pharm final questions part 1

A client, recovering from a cold and now experiencing a hacking cough, asks if taking an antihistamine would be helpful. What response demonstrates the nurse's understanding of the effective use of antihistamines? Select all that apply.

"Antihistamines are not recommended because they tend to worsen your cough." "Antihistamines are used for allergy-related coughs.

A postsurgical client has been provided with a morphine patient-controlled analgesic (PCA) but has expressed reluctance to use it for fear of becoming addicted. How can the nurse best respond to this client's concerns?

"It is not uncommon to develop a dependence on pain medications, but this usually takes place over a long period and is not the same as addiction."

A postoperative surgical client, prescribed twice-daily administration of docusate sodium, is concerned about developing diarrhea. What should the nurse teach the client about docusate sodium?

"This medication will only soften your stools over the next couple of days."

A client is concerned because his drug regimen for drug-resistant TB is different from that of his friends. Which explanation by the nurse is accurate?

"Treatment is based on drug susceptibility reports.

The nurse prepares to administer acetylcysteine by nebulization to an adult client diagnosed with chronic bronchitis. Which measures would the nurse provide for safe and effective drug administration? Select all that apply.

-Administer prescribed bronchodilator aerosolized treatment 10 to 15 minutes before the acetylcysteine treatment. -Assess for improvement in coughing up increased amounts of mucous, respirations less than 26, and SaO2 greater than 90%. -Report dyspnea, chest tightness, bronchospasms, and inability to expel secretions to the prescriber.

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

2 days

The nurse is conducting a first aid class and informs the class that in the case of acute, nonspecific diarrhea in adults where fluid losses are not severe, clients usually need only simple replacement of fluids and electrolytes lost in the stool. The nurse instructs the class to drink how much fluid during the first 24 hours?

2 to 3 L of clear liquids

A woman who has given birth to a baby girl by cesarean delivery is experiencing abdominal pain. The client receive a bolus dose of morphine intravenously. The nurse would recommend that the mother refrain from breast-feeding the baby for how long?

4 to 6 hours

The nurse is caring for four clients. For which client would the nurse question