is:

Antihistamines are not recommended because they can dry lower respiratory secretions and worsen secretion retention and cough.

A student nurse is researching the charts of 25 patients with a diagnosis of chronic pharyngitis and what medication is most commonly prescribed. What type of medication would the nurse expect to find in the majority of the chart audits?

Antitussives

The client asks, "What is the difference between antitussive medications and expectorants?" The best response is:

Antitussives suppress coughing, and expectorants loosen bronchial secretions.

Prior to the administration of a sympatholytic drug, the nurse should check a patient's blood pressure and:

Apical pulse

A nurse is preparing to give a patient an initial dose of a penicillin preparation. What is the first action the nurse should take?

Ask the patient if he or she has ever had an allergic reaction to a penicillin.

The nurse is caring for a patient who is taking amitriptyline for depression. What nursing intervention would be most appropriate if this patient developed orthostatic hypotension?

Asking the patient to sit on the side of the bed for 1 minute before getting up

The client reports to the nurse that the client is having ringing in the ears. The nurse questions the client on use of what medication?

Aspirin

A patient who experiences frequent constipation asks the nurse for advice regarding which agent would be best for long-term daily use? The nurse will respond that the best for daily use is which of the following?

Docusate (Colace)

While speaking with a client, the nurse notes that the client stares off, unblinking. The nurse notes that after several prompts, the client blinks rapidly and then resumes normal conversation. The type of seizure demonstrated by this client is a(n):

absence seizure.

Morphine has been prescribed for a 28-year-old man with severe pain due to a back injury. The nurse will advise the patient to avoid:

alcohol

A patient has recently been prescribed a drug that treats his hypertension by blocking the sympathetic receptors in his sympathetic nervous system. This action is characteristic of:

an adrenergic antagonist.

What effects are exerted by aspirin? (Select all that apply.)

analgesic antipyretic anti-inflammatory

A priority nursing assessment for a patient who is to receive an alpha- or beta-adrenergic agonist would be to:

assess heart rate.

A 78-year-old man is admitted to the emergency department (ED) with bradycardia resulting from overdose of donepezil, a cholinergic drug prescribed for treatment of Alzheimer's disease. The nurse knows that the ED physician is likely to order:

atropine

The nurse may advise a patient to take what after a myocardial infarction to prevent straining during defecation?

Docusate (Colace)

A patient is diagnosed with Alzheimer's disease. Which medications are administered for the treatment of Alzheimer's disease?

Donepezil (Aricept)

A nurse is instructing a patient on the administration of an opioid medication. What medication effect will develop?

Drowsiness

After administering an anticonvulsant medication, the nurse should monitor for which adverse reactions? (Select all that apply.)

Drowsiness Ataxia Urticaria Gingival hyperplasia

A patient with a severe depression has been hospitalized, and the physician has ordered amitriptyline. What common adverse effect might this patient have?

Dry mouth

A patient with allergic rhinitis is prescribed an antihistamine. The nurse instructs the patient to suck on a sugarless hard candy to prevent which condition?

Dryness of the oral mucosa and the throat

A client is prescribed propranolol (Inderal). Which condition in the client's history may affect the treatment regimen?

Elevated glucose

A nurse is conducting client teaching prior to discharge home. The client is taking ciprofloxacin. What would you teach this client is the best way to prevent crystalluria caused by ciprofloxacin?

Encourage at least 2 L of fluid per day.

Anaphylaxis kits for clients allergic to bee stings would contain which medications?

Epinephrine

Which of the following are effects that a client might experience while taking diphenoxylate (Lomotil)? Select all that apply:

Euphoric effects Sedative effects Slowed GI effects

After teaching a patient who is prescribed a scopolamine patch, the nurse determines that the teaching was successful when the patient states that she will change the patch in which time frame?

Every 3 days

A client should be instructed to take sublingual NTG how often if he experiences chest pain?

Every 5 minutes times 3

A patient is diagnosed with type 1 diabetes. What distinguishing characteristic is associated with type 1 diabetes?

Exogenous insulin is required for life.

The two major classifications of diabetes are type 1 and type 2. What is a distinguishing characteristic of type 1 diabetes?

Exogenous insulin is required for life.

A 57-year-old female client has a history of two myocardial infarctions in the past 3 years. She presents to the physician's office with symptoms of an overactive bladder. She requests an anticholinergic medication that she saw advertised on television. What does the nurse expect the physician to do for this client?

Explain to the client that the medication is contraindicated because of her medical history

A client's thought disorder has been treated with haloperidol (Haldol). For what adverse effect should the nurse most closely monitor the client?

Extrapyramidal effects

Blood coagulation results from the activation of one of two pathways: one pathway occurs in tissue, and the other occurs in the vascular system. What are the names of these pathways?

Extrinsic and intrinsic pathways

A client's past experience with pain has little impact on the patient's perception of pain.

False

Second generation antihistamines are associated with a higher risk of sedation than first generation antihistamines.

False

The first step in treating obstructive pulmonary disorders involves medication therapy.

False

What histamine2 antagonist is approved for use in children?

Famotidine

Which H-2 antagonist would the nurse identify as most potent?

Famotidine

A client with chronic pain and a history of poor adherence to medication schedules requires a narcotic analgesic that can provide a steady delivery of pain relief. What medication is most likely to meet this client's needs?

Fentanyl

Which drug is most commonly used orally to treat infections caused by Candida albicans?

Fluconazole (Diflucan)

A patient has been administered atropine for sinus bradycardia. Which symptom is noted with large doses of atropine?

Flushing

A patient is admitted to the nursing unit with OCD. What drug has been found to be effective for treating OCD?

Fluvoxamine

A nurse is caring for a patient receiving heparin therapy. The nurse instructs the patient and family that certain foods must be taken in limited quantity as they interfere with the effect of the therapy. Which foods must be taken in limited quantity?

Foods rich in vitamin K

A nurse is sending a patient home on heparin therapy. What is important when teaching a patient to administer heparin subcutaneously?

Insert the needle at a 45- to 90-degree angle.

What is an example of rapid acting insulin?

Insulin lispro (Humalog)

Lidocaine (Xylocaine) is available in a variety of dosage forms. How should a nurse administer lidocaine to a client with a ventricular arrhythmia?

Intravenously

The client has been depressed since her father died 6 months ago and the health care provider has prescribed amitriptyline.What aspect of this client's health history should prompt the nurse to contact the prescriber?

Ischemic heart disease

A female client reports that her seizure was preceded by a brief warning, which she describes as an unusual smell. This is known as a(n):

aura.

A female patient diagnosed with chronic atrial flutter has been prescribed verapamil in conjunction with digoxin to control ventricular rate. To enhance the therapeutic effect of the drug, the nurse will instruct the patient to:

avoid grapefruit and grapefruit juice.

A nurse is caring for a patient prescribed an antidiarrheal drug. For which preexisting condition of the patient should the nurse administer the drug with caution?

Hepatic impairment

A nurse should be cautious administering sedatives and hypnotics to which clients? (Select all that apply.)

Hepatic impairment Renal impairment Mental health problems Habitual alcohol use

A patient is admitted to the emergency department with a suspected overdose of acetaminophen (Tylenol). What adverse effect is most common in acute or chronic overdose of acetaminophen (Tylenol)?

Hepatotoxicity

A 76-year-old client is receiving IV heparin 5,000 units qh. An activated thromboplastin time (aPTT) is drawn 1 hour before the 8:00 AM dose; the aPTT is at 3.5 times the control value. What would be the most appropriate action?

Hold the dose and call the result to the physician.

A 91-year-old patient, who is being prepared for discharge, has been prescribed the diuretic spironolactone. While teaching the patient about the drug, what major adverse effect should the nurse be sure to mention?

Hyperkalemia

A patient has been prescribed a monoamine oxidase inhibitor (MAOI) by the physician. Before administration of the drug, the patient wants to know the adverse reactions of the drug. What is an adverse reaction to the drug?

Hypertensive crisis

The physician has ordered a change of prescription from rapid-acting insulin to an intermediate-acting type. Which adverse effect must the nurse closely monitor for in the patient?

Hypoglycemia

Which electrolyte imbalance can precipitate digoxin toxicity?

Hypokalemia

A nurse is caring for a 59-year-old client who has been prescribed nitroglycerin to control angina. Which adverse effect might the nurse observe in this patient?

Hypotension

The nurse should be cautious and closely monitor clients receiving phenytoin (Dilantin) with which medical conditions? (Select all that apply.)

Hypotension Hepatic impairment

A client has a serum lithium level of 2.2 mEq/L. The nurse should expect to assess what symptoms? Select all that apply.

Hypotension Hyperreflexia Seizures

An 85-year-old client has been diagnosed with a drug-resistant urinary tract infection. The client has been started on a regimen of aminoglycosides. The client is concerned about adverse reactions such as nephrotoxicity. When providing client education about the medication, the nurse would state:

If nephrotoxicity occurs, it is usually reversible if the drug is stopped.

A school-aged child has been diagnosed with a seizure disorder and phenytoin (Dilantin) has been prescribed . What nursing diagnosis would be most appropriate if the child demonstrated adverse effects to the drug related to cellular toxicity?

Impaired skin integrity related to dermatological effects

The nurse is caring for a patient who is receiving an aminoglycoside. What would be a priority assessment on this patient?

Impairment of balance

Diabetic retinopathy is a disorder diabetics develop as a result of a thickening of the basement membrane. What is this caused by?

Inability of oxygen to diffuse across vessel membrane to tissues in the eye

An ED patient presents with dyspnea, tachycardia, and chest pain. The patient has a history of cardiomyopathy. The nursing assessment reveals hypotension with an apical pulse of 134 bpm. What would the nurse conclude might be causing the symptoms?

Inadequate cardiac output

A client with symptomatic bradycardia has been receiving atropine for the past 4 days. The client reports constipation, a common adverse effect of the drug. What is the most important suggestion the nurse could give the client?

Increase bulk in the diet.

What are cardiac glycosides used for?

Increase the force of the contraction of the heart

The pharmacology instructor points out that the use of anti-psychotic drugs perioperatively has very real risks. What is a risk of using anti-psychotic medications during a surgical procedure?

Increased CNS activity

A physician has prescribed a loop diuretic for a patient with hypertension. The patient also has diabetes mellitus. What condition should the nurse monitor for in this patient after administering the prescribed drug?

Increased blood glucose levels

Adrenergic drugs produce which effect?

Increased heart rate

A client has been experiencing severe pain and is being treated with narcotics. What should the nurse include in the plan of care as a desirable and measurable outcome for this client?

Increased independence with AM care

A group of students are reviewing the adverse effects associated with loperamide. The students demonstrate a need for additional teaching when they identify what as an adverse effect?

Sedation

A patient suffers from depression and states feelings of gloom and inability to perform the activities of daily living. What neurotransmission is decreased?

Serotonin

The nurse teaches the client with coronary artery disease to avoid which activity?

Shoveling snow

A patient reports chronic abdominal pain. The patient has a 40-pack year history but reports a decrease in smoking to approximately ½ pack/day. The physician, after thorough assessment and evaluation and labs, prescribes a treatment regimen for duodenal ulcer. What important teaching would the nurse include in relation to treatment?

Smoking's effects on healing

A nurse caring for a client receiving clozapine (Clozaril) needs to be mindful of the symptoms that indicate bone marrow suppression as agranulocytosis has been associated with the use of clozapine. Which of the following are symptoms of bone marrow suppression? Select all that apply:

Sore throat Fever Chills Weakness

Which herbal product should a nurse specifically question patients about due to the potential for adverse reactions when taken with antidepressants?

St. John's wort

A patient has been taking phenytoin (Dilantin) for a seizure disorder. The client has recently run out of medication and has not obtained a refill. What is the patient at risk for developing?

Status epilepticus

A hospice patient is receiving opioids for treatment of cancer pain. Which laxative will assist in the prevention of constipation?

Stimulant

The nursing students are studying sympathomimetic drugs. How do these drugs act on the body?

Stimulate both alpha and beta receptors.

A patient who is using a topical antifungal agent for a mycosis calls the clinic to report a severe rash that is accompanied by blisters. What will the nurse instruct the patient to do?

Stop using the drug immediately

Enoxaparin (Lovenox) should be administered via which route?

Subcutaneous injection

A graduate of a nursing program is scheduled to take the NCLEX today. The test-taker's heart is racing and pupils are dilated. What can the test-taker attribute to this reaction?

Sympathetic nervous system

The adrenergic branch of the autonomic nervous system is also known by which name?

Sympathetic nervous system

A nurse is monitoring the vital signs of a patient who has been administered epinephrine. Which of the readings should nurse report immediately to the primary health care provider?

Systolic blood pressure below 100 mm Hg

The nurse caring for a 38-year-old patient started on albuterol (Proventil) should advise the patient that the patient may experience what adverse effect?

Tachycardia

A patient with congestive heart failure has been digitalized. The patient requires long-term digoxin therapy. Which instructions should the nurse provide the patient on discharge?

Take the drug regularly without skipping a dose.

A nurse is charting a client who has repetitive tongue thrusting, jaw movements, and a facial tick. What term could the nurse use in charting to describe these findings?

Tardive dyskinesia

A nurse observes rhythmic, involuntary facial movements in a patient who has been administered antipsychotic drugs. The patient also makes chewing movements and, at times, his tongue protrudes. What is the most likely reason for the patient's behavior?

Tardive dyskinesia

Ms. Main is sent home with subcutaneous heparin after a total hip replacement. What symptom would indicate a serious drug reaction?

Tarry stools

After reviewing the various classifications of antibiotics, a group of students demonstrate understanding of the material when they identify which drug as being structurally related to the macrolides?

Telithromycin

The nurse is caring for a 6-year-old child who has pyelonephritis. The use of what group of antibiotics would be contraindicated due to the client's age?

Tetracyclines

A 79-year-old male client is brought to the emergency department by his family because he is "talking to people who aren't there." During the initial admission assessment, his daughter mentions that her mother died 4 months ago and "Dad just hasn't been the same. The doctor has even put him on antidepressant medication. I go by the house every day to make sure he takes his medication." What would the nurse suspect is happening to this client?

The client is having hallucinations as an adverse effect of antidepressant therapy

The nurse is caring for a client who is taking lithium for the treatment of bipolar disorder. The client's most recent laboratory findings reveal a serum lithium level of 1.4 mEq/L. What assessment findings should the nurse attribute to the client's lithium level?

The client is lethargic and weak

While assessing clients receiving opioid analgesics for pain management, what would require health care provider notification?

The client with a pulse of 118, a respiratory rate of 8, and a BP of 80/60

Your client was given tetracycline as a young child. You can tell this by changes in:

The color of her teeth.

After teaching a group of students about inhaled steroids, the instructor determines that the teaching was successful when the students state:

The drugs are not for use during an acute attack.

A 78-year-old female patient who is about to begin home care has been prescribed anticholinergic drugs. What should the home care nurse explain to the patient and her family?

The effects of anticholinergic drugs include decreased gastrointestinal motility, decreased sweat production, and blurred vision. These effects put the older adult at increased risk of constipation, heat stroke, and falls. The risk of constipation can be reduced by increasing fiber and fluids in the diet. The risk of falls can be reduced by assisting the patient during ambulation.

Why are selective serotonin reuptake inhibitors considered the first line of drug therapy for patients with depression?

The medications have fewer anticholinergic effects than alternatives.

The nurse is discussing diabetes with a group of individuals who are at risk for the disease. Which statement by a participant indicates an understanding of the role of insulin in the disease?

"Insulin assists glucose molecules to enter the cells of muscle and fat tissues."

A patient with myoclonic seizures has been prescribed clonazepam as an adjunctive treatment by the neurologist. What teaching point should the nurse prioritize when explaining this new drug regimen to the patient?

"Make sure you don't stop taking this abruptly because that might bring on a seizure."

The nurse should not administer tetracyclines with which of the following? Select all that apply.

- cheese - tums - peri-colace - feosol

The nurse has just completed discharge instructions to a client who will be using a pen device to deliver his insulin dose. What statement by the client indicates a need for further instruction?

"If I forget to take my insulin pen, I will be able to use the one that my wife uses."

A patient with a longstanding diagnosis of chronic renal failure has experienced a significant decline in urine output in recent days, prompting him to seek care at a local clinic. A nurse at the clinic has suggested to a colleague that the administration of a diuretic such as hydrochlorothiazide may improve the patient's urine output. How should the colleague best respond to this suggestion?

"Actually, patients with renal failure usually can't take hydrochlorothiazide."

The wife of a patient who is taking haloperidol calls the clinic and reports that her husband has taken the first dose of the drug and it is not having a therapeutic effect. An appropriate response by the nurse would be:

"Continue the prescribed dose. It may take several days to work."

A nurse is providing patient education to a 13-year-old girl who was just diagnosed with type 1 diabetes mellitus. Which statement by the patient will alert the nurse that special instructions regarding insulin are necessary?

"I am on the middle school track team."

A nurse is caring for a 55-year-old client who is receiving sustained-release metoprolol. What statement by the patient would lead the nurse to believe that the client needs additional instruction?

"I can take any over-the-counter pain reliever while on metoprolol."

Which statement by a 54-year-old client indicates an understanding of how to take sublingual nitroglycerin?

"I can take up to 3 tablets at 5-minute intervals."

The health care provider has prescribed alprazolam (Xanax) for a client. The nurse confirms that the client understands the drug's action when the client makes which statement?

"I may be a little drowsy at first when I start taking this medication."

An older client is taking an anticholinergic agent. After teaching the client about the drug, which client statement indicates the need for additional teaching?

"I need to exercise frequently outside in the warm weather."

The nurse has provided teaching for a patient who has a new order for nadolol (Corgard) to treat their hypertension. What statement by the patient concerning nadolol (Corgard) would indicate that the teaching has been effective?

"I should never stop taking this drug abruptly, but will taper the doses gradually."

A nurse is caring for a patient who is taking metoprolol (Lopressor). Which statement would indicate that teaching by the nurse concerning the beta-adrenergic antagonist has been effective?

"I should never stop taking this drug abruptly."

A patient is instructed to take diphenhydramine (Benadryl) after an allergic reaction. Which statement by the patient indicates successful teaching concerning the administration of diphenhydramine (Benadryl)?

"I should not drive my car after taking this medication."

Ms. Kime is prescribed ranitidine in addition to the antacid that she already takes for gastric reflux. Which statement made by the patient indicates that she understood the teaching provided about taking these medications?

"I should take ranitidine 2 hours before or after my antacid dosage."

A patient is discharged from the hospital with a prescription of warfarin (Coumadin). Which statement indicates successful patient teaching?

"I will avoid herbal remedies."

The nurse is teaching a 62-year-old patient about hydrochlorothiazide, which the physician has prescribed for treatment of hypertension. What statement, made by the patient, suggests that the patient understands the teaching?

"I will need to stand slowly."

A male client has been ordered spironolactone (Aldactone) for hypertension. Which statement by the client indicates a need for further education?

"I will take the medication when my blood pressure is elevated."

A family member asks the nurse if his relative, who is taking prochlorperazine for schizophrenia, can go on a beach vacation. What is one point of education that the nurse would make sure the client and family understand?

"Prochlorperazine can make you very sensitive to light. Make sure you wear sunscreen and cover up as much as possible to prevent sunburn."

A nurse is caring for a client who has been diagnosed with HIV. The client tells the nurse that he is considering supplementing his antiretroviral drug therapy with an herbal regimen that he read about recently. What should the nurse say in response?

"Some herbal supplements could interfere with your medication, so talk with your physician first."

A female client is crying and states that everyone thinks she is a "drug seeker," and that no one will listen to her. She states she is not an addict, but she has abdominal pain and must have something to make the pain subside. What is the best response of the nurse?

"Tell me more about your pain." - Nurses must lessen the barriers to good pain management by showing sensitivity to the client and conducting a through assessment. The nurse needs to encourage the client to share information regarding pain so that an appropriate treatment plan can be designed. Nurses must demonstrate nonjudgmental attitudes with clients.

A 72-year-old female client is admitted to the hospital for surgery. After the patient returns to the floor, the patient's daughter tells the nurse she is concerned that her mother will overdose on morphine because she keeps pressing the button on her PCA pump. What would be the nurse's best response?

"The device is preset, so your mother cannot get more than a specific amount."

A nurse is teaching a patient who has just been prescribed lansoprazole (Prevacid). What statement would indicate that the patient correctly understands the action of this medication?

"The medication inhibits acid secretions."

A patient, newly diagnosed with COPD, calls the clinic and asks the nurse why the patient has to take the medication if their lungs don't work right. What would be an appropriate response by the nurse?

"The medication that has been ordered for you is to help relieve the inflammation and promote dilation of the bronchi."

An 86-year-old client who was admitted earlier in the week with thrombophlebitis is being sent home on enoxaparin. Which statement by the client suggests that he understands proper management of his condition and proper use of the drug?

"The medication will increase my risk of bleeding."

A 42-year-old male client is prescribed glargine insulin for management of his type 2 diabetes mellitus. The nurse caring for the client develops a teaching plan regarding glargine insulin therapy. Which statement made by the client indicates that the client needs additional teaching?

"The medication will peak in 3 hours."

A patient has been diagnosed with depression. The physician has ordered sertraline. The patient asks, "How soon will it be until I feel better?" What would be the best response?

"The medication will start to work in as soon as 10 days, but it may take up to 4 weeks to be fully effective."

A physician has prescribed an antidepressant medication for a 15-year-old female patient. Which statement would be appropriate for inclusion in patient teaching?

"There may be an increased risk of suicide while taking this drug."

A 70-year-old woman has experienced peripheral edema and decreasing stamina in recent months and has sought care from her primary care provider. The patient's subsequent diagnostic workup has resulted in a diagnosis of chronic heart failure. The woman has been prescribed digoxin and the nurse has begun patient education. What should the nurse teach the patient about her new medication?

"This drug won't cure your disease, but it will help you be able to exercise more and be more comfortable."

A 50-year-old female patient received atropine and meperidine (Demerol) preoperatively. After surgery, the patient reports mouth dryness. What would be the best response to the patient?

"This is caused by your preoperative medication, which decreased your saliva. It is only temporary and will improve."

The nurse is teaching a 61-year-old client about the narcotic antitussive syrup that the physician has prescribed. Which client statement suggests that the client understands what the nurse has taught?

"This medication might cause drowsiness, so I will avoid driving while I use it."

One week ago, a client began taking ethosuximide (Zarontin) 500 mg/day PO for the treatment of absence seizures. The client reports gastrointestinal (GI) upset after taking with the drug. What health education should the nurse provide?

"Try taking your pills at the same time as you eat some food."

What instructions should a nurse include when teaching a client who has depression about the use of amitriptyline?

"Use sugarless hard candies and gum to deal with dry mouth."

A female patient is being administered heparin IV and has been started on warfarin (Coumadin). The patient asks the nurse why she is taking both medications. What is the nurse's most accurate response?

"Warfarin takes 3-5 days to develop anticoagulant effects, and you still need heparin."

A patient is switched from furosemide (Lasix) to spironolactone (Aldactone). The patient asks the nurse why she has been switched to a new medicine. What is the best answer that will provide patient education regarding the change?

"You will lose less potassium with spironolactone than with furosemide."

When developing the teaching plan for a patient receiving an antihistamine, which would the nurse include? (Select all that apply.)

- Advising the patient to avoid alcohol consumption - Using sugarless candies or lozenges to combat dry mouth

Anxiolytic drugs can be used in the management of which conditions? (Select all that apply.)

- Alcohol withdrawal - seizures - panic attacks

Which are examples of benzodiazepine antianxiety drugs? (Select all that apply.)

- Alprazolam (Xanax) - Chlordiazepoxide (Librium) - Lorazepam (Ativan)

Which of the following statements are true in regards to anticoagulants? Select all that apply:

- Anticoagulants prevent formation of a thrombus. - Anticoagulants prevent extension of a thrombus.

To decrease the risk of injury to a client taking an opioid, what should the nurse do? (Select all that apply.)

- Assist client from their bed to the toilet. - Assist client with rising from a lying position. - Assist client with hall-walking activities.

The nurse is providing discharge instructions to a client who has just been diagnosed with type 1 diabetes. What instructions are most important for the client to follow related to diet? (Select all that apply.)

- Avoid drinking beer, wine, or liquor. - Use artificial sweeteners instead of sugar in tea and coffee. - Read food labels carefully to look for hidden sources of sugar.

What are the most important physical assessments for a nurse to perform when admitting a client diagnosed with elevated blood pressure due to anxiety? (Select all that apply.)

- BP - Respiratory rate - Skin temperature and color

A nurse caring for a client in the hospital is being discharged today with a prescription for benzonatate (Tessalon Perles) 200 mg one capsule 3 times daily. What would the nurse tell the patient about this prescription during discharge counseling? (Select all that apply.)

- Benzonatate can cause GI upset and sedation. - The patient should drink plenty fluids.

Which of the following antacids may produce constipation and should be used cautiously in clients that have chronic constipation? Select all that apply:

- Calcium carbonate (Mylanta) - Aluminum hydroxide (ALternaGEL)

What reduces the secretion of gastric acid by inhibition of the hydrogen-potassium adenosine triphosphate (ATPase) enzyme system of the gastric parietal cells? (Select all that apply.)

- Esomeprazole (Nexium) - Lansoprazole (Prevacid)

What are examples of nonbenzodiazepine-type hypnotic and sedative drugs? (Select all that apply.)

- Eszopiclone (Lunesta) - Zolpidem (Ambien) - Zaleplon (Sonata)

A nurse monitoring a client taking penicillin should be aware of the common GI tract adverse reactions, including which of the following? Select all that apply.

- Glossitis - Stomatitis - Diarrhea - Gastritis

What does the use of cardiotonics lead to? (Select all that apply.)

- Improved myocardial contractility - Increased myocardial efficiency - Improved perfusion to all body tissues

The nurse admits a client who has been diagnosed with diabetic ketoacidosis, and will look for what assessment findings consistent with this diagnosis? (Select all that apply.)

- Ketones in the urine - flushed, dry skin

During an assessment, the nurse notes respiratory depression in a client receiving an opioid medication for pain. Which of the following actions should the nurse perform next? Select all that apply.

- Make an effort to arouse the patient to change his breathing pattern if possible. - Review the medical record for which drug could be causing the symptom. - Review the allergy and health histories and current treatment modalities.

What symptoms should lead the nurse to suspect that a client receiving a cefuroxime ingested alcohol during treatment? Select all that apply.

- chest pain - throbbing headache - dyspnea

The nurse is working with a chronically ill client who is being administered opioid analgesics for pain management. While caring for this client, the nurse needs to keep which of the following in mind? Select all that apply.

- Morphine sulfate (MS Contin) is the most widely used medication for management of chronic severe pain. - Administering naloxone (Narcan) to clients to increase respiratory rate may lead to the client experiencing intense pain and/or withdrawal symptoms. - Tolerance to the medication may develop quickly, requiring larger doses to achieve the same level of pain control. - Respiratory depression rarely occurs.

The nurse should include which client teaching points when discussing the use of sedatives or hypnotics, and interactions with other drugs? (Select all that apply.)

- Opioid analgesics should be used cautiously. - Alcohol use can increase sedative effects.

What are situations in which the nurse would hold the drug and notify the physician? (Select all that apply.)

- PT exceeds 1.5 times the control value - There is evidence of bleeding - INR is greater than 3.0

The nursing instructor is discussing the indications for using heparin with the students. What are the indications for using heparin? (Mark all that apply.)

- Prevention and treatment of pulmonary emboli - Treatment of atrial fibrillation with embolization - Prevention and treatment of venous thrombosis - Diagnosis and treatment of DIC

Cephalosporins should be used cautiously in clients with which of the following? Select all that apply.

- Renal disease - Hepatic impairment - Bleeding disorder - Known penicillin allergy

A febrile client is ordered to receive sulfonamide therapy for an infection. The nurse needs to evaluate the client for what during the course of therapy? Select all that apply.

- Response to drug therapy - Occurrence of adverse reactions - Decrease in temperature

What should the nurse tell the client about storage of oral nitroglycerin products? (Select all that apply.)

- Store oral nitroglycerin in the original container. - Store oral nitroglycerin with the container lid tightly sealed. - Store oral nitroglycerin away from light exposure.

When focusing on the lifestyle of the patient with HIV, what are important teaching considerations? (Select all that apply.)

- Take drug therapy as prescribed. - Transmission can occur while on medication. - Advise the patient about the adverse effect of granulocytopenia.

Fluconazole is the prototype for antifungals. Which are characteristics of fluconazole? (Select all that apply.)

- Treatment of oropharyngeal, esophageal, and vaginal candidiasis - Binds to sterols in the fungal cell membrane - Metabolized in the liver and excreted in the urine

Fluoroquinolones are primarily used to treat which of the following infections? Select all that apply.

- Urinary tract infections - Sexually transmitted infections - Bone and joint infections - Skin infections

The drugs used to treat systemic fungal infections can be toxic to the host and are not used indiscriminately. Which client would the nurse be especially cautious with if an antifungal agent was ordered? Select all that apply.

- a 4-year-old diagnosed with thrush - a newly admitted client with suspected fungal infection - a 56-year-old with cirrhosis

Amphotericin B is a very potent drug with many unpleasant adverse effects. For which clients would the nurse question a doctor's order for amphotercicn B? Select all that apply.

- a 65-year-old patient with diabetes on dialysis - a 22-year-old with cancer undergoing chemotherapy - a 46-year-old woman with a BMI of 16 - a 66-year-old man with the labs of K 3.4, Na 135, and Mg 2.0

Drugs to treat systemic fungal infections can be toxic to the host and are not used indiscriminately. Which are factors considered before an antifungal is prescribed? (Select all that apply.)

- age of client - was a culture obtained - hepatic function

A 5-year-old boy is brought to the ED with an asthma exacerbation, including wheezing (a high-pitched, whistling sound caused by turbulent airflow through an obstructed airway). Those who have asthma chronically present with what signs, even when they may appear symptom free? (Select all that apply.)

- airway inflammation - damaged airway mucosa

What represents the two types of receptors that are found in the adrenergic nervous system? Select all that apply.

- alpha receptors - beta receptors

Which of the following represents the categories of drugs used to treat viral infection? (Select all that apply.)

- antiretroviral - antiviral

The nurse explains to the client that with heart failure, the client may experience which symptom? (Select all that apply.)

- anxiety - weakness - fatigue - SOB

Which would the nurse include as possible adverse effects when teaching a patient about albuterol? (Select all that apply.)

- bronchospasm - nervousness - sweating

Which dosage forms are used for digoxin (Lanoxin) maintenance therapy? (Select all that apply.)

- capsule - injection - tablet

The nurse should complete which of the following during acute breathing distress before initiation of a broncodilator? Select all that apply:

- check bp - check pulse - check respiratory rate

A 42-year-old woman with a systemic fungal infection is admitted to the hospital. The nurse practitioner prescribes ketoconazole. The nurse preparing to administer this medication understands that azole antifungals require caution under certain conditions. To which patient would the nurse be especially cautious about administering this drug? Select all that apply.

- client with hepatic dysfunction - a pregnant woman with a history of headaches

There are two types of antitussives, centrally acting and peripherally acting. Which are centrally acting antitussives? (Select all that apply.)

- codeine - dextromethorphan

The nurse is preparing a teaching plan for a patient who is receiving sucralfate. Which would the nurse need to address? (Select all that apply.)

- eating a high fiber diet - ensuring safety precautions - taking the drug on an empty stomach - encouraging frequent mouth care

A 27-year-old athlete with newly diagnosed asthma presents for patient education regarding situations that could precipitate an asthma attack. The nurse teaches that acute episodes of asthma may last minutes to hours. In this teaching, which precipitants would the nurse state may cause the asthma? (Select all that apply.)

- exercise - allergens - pollutants

When caring for an older adult client taking an antacid, the nurse should institute which safety precautions? Select all that apply.

- fall risk - bed alarm - strict intake and output

What symptoms might a nurse observe in a client having a disulfiram-like reaction with administration of a cephalosporin and alcohol? Select all that apply.

- flushing - respiratory difficulty - vomiting - sweating

What is an indication for the use of antacids? (Mark all that apply.)

- gastric hyperacidity - gastritis - peptic esophagitis - hiatal hernia

During ongoing assessment of clients receiving insulin detemir (Levemir), the nurse assesses the client for symptoms of hypoglycemia that include which symptoms? (Select all that apply.)

- headache - confusion - diaphoresis

The home health nurse is visiting with a client who has been prescribed diphenoxylate with atropine (Lomotil) for chronic diarrhea. Which of the following adverse effects should the nurse be aware of when assessing the client's present condition? Select all that apply.

- headache - urinary retention

When teaching a patient to use a dry powder inhaler, which of the following is true? Select all that apply:

- hold breath for 10 seconds - inhale quickly

When caring for a client receiving amphotericin B, the nurse includes what assessments in the plan of care? Select all that apply.

- liver function - renal function - orientation - reflexes

What should be observed during ongoing assessment of a client taking an antitussive? (Select all that apply.)

- lung sounds - frequency of cough - therapeutic effect - pain assessment

While administering aminoglycosides to clients, the nurse must be aware of what toxicities that can result from their use? (Select all that apply.)

- nephrotoxicity - ototoxicity - neurotoxicity

Decongestants are available in which dosage forms? (Select all that apply.)

- oral tablets - nasal sprays - nasal drops

An opioid antagonist will reverse which opioid effects? (Select all that apply.)

- respiratory depression - constipation - analgesia - hypotension - bradycardia

Which of the drug-specific nursing diagnoses may be used in the administration of a cephalosporin? (Select all that apply.)

- risk for impaired comfort - risk for impaired skin integrity - diarrhea - impaired urinary elimination

What are sedatives and hypnotics used to treat? (Select all that apply.)

- status epilepticus - preoperative sedation - insomnia

Cardiotonic drugs are used to treat which medical condition? (Select all that apply)

-HF and A fib

When administering narcotics to clients, the nurse must monitor for which side effects?

constipation

AT 1030, the nurse administers morphine 5 mg IV as prescribed for a client in pain. The nurse should expect to assess for the drug's maximum effect at what time?

1040

The nurse instructs a patient who is using albuterol for exercise-induced bronchospasm to use the inhaler at which time?

15 minutes prior to exercising

Unwanted anticholinergic effects include:

constipation and dry mouth.

A patient is receiving digoxin. The nurse monitors the patient's digoxin level. Which finding would the nurse interpret as therapeutic?

1.5 ng/mL

A physician has prescribed sublingual nitroglycerin and the nitroglycerin patch for a client. When the nurse explains the medications to the client, what advantage of the patch might the nurse mention?

It has a longer duration of action than sublingual tablets.

The nurse should counsel a patient to discontinue use of over-the-counter antidiarrheals and seek treatment from a physician if diarrhea persists for how long?

2 days

A patient has edema of the lower extremities with crackles in the lung bases. The patient is prescribed furosemide 40 mg two times per day orally. What is the recommended weight loss per day?

2 pounds per day

Recovering from laxative abuse takes time and patience. After using laxatives to stimulate defecation, approximately how long will it take for the fecal column to re-establish with normal food intake?

2 to 3 days

A 60-year-old patient with rheumatoid arthritis visits the health care facility for a regular checkup. The patient informs the nurse that the patient has been using an over-the-counter NSAID for the last few days. Why should the nurse caution the patient against the use of NSAIDs on a long-term basis?

Increased risk of GI bleeding

Ms. Law has been taking omeprazole for the last 10 years. What is the risk to the patient from long-term use of omeprazole?

Increased risk of gastric cancer

A patient is administered epinephrine in conjunction with a local anesthetic. What effect will epinephrine produce?

Increased vasoconstrictive effects

When preparing to administer an insulin injection, the nurse would use which sized needle?

25 gauge, ½ inch

A client may administer a maximum of how many doses of sublingual nitroglycerin in a 15-minute period?

3

Which would be appropriate to include in teaching a client with type 2 diabetes?

It is possible with weight loss and exercise to discontinue the use of antidiabetic medication.

After teaching a class about the various drugs used to control blood glucose, the instructor determines that the teaching was successful when the class identifies what as a biguanide?

Metformin

A patient is taking nonsteroidal anti-inflammatory agents for arthritis of the knees and hips. Which disease is a result of cellular destruction of the gastrointestinal tract from this medication?

Peptic ulcer disease

A child is prescribed an inhaled corticosteroid agent to decrease respiratory inflammation related to exposure to an animal. The patient's parent administers high doses of the therapy after 2 days of administration. What is the patient at risk for?

Adrenal insufficiency

Your 55-year-old patient is receiving both digoxin (Lanoxin) and potassium supplements along with hydrochlorothiazide. When monitoring daily laboratory values, you know it is important for your patient to maintain which serum potassium level?

3.5-5.0 mEq/L

The nurse assesses a patient's blood glucose level after administering insulin. Which result would the nurse interpret as indicative of severe hypoglycemia?

34 mg/dL

When a patient is started on an antidepressant, it is important for the nurse to explain to the patient that it may take time to see a change in mood, but that adverse reaction may occur soon after initiation of therapy. How long can it take for the patient to see the beneficial effects of an antidepressant?

4 weeks

A male patient calls the clinic because he is concerned about his pulse rate. The patient is taking digoxin. The nurse would tell the patient to hold the medication if he reports a pulse rate of:

52 beats/minute.

A nurse is caring for a patient receiving digoxin for ventricular arrhythmia. Which apical pulse rate indicates that the nurse should withhold the drug and report to the health care provider immediately?

58 beats/minute

The nurse on a psychiatric unit contributes to the care of many clients, most of whom have physical as well as psychiatric health problems. For which client would clozapine (Clozaril) most likely be contraindicated?

45-year-old with bone marrow suppression

A patient receives furosemide intravenously at 9 AM. The nurse would expect to assess peak effects of the drug at which time?

9:30 AM

Heparin therapy is prescribed to a patient with deep vein thrombosis. Which patient would be at greatest risk of bleeding from this therapy?

A 45-year-old corporate executive with peptic ulcer disease

Which patient should be advised by the nurse to avoid over-the-counter cold and allergy preparations that contain phenylephrine?

A 47-year-old female with hypertension

In which patients should the nurse question the physician's order for IV morphine?

A 78-year-old female with osteoarthritis

Mr. Tan is a 69-year-old man who prides himself in maintaining an active lifestyle and a healthy diet that includes adequate fluid intake. However, Mr. Tan states that he has experienced occasional constipation in recent months. What remedy should be the nurse's first suggestion?

A bulk-forming (fiber) laxative

The nurse is providing care on an inpatient psychiatric unit. Which adult client should the nurse monitor most closely for signs of adverse drug effects?

A client who is taking phenelzine (Nardil)

A client tells the nurse that the client recently started on SSRIs for the treatment of depression. The client asks if there are any side effects to the SSRIs. The nurse should inform the client to watch for the following adverse effects:

A high incidence of nausea, diarrhea, and weight loss, as well as anxiety, nervousness, and insomnia.

A school-aged child is brought to the clinic by her parents. The parents state that the child will be engaged in some activity at home and then will just stop suddenly for a few seconds and then pick up the activity again as if there had been no break in what she was doing. This child should be assessed for what neurological disorder?

Absence seizures

What is the substance responsible for transmission of nerve impulses across the parasympathetic nervous system?

Acetylcholine

A patient is taking a nonsteroidal anti-inflammatory agent. Which instruction should the patient be given in regards to administration?

Administer medication with food - To prevent gastrointestinal irritation, instruct the patient to administer the medication with food. The administration of an NSAID with orange juice will increase gastric acid and not protect the gastric mucosa. Crushing enteric-coated tablets will eliminate the protection of the gastric mucosa. Nonsteroidal anti-inflammatory agents administered every other day will not protect the patient from gastric irritation.

A patient's GI discomfort is prescribed antacids. Nursing interventions associated with this prescription should include:

Administer the antacid 1 hour before or 2 hours after other oral medications.

A nurse is caring for a patient with acute renal failure. The physician has prescribed a diuretic therapy for the patient to promote dieresis. What intervention should the nurse perform to prevent the inconvenience caused by increased urination?

Administer the drug early in the day.

When would it be desirable to give your patient a laxative? (Mark all that apply.)

After having a baby After an MI After anthelmintic therapy

A client is diagnosed with depression and prescribed sertraline (Zoloft) on an outpatient basis. The client should warn the client about what possible adverse effects ? Select all that apply.

Agitation Insomnia Dry mouth

The parents of a 7-year-old boy who has just been diagnosed with allergic asthma are being taught about their son's medication regimen by the nurse. The nurse is currently teaching the parent's about the appropriate use of a "rescue drug" for acute exacerbations of their son's asthma. What drug should the nurse suggests the parents to use in these situations?

Albuterol

The asthmatic client is being treated with two inhalers, albuterol and flunisolide. The nurse teaches the client that the two medications should be administered in what order?

Albuterol first, wait five minutes and then follow with flunisolide

The nurse knows that benzodiazepines such as lorazepam should not be administered in combination with this because of the potential for respiratory depression and hypotension? (Select all that apply.)

Alcohol Codeine Barbiturates

When the nurse is engaging in patient teaching with patients taking anti-psychotic medications and their families, what would be important to include to decrease adverse effects of the medication?

Alcohol should be avoided.

Bismuth salicylate (Pepto-Bismol) is contraindicated in clients with which of the following conditions?

Allergy to aspirin

Anticoagulant drugs prevent thromboembolic disorders. How does warfarin, one of the anticoagulant drugs, act on the body?

Alters vitamin K, reducing its ability to participate in the coagulation of the blood

What client is being treated with a typical antipsychotic?

An agitated client who was given haloperidol during acute psychosis

Venlafaxine (Effexor) is an antidepressant that has become more popular with adults in treating their depression. Why has it become more popular?

An extended release form is available.

A patient is brought to the Emergency Department (ED) and is found to have cholinergic toxicity. What is the drug of choice to treat this condition?

Atropine

A patient is admitted to the emergency room after a car accident. Based on the experience of the emergency room nurse, what system will affect a response to the emergency?

Autonomic nervous system

A patient taking anticholinergic drugs should be taught to minimize the risks of heat exhaustion and heat stroke. What would be one way to meet this goal?

Avoid extremes of temperature

A nurse is assigned to administer glargine to a patient at a health care facility. What precaution should the nurse take when administering glargine?

Avoid mixing glargine with other insulin.

A female client is diagnosed with type 1 diabetes. She suddenly reports feeling weak, shaky, and dizzy. What should the nurse's first response be?

Perform a blood sugar analysis.

A 25-year-old client arrives at the walk-in clinic reporting vomiting and a burning sensation in the midepigastric region. The nurse suspects that the client has peptic ulcer disease. Which is a potential cause of peptic ulcer disease?

Infection with H. pylori

A patient is taking spironolactone (Aldactone). When providing patient teaching about this medication, what foods should the patient be instructed to avoid?

Bananas

A client experiencing psychosis is admitted through the emergency department and administered chlorpromazine (Thorazine) 25 mg intramuscularly. After administration of the medication, what is the nurse's priority assessment?

Behavior and cognition

The anatomy and physiology instructor is discussing adrenergic receptors with the nursing class. What adrenergic receptor would the instructor tell the students is found in the heart and can stimulate increased myocardial activity and increase heart rate?

Beta1

A patient is experiencing an acute asthma attack. What is the first-line therapy for relief of an acute asthma attack?

Beta2-adrenergic agonist

A patient receives a dose of insulin lispro at 8 AM. The nurse would be alert for signs and symptoms of hypoglycemia at which time?

Between 8:30 AM and 9:30 AM

A nurse is caring for a client with cancer regularly administered opioids. The client tells you she needs a laxative. What would be the best laxative?

Bisacodyl

A physician prescribes a chemical stimulant laxative. Which would be appropriate?

Bisacodyl

A female patient who takes ethosuximide for the treatment of absence seizures calls the clinic to report that she has developed a sore throat and a slight fever. The nurse will explain that she should come to the clinic to have what checked?

Blood cell count

What should the nurse's pre-administration assessment for a client receiving a sedative or hypnotic include? (Select all that apply.)

Blood pressure Pulse Respiratory rate

The client receiving propranolol (Inderal) at home for management of a ventricular dysrhythmia should monitor which parameter?

Blood pressure daily

Which assessment finding in a patient receiving cholinergic agonists warrants immediate action by the nurse?

Blood pressure decreased from 110/90 mm Hg to 80/50 mm Hg

A nurse educating a client and their family about ethosuximide (Zarontin) should tell them to notify the physician if which adverse reaction occurs? (Select all that apply.)

Blurred vision Joint pain Bruising

What sign is most indicative of dehydration in a patient taking diuretics?

Body weight

A nurse administering valproic acid (Depakote) to a client should monitor the client for increased effects and toxicity of valproic acid (Depakote) when which of the following medications are initiated? Select all that apply:

Cimetidine (Tagamet) Amitriptyline (Elavil)

An elderly patient is admitted to the medical floor with a fever, cough, sore throat, and stuffy nose. What virus should the nurse suspect this patient to have?

Influenza

Which intervention would be an appropriate part of a plan of care for a patient with a seizure disorder?

Informing the patient and family that seizure control is not gained immediately

A nurse is caring for a patient who is prescribed barbiturates. Which effects of barbiturates should the nurse monitor the patient for? (Select all that apply.)

CNS depression Mood alteration Hypnosis

A 71-year-old man with a history of heart disease and diabetes has had an antihistamine prescribed. The nurse is concerned with this prescription because of the risk for:

Cardiac arrhythmias

The nurse is caring for a patient who has been prescribed a chemical stimulant laxative. This medication may have either a slow, steady effect or may cause severe cramping and rapid evacuation of the contents of the large intestine. What drug would the nurse be teaching this patient about?

Cascara

A patient presents to the Emergency Department (ED) having an acute asthma attack. An ED physician has ordered a sympathomimetic (epinephrine). The nurse is aware that this classification of drug will what?

Cause dilation of the bronchi with increased rate and depth of respiration

Michael is 3 days postoperative from open heart surgery. He has not had a bowel movement since the day prior to surgery. The physician has ordered magnesium hydroxide. The nurse administering this medication knows that the drug acts by which mechanism?

Causing the retention of water in the intestinal lumen

An elderly client is treated for pneumonia with clindamycin (Cleocin). One week after the completion of the medication, the client develops diarrhea. What is the most probable cause of the diarrhea?

Change in normal flora

A 96-year-old client is receiving digoxin (Lanoxin) and furosemide (Lasix). In the morning, the client reports of a headache and nausea. What will the nurse do first?

Check the client's laboratory values and vital signs.

The nurse is caring for a patient who takes an antidysrhythmic. What would be a priority nursing action before administering this drug?

Check the patient's apical and radial pulses.

A patient with impaired renal function is to receive dofetilide (Tikosyn) for conversion of atrial fibrillation. Which should the nurse do before administering the drug?

Check the patient's creatinine level.

Administration of which classes of medications can decrease secretions of the upper respiratory tract?

Cholinergic blocking drug

The nurse explains to the client that NSAIDs act by which actions?

Inhibiting the synthesis of prostaglandins

The nurse is aware that premixed insulins (those that contain both regular and NPH insulin) are least effective in what type of client?

Client who has difficulty controlling his diabetes

Which of the following clients are at increased risk for the development of lithium toxicity? Select all that apply:

Clients receiving furosemide (Lasix) Clients experiencing diarrhea Clients with renal insufficiency Clients experiencing vomiting

What must be taken into consideration when an antibiotic is chosen?

Culture and sensitivity test results

A nurse is required to administer an anti-infective drug to a patient. The nurse knows that which of the following tests need to be conducted before administering the first dose of an anti-infective drug to the patient?

Culture tests

A 72-year-old female patient is being discharged home from the hospital on newly prescribed anticholinergic drugs. A referral to the home health nurse has been made. What should the home health nurse make sure the patient and caregivers know?

Do not drive or use machinery.

When teaching a patient on an MAO inhibitor, what would be important to include in the teaching?

Do not take OTC drugs.

A new mother had to have an episiotomy during the birth of her baby. Two days after delivery, the patient is in need of a laxative. What will the nurse administer?

Docusate (Colace)

The nurse is assessing a patient with glaucoma. What therapeutic effect will the health care provider expect from the cholinergic agonist administered?

Decreased intraocular pressure

A client for whom antiretroviral therapy has been prescribed informs the nurse that the client is taking oral contraceptives. What should the nurse inform the client is one of the effects of combining birth control pills with antiretroviral therapy?

Decreases effectiveness of birth control pills

A patient has been noncompliant with his diabetic medication regimen and develops diabetic ketoacidosis. Which would the nurse assess?

Deep respirations

A 45-year-old female client is being seen in the physician's office for a dry, hacking cough that is keeping her up at night. The physician prescribes dextromethorphan for the cough. Which statement is true about dextromethorphan?

Dextromethorphan works in the medulla to suppress the cough reflex.

A patient who experiences frequent constipation will use psyllium (Metamucil). The nurse knows which of the following are contraindications to psyllium? Select all that apply.

Difficulty swallowing Gastrointestinal obstruction Fecal impaction Undiagnosed abdominal pain

A client is being treated for hypokalemia. The client's current medications include Inderal, digoxin, and Coumadin. The client reports nausea, abdominal discomfort, and visual changes. Which problem would the nurse suspect?

Digitalis toxicity

What is given to treat a massive digoxin overdose?

Digoxin immune Fab (Digibind)

A patient has been prescribed digoxin (Lanoxin) and furosemide (Lasix) for treatment of congestive heart failure. What is the patient at risk for developing with this combination of medications?

Digoxin toxicity

A patient is diagnosed with acute supraventricular tachycardia. Which class IV calcium channel blocker is administered intravenously to treat acute supraventricular tachycardia?

Diltiazem (Cardizem)

The pharmacology instructor is discussing the various diuretic agents and their sites of action in the nephron. In what part of the nephron do thiazide diuretics act?

Distal tubule

A nurse has admitted a client with a systemic fungal infection to the unit. The client is started on fluconazole (Diflucan) IV. While writing the plan of care for this client, what would be an appropriate nursing diagnosis?

Disturbed sensory perception (kinesthetic) related to CNS effects

Diuretics increase the production and output of urine. Which statement helps explain how diuretics achieve these effects?

Diuretics reduce the reabsorption of water in the kidneys.

A nurse diabetes educator is planning an initial visit to a home care patient who was recently diagnosed with diabetes mellitus. Which skills would the nurse teach the patient to accomplish?

For most patients, the goal of diabetes education is self-care in terms of diet, exercise, medication administration, and blood glucose monitoring, as well as prevention, recognition, and treatment of complications. The nurse plays a significant role in patient education and training.

A diabetic patient has been admitted to the ICU with diabetic ketoacidosis. The family asks the nurse what the signs of ketoacidosis are. What would be the nurse's best response? (Mark all that apply.)

Fruity breath

An elderly patient with a history of congestive heart failure has been admitted to hospital with failure to thrive and admission blood work reveals a hemoglobin level of 6.9 g/dL. The care team has consequently administered two units of packed red blood cells, but auscultation of the client's lungs now reveals diffuse crackles. Administration of what drug is likely to resolve the patient's pulmonary edema?

Furosemide

Which is an example of a loop diuretic?

Furosemide (Lasix)

A nurse is caring for a patient who has self-administered large doses of ibuprofen for several consecutive days. The nurse should caution the patient that overuse of ibuprofen may cause:

GI bleeding - Adverse effects of ibuprofen and other nonsteroidal anti-inflammatory drugs include GI irritation, ulceration, and bleeding.

Tonic-clonic seizures and myoclonic seizures are classified as what type of seizures?

Generalized seizures

The client is currently receiving a continuous IV infusion of heparin. Which procedure should the nurse avoid when possible?

Giving intramuscular injections

Clients with what disorder should not be given anticholinergic drugs?

Glaucoma

A patient is brought to the Emergency Department (ED) with severe hypoglycemia. What drug would the nurse prepare to administer intravenously?

Glucagon (GlucaGen)

The nurse is caring for a 7-month-old infant who has been brought to the clinic by his mother. The mother reports that the baby has not had a bowel movement in 4 days. The nurse will recommend:

Glycerin (Sani-Supp)

A diabetic patient is taking regular and NPH insulin to manage his diabetes. What is the best evaluation tool to measure the overall patient response to the insulin therapy?

Glycosylated hemoglobin (HbAlc) levels

A female patient presents at the clinic with a dry, nonproductive cough. The patient is diagnosed with bronchitis, and it is determined that she will need help thinning sputum so that the cough can become productive. What does the nurse expect the physician will prescribe?

Guaifenesin

The nurse is caring for a client newly diagnosed with schizophrenia and whose medical history requires a typical antipsychotic. When explaining possible anticholinergic effects to the client, the nurse should address what potential problems related to these effects? Select all that apply.

Gum ulceration Constipation Urinary retention Blurred vision

A male patient is taking misoprostol (Tagamet). Which adverse effect is more likely to occur with cimetidine than with other histamine2 receptor antagonists?

Gynecomastia

A client taking an oral antifungal agent reports gastrointestinal upset. Which would be most appropriate to suggest?

Having the client take the drug with food

Jack Thomas is a 45-year-old automobile mechanic with a history of throat cancer. Jack has just undergone radical neck resection. As a result of the surgery, Jack suffers from xerostomia, a dry mouth condition. He is prescribed pilocarpine therapy. What advice should you give Jack regarding the drug therapy?

Jack should be cautioned about blurred vision and its hazards.

A male client presents to the emergency department reporting rapid heart rate, severe headache, and pounding in his chest. While obtaining his history, the nurse learns that the client stopped taking his medications because he ran out and didn't have funds to fill his prescriptions. The nurse knows that which medications being abruptly stopped could be causing his symptoms?

Labetalol

A clinic patient requires a laxative for the treatment of chronic constipation. The nurse knows that this patient has a history of congestive heart failure (CHF). What medication would this patient be a candidate for?

Lactulose (Chronulac)

A client, in the manic phase of bipolar disorder, is being discharged home on an antimanic drug. What antimanic drug will best provide long-term maintenance of the client's bipolar disorder?

Lamotrigine (Lamictal)

A patient receives 25 units of NPH insulin at 7 AM. At what time of day should the nurse advise the patient to be most alert for a potential hypoglycemic reaction?

Late afternoon

Which is a common cause of diarrhea in older adults?

Laxative overuse

A patient with impaired liver function is suffering from a seizure disorder, which is noted to consist of partial seizures. Which medication is administered to a patient with impaired liver function?

Levetiracetam (Keppra)

What assessment finding should lead the nurse to suspect that a client receiving antipsychotic therapy is developing tardive dyskinesia?

Lip smacking

An older adult client is prescribed an anti-infective agent. Which would the nurse need to keep in mind?

Liver and kidney function may be reduced, requiring cautious use.

A patient has an important presentation to make in 4 hours and needs relief from the congestion of seasonal rhinitis. The patient calls the nurse, explains the situation, and tells the nurse that he cannot afford to be drowsy. Which antihistamine would be a good choice this patient?

Loratadine (Claritin)

A patient diagnosed with schizophrenia is being seen by the home care nurse. What is the most important aspect of patient teaching with this patient?

Maintain medication regime

The nurse on the coronary unit is caring for a patient with known coronary artery disease who is being treated with cholestyramine (Questran) and hydrochlorothiazide (HydroDIURIL). What action will the nurse take?

Make sure that the drugs are given at least 2 hours apart

The nurse is caring for a patient receiving cardiotonic drugs. The patient has edema. Which intervention should be taken to alleviate edema?

Measurement of intake and output

A critical care nurse is caring for a patient after open-heart surgery. What nursing intervention would the nurse initiate to help detect life-threatening dysrhythmias and manage and minimize any that occur?

Monitor cardiac rhythm continuously.

The nurse is writing a plan of care for a client receiving an alpha-specific adrenergic agonist. What is the priority component of client's plan of care?

Monitoring blood pressure and heart rate frequently

The nurse is administering intravenous amiodarone to a patient in the emergency department. Which task would the nurse need to prioritize?

Monitoring the patient's blood pressure

A client with cystic fibrosis may use which type of medication to reduce the viscosity of respiratory secretions?

Mucolytic

Chronic use of nasal decongestants may cause which condition?

Mucosal ulcerations

A nurse is caring for a patient in the early stage of rheumatoid arthritis. The nurse would expect which medication classification to be used in the treatment of this patient?

NSAIDs - The NSAIDs are indicated for relief of the signs and symptoms of rheumatoid arthritis and osteoarthritis, for relief of mild to moderate pain, for treatment of primary dysmenorrhea, and for fever reduction.

The patient returns to the unit following surgery. The patient reports being in pain. After checking the medication administration record in the patient's chart, the nurse sees that the patient has not received the morphine the physician has ordered for over an hour. As the order reads q 1-2 hours, the nurse administers the low dose of the morphine. The PACU nurse calls to tell the floor nurse that the nurse forgot to chart the last dose of morphine the patient had received just before the patient was transferred to the floor. What drug would the floor nurse be sure to have on the unit that is used to reverse the effects of opioids?

Naloxone hydrochloride (Narcan) tartrate

A patient has been given MS Contin. The nurse enters the room and find the patient is unresponsive. The patient's respirations are 8 per minute. What medication will be ordered for the patient?

Narcan (Naloxone)

The nurse should advise clients taking laxatives of which of the following adverse effects? Select all that apply:

Nausea Perianal irritation Bloating Cramps

What serious adverse effect is most associated with amphotericin B?

Nephrotoxicity

The client uses his sympathomimetic inhaler frequently. The nurse evaluates the client for which of the following symptoms related to frequent use of the sympathomimetic inhaler?

Nervousness

A client is admitted to the emergency department with severe recurrent convulsive seizures. What drug should the nurse expect to be ordered for use in emergency control of status epilepticus?

Phenobarbital

The nurse should closely monitor clients receiving which of the following anticonvulsants for gingival hyperplasia? Select all that apply:

Phenytoin (Dilantin) Ethosuximide (Zarontin)

A nurse is caring for a patient diagnosed with type 2 diabetes. What should the nurse inform the patient are risk factors associated with type 2 diabetes?

Obesity

A nurse is caring for a patient with diabetes mellitus who is receiving an oral antidiabetic drug. Which of following ongoing assessments should the nurse perform when caring for this patient?

Observe the patient for hypoglycemic episodes.

Pseudoephedrine (Sudafed) is prescribed for a client suffering from nasal and sinus congestion. What is the most important assessment the nurse should complete before the client leaves the clinic to purchase the medication?

Obtain the client's BP

Ms. Jaegger is prescribed omeprazole for the treatment of gastroesophageal reflux disorder. What is the mechanism of action for this medication?

Omeprazole suppresses the last phase of gastric acid production.

A nurse is caring for a 66-year-old female client who is receiving digoxin. When preparing to administer a dose, the nurse observes that the client's apical pulse rate is 55 bpm. What is the appropriate action to take?

Omit the dose and contact the physician.

A patient has been prescribed clozapine. Which information should the nurse give to the patient regarding the drug?

Only a 1-week supply is dispensed at a time

What is the safest precaution to take when administering an antiarrhythmic drug intravenously (IV)?

Place the client on a cardiac monitor.

The pharmacology instructor is discussing effects on the heart of different medication. What is the term the instructor would use to describe the effect of a medication that increases the force of the contractions of the heart?

Positive inotropic

A nurse is caring for a patient who is taking digoxin and a loop diuretic. Which would be most important for the nurse to monitor?

Potassium levels

An elderly patient is admitted to the medical division after a fall. At home he is taking amitriptyline (Elavil) 25 mg three times per day. What adverse effect could be related to the patient's fall?

Orthostatic hypotension

A patient is admitted to emergency and is unconscious as a result of a head injury. The patient's intracranial pressure is increased. What diuretic will be administered to the patient?

Osmotic diuretic

A patient is taking warfarin (Coumadin) to prevent clot formation related to atrial fibrillation. How are the effects of the warfarin (Coumadin) monitored?

PT and INR

The nursing instructor is discussing signs and symptoms of benzodiazepine withdrawal. What signs or symptoms should the instructor include in their discussion? (Mark all that apply.)

Palpitations Insomnia Seizures

A patient has received the evening meal and is recovering from surgery. What nervous system is stimulated?

Parasympathetic nervous system

The nurse refers a patient to a psychiatrist for medication to treat a severe anxiety disorder. What medication does the nurse expect the patient to be given?

Paroxetine (Paxil) 10 mg po qd

Constipation is a common problem. The nurse knows that there are many ways to decrease the risk of constipation. These include which of the following? Select all that apply.

Partake in daily physical exercise. Consume food rich in fiber. Drink 64 to 80 ounces of fluids daily. Set a routine time and place for daily bowel movement.

Which patients are at a greater risk for liver failure during administration of acetaminophen?

Patients who consume alcohol habitually

A client comes to the mental health clinic for a regular appointment. The client tells the nurse he has been taking oral fluoxetine (Prozac) 20 mg daily for the past 3 weeks and that he has lost 3 pounds during that time due to a loss of appetite. What action should the nurse take?

Reassuring the client that this is a common adverse effect with this medication

A client is admitted to the intensive care unit with diabetic ketoacidosis. The nurse knows that the client will be placed on an intravenous insulin drip. The only type of insulin that can be administered intravenously is:

Regular

A patient is in diabetic ketoacidosis. The patient blood glucose level is over 600. The physician has ordered the patient to receive an initial dose of 25 units of insulin. What type of insulin will be administered intravenously?

Regular insulin

Ranitidine is a histamine2 receptor antagonist (H2RA) prescribed for treatment of peptic ulcer disease and gastric reflux. Dosage of ranitidine must be reduced in patients with what condition?

Renal disease

A critical care nurse is caring for a client taking aminoglycosides. What should the nurse monitor closely to determine whether dosage adjustment is required?

Renal function

The nurse is caring for a client receiving ethotoin to control seizure activity. When reviewing the client's laboratory results, the nurse learns that the client's serum ethotoin level is 67 mcg/mL. What is the nurse's best action?

Report this to the provider and monitor for signs of toxicity

A patient has a complex cardiac history that includes recurrent ventricular fibrillation. After the failure of more conservative treatments, his care team has introduced oral amiodarone. What assessments should be prioritized by the nurse who is providing care for this patient?

Respiratory assessment

An opioid naïve patient experiences acute pain after surgery and is put on opioid therapy. Which severe adverse reactions of opioid treatment should the nurse monitor for in the patient?

Respiratory depression

A client has been prescribed phenytoin for the treatment of seizures. How should the nurse most accurately determine whether the client has therapeutic levels of the medication?

Review the client's laboratory blood work

Antipyretic drugs, such as aspirin, ibuprofen, and acetaminophen, often are used to alleviate the discomforts of fever and protect vulnerable organs, such as the brain, from extreme elevations in body temperature. However, the use of aspirin in children is limited due to the possibility of what disease?

Reye's Syndrome

The nurse is teaching a client how to prevent Candida infections. Which would the nurse include in the instructions?

Rinse mouth with water after each use

Prior to and following a transurethral prostatic resection (TUPR), a 73-year-old man has been scheduled to receive a total of five intravenous doses of cefazolin. Which of the following nursing diagnoses should the nurse associate with this antibiotic therapy?

Risk for Infection related to overgrowth of nonsusceptible organisms

What are common nursing diagnoses for a client taking antipsychotic medications? (Select all that apply.)

Risk for Injury Risk for Impaired Physical Mobility Risk for Infection At Risk for Unstable Blood Glucose.

A nurse in a health care facility is caring for a patient who is administered milk of magnesia to control constipation. Which nursing diagnosis should the care plan for this patient include?

Risk for imbalanced fluid volume

The patient with HIV is experiencing nausea and vomiting related to antiviral medications. This patient has lost 20 pounds in the last 2 months since starting the drug therapy regimen. What is the highest priority nursing diagnosis for this patient?

Risk for imbalanced nutrition less than body requirements

Which nursing diagnosis would be most important for a nurse to include in the plan of care for a client who is receiving an antiseizure agent and experiencing common adverse effects?

Risk for injury

A patient newly diagnosed with depression has been prescribed fluoxetene, a selective serotonin reuptake inhibitor (SSRI). Why would the physician order an SSRI for a newly diagnosed patient?

SSRIs usually produce fewer and milder adverse effects than other antidepressants.

The nurse is writing a plan of care for a patient taking anticholinergic drugs. What is an appropriate goal for this patient's plan of care?

The patient will experience relief of symptoms for which anticholinergics are given.

The patient has been taking a sleep medication for the last 6 months and informs the primary care provider that she sleeps great now and wants to discontinue the drug. The provider tells the patient that this is not a good idea. What is the best rationale for this advice?

The provider believes that stopping the drug abruptly may cause serious consequences for the patient.

Why are inhaled steroids used to treat asthma and COPD?

They act locally to decrease release of inflammatory mediators

A 36-year-old male client undergoes dialysis three times weekly while waiting for renal transplant. A diuretic has been added to his current medications to combat developing edema. Why would potassium-sparing diuretics be contraindicated?

They may cause hyperkalemia.

Expectorants elicit their effect by which mechanism?

Thinning respiratory secretions

The nurse is administering sublingual nitroglycerin to a patient. Prior to administering the medication, the nurse informs the patient that immediately after administration, the patient may experience:

Throbbing headache or dizziness

Which would the nurse identify as the end of the intrinsic pathway?

Thrombin formation

The squad just delivered a 73-year-old man with crushing chest pain to the ED. He has a history of cardiovascular disease. Onset of symptoms is within the last 60 minutes. What medication would the nurse expect the physician to order for this thromboembolic disorder?

Thrombolytic drugs

The nurse teaches a patient with rheumatic disease who is being prescribed salicylate therapy to monitor themself for:

Tinnitus

A nurse is presenting an educational event for a group of new parents. One factor that the nurse addresses is the overuse of acetaminophen, which can cause liver toxicity. What would the nurse tell the parents it is important to do?

To check the label of OTC medications carefully to watch for inclusions of acetaminophen

The nurse is caring for a patient experiencing an acute angina attack. Sublingual nitroglycerin has been administered and the nurse begins to monitor vital signs. Why is this done?

To monitor blood pressure for hypotension

A child suffers from tics and verbal outbursts while awake. The patient is prescribed haloperidol (Haldol). What disease process is haloperidol (Haldol) used to treat?

Tourette's syndrome

A male client has been admitted with digitalis toxicity. He has been taking the same dose for more than 20 years. His family is asking how common this problem is and how he developed a toxic level while taking the usual dose. The nurse's best explanation would be:

Toxicity can occur even on low-dose therapy due to many factors, including advanced age, contributing medical conditions, and declining renal function.

Which statement reflects the treatment of HIV infection?

Treatment of HIV infection for an individual client is based on the clinical condition of the client, CD4 T cell count level, and HIV RNA (viral load).

A nurse educating a client starting lithium (Eskalith) should educate the client about which side effects? (Select all that apply.)

Tremors Polyuria

Anticholinergic effects such as dry mouth, sedation, and urinary retention are common adverse events occurring with the use of which classes of antidepressants?

Tricyclic antidepressants

A therapeutic theophylline level ranges from 10 to 20 mcg/mL.

True

Anticholinergic agents are also called parasympatholytic agents.

True

Anticholinergics block acetylcholine at the muscarinic receptors.

True

Expectorants are indicated for patients who have a dry, nonproductive cough.

True

Glycosylated hemoglobin levels provide reliable evidence of blood glucose control.

True

Leukotriene receptor antagonists are administered orally.

True

Mucolytics are often used for patients with cystic fibrosis, COPD, or tuberculosis.

True

Patients who are receiving alpha-specific adrenergic agents should not stop taking the drug abruptly.

True

Respiratory distress is a contraindication for the use of barbiturates.

True

The patient receiving omeprazole should swallow the tablet whole with a large glass of water.

True

The statement, "Antibiotics are not effective against viral infections," is which type of statement?

True

The use of calcium carbonate is associated with the development of acid rebound.

True

Warfarin typically takes 3 days to achieve its onset of action.

True

An inhaled sympathomimetic drug has been ordered for a teenage athlete who has exercise-induced asthma. What should the patient be instructed to do?

Use the inhaler 30 to 60 minutes before exercising to ensure peak therapeutic levels when needed

A client has been admitted to the health care facility with myoclonic seizures. Once stabilized, the nurse should anticipate that the client will be prescribed what medication?

Valproic acid

A patient who has been treated with warfarin (Coumadin) after open heart surgery is involved in a car accident and has a laceration on her head. Which medication will be administered to assist in the development of clotting factors?

Vitamin K

A patient who is receiving warfarin (Coumadin) has blood in his urinary drainage bag. What medication will likely be ordered by the physician?

Vitamin K

For clients taking clozapine (Clozaril), it is necessary to monitor what lab test for the first 6 months?

White blood cells

A nurse assessing a patient on digoxin observes features of toxicity. Which visual disturbance should the nurse assess for in such patients?

Yellow or green vision

The nurse is caring for a patient who is going home on sucralfate (Carafate). The nurse would teach the patient to take sucralfate:

before meals

A patient with arthritis is on NSAID therapy. What should be evaluated by the nurse to determine the effectiveness of NSAID therapy?

better mobility

A female patient is taking warfarin (Coumadin) after open heart surgery. The patient tells the home care nurse she has pain in both knees that began this week. The nurse notes bruises on both knees. Based on the effects of her medications and the report of pain, what does the nurse suspect is the cause of the pain?

bleeding

A trauma patient has been receiving frequent doses of morphine in the 6 days since his accident. This pattern of analgesic administration should prompt the nurse to carefully monitor the patient's:

bowel patterns

Epinephrine causes relaxation of:

bronchioles

The client is experiencing chest pain and has taken three sublingual nitrogylcerin tablets, but the pain remains. What should the client do next?

call 911

When caring for a patient with a cardiac dysrhythmia, the most appropriate goal for the patient is to maintain:

cardiac output.

The client has difficulty swallowing and requests the nurse crush all medications. The nurse notes that the client has been prescribed an extended release opioid. The nurse should contact the health care provider because:

chewing or crushing destroys the long-acting feature and constitutes an overdose.

A man is prescribed ciprofloxacin to treat a sexually transmitted infection. The nurse will instruct the patient to

complete the entire course of drug therapy.

A 51-year-old man is being discharged from the hospital following treatment with anticoagulants for a deep vein thrombosis. The nurse will instruct the patient to:

consider safety measures to prevent bleeding and be alert for signs of bleeding.

The nurse should warn a patient taking aluminum and calcium-containing antacids about which adverse effects?

constipation

A patient comes to the clinic with what appears to be a cold. What group of upper respiratory drugs cause local vasoconstriction, which decreases blood flow and shrinks swollen membranes to improve air flow?

decongestants

The chest pain and pressure a client experiences during an anginal attack is caused by:

decreased oxygen supply to the heart

A male client is given morphine for myocardial ischemic pain. The nurse needs to monitor the patient more frequently for which adverse effect?

decreased respiratory rate

A patient has a history of tonic-clonic seizures that have been successfully treated with phenytoin (Dilantin) for several years. Phenytoin achieves a therapeutic effect by:

decreasing the influx of sodium into neurons.

As the nurse caring for a young child is diagnosed with type 1 diabetes (IDDM), you know that they become at high risk for what and you include assessment and management of this in their care plan?

delayed growth and development

A nurse is caring for a client who is receiving a broad spectrum anti-infective agent. What is one unwanted effect of taking a broad spectrum anti-infective agent?

destruction of the normal flora

The pathophysiology class is studying diabetes. A student asks the instructor what is considered a sign of a hypoglycemic reaction. The instructor's response would be:

diaphoresis

While preparing a client for an eye examination, the nurse explains that the eye drops, an ophthalmic anticholinergic preparation, will cause the pupil to:

dilate.

What pharmacologic principle causes nephrotoxicity when gentamicin is administered?

distribution

What adverse effect of most oral antihistamines presents a priority safety concern for older adult clients?

drowsiness

The patient will receive ranitidine (Zantac) 150 mg PO at bedtime. Prior to administration, the nurse should inform the patient that common side effects related to this medication include:

headache

The nurse is caring for a 76-year-old client who is receiving IV heparin 5000 units q4h. At the initiation of therapy, the patient's control activated thromboplastin time (aPTT) was found to be 35 seconds. One hour prior to the next scheduled dose, aPTT is determined to be 92 seconds. Based on this result, the nurse will:

hold the dose and contact the physician.

A nurse in the intensive care unit is caring for a patient in shock and has started IV administration of dopamine (Intropin). For a patient in shock, dopamine helps to:

increase blood pressure.

The client has been prescribed a fluoroquinolone. The nurse knows that nursing interventions for clients taking fluoroquinolones include to:

increase fluid intake

What is the resulting physiologic effect when the parasympathetic nervous system is stimulated?

increased GI motility

The triage nurse in the emergency department has a 42-year-old patient with asthma present for treatment. The patient's respiratory rate is 40 breaths per minute. Based on this objective data, what is the correct nursing diagnosis for this patient?

ineffective breathing pattern

A patient is instructed on the administration of inhaled corticosteroid agents to treat asthma. How do inhaled corticosteroid agents assist in the treatment of asthma?

inhaled corticosteroid agents will reduce airway inflammation

A patient is being discharged home with a prescription for sublingual nitroglycerin. The nurse will instruct the patient and family to

keep the tablets in the original dark bottle.

What is a contraindication to use of a fluoroquinolone?

lactation

Antipsychotic drugs are contraindicated in clients with:

liver damage, coronary artery disease, severe hypertension, bone marrow depression, or cerebrovascular disease.

MAO inhibitors are rarely used in clinical practice today, mainly because they:

may interact with some foods and drugs to produce severe hypertension and possible heart attack.

A 12-year-old child who has been taking sertraline for the past 2 weeks has returned to the clinic to be seen. It will be critical for the nurse to assess for

onset of suicidal ideation.

Opioid antagonists may produce withdrawal symptoms in patients physically dependent on:

opiods

A 58-year-old male patient who has been diabetic since age 14 states he has pain in his feet and hands. This pain is a result of:

peripheral neuropathy.

An anatomy and physiology instructor scratches chalk across the blackboard, causing a screeching sound. Several students get a feeling sd though their "hair is standing on end." This response is part of the sympathetic stress reaction and is called:

piloerection

A nurse is caring for a 49-year-old woman in the intensive care unit. The patient was in a motor vehicle accident and is in severe pain. She is being given morphine. After 2 days in the unit, the nurse suspects that the patient is developing a cold. The nurse will monitor for:

pneumonia

The nurse is administering an H-2 receptor antagonist to a patient with multiple burn trauma to prevent the development of stress ulcers based on the understanding that the drug:

provides protection of the stomach lining via acid blockage.

A patient is hospitalized for heart failure and is scheduled to receive oral digoxin at 8 AM. The nurse will withhold the medication and notify the prescriber if the patient's:

pulse is 52 beats per minute.

A high school student was diagnosed with asthma when he was in elementary school and has become accustomed to carrying and using his "puffers". In recent months, he has become more involved in sports and has developed a habit of administering albuterol up to 10 times daily. The nurse should teach the student that overuse of albuterol can lead to

rebound bronchoconstriction.

The pharmacology instructor is discussing adverse effects associated with nasal decongestants. What is an effect of excessive use of these products?

rebound nasal congestion

The pharmacology instructor is discussing clopidogrel. According to the instructor, this drug is frequently used for

reduction of myocardial infarction in patients with atherosclerosis.

A patient enters the emergency room with reports of visual changes, drowsiness, and tinnitus. The patient is confused and hyperventilating. These symptoms may be attributable to:

salicylate intoxication - Salicylate intoxication may occur with an acute overdose of aspirin. Manifestations of salicylism include nausea, vomiting, fever, fluid and electrolyte deficiencies, tinnitus, decreased hearing, visual changes, drowsiness, confusion, hyperventilation, and others. Acute acetaminophen toxicity results in potentially fatal hepatotoxicity. Ibuprofen overdose will cause gastric mucosal damage. Caffeine overdose will produce tachycardia.

A nurse is providing health teaching to a newly diagnosed asthmatic client. The client has been prescribed theophylline. The nurse should encourage this client to stop:

smoking cigarettes

Another name for adrenergic drugs is:

sympathomimetic drugs.

What would the nurse teach the patient to monitor for when beginning an antidysrhythmic drug regimen?

syncope

A client reports gastrointestinal (GI) upset when taking phenytoin (Dilantin). The nurse should tell the client to:

take the medication with meals.

Clopidogrel (Plavix) is used frequently for:

treatment of peripheral artery disease.

A nurse is caring for two clients who are status postoperative for abdominal surgery. What is the best way to evaluate pain response after administering analgesia?

use a pain assessment tool before and 30 minutes after medication administration

A patient has been prescribed doxycycline (Vibramycin). Which of the following teaching instructions is important with this medication?

void sun exposure

The nurse is caring for a client taking insulin. The nurse realizes the client is experiencing symptoms of hypoglycemia when the client displays:

weakness, sweating, and decreased mentation.

A 34-year-old executive for an insurance company has been taking lorazepam for the last 6 months for anxiety. The client abruptly stopped the medication. The client then calls the physician and reports feeling irritable, increased heart rate, and restlessness. What would explain the client's current symptoms?

withdrawal from stopping the medication

Which condition would occur due to the administration of an opioid antagonist in a patient who is physically dependent on opioids?

withdrawal symptoms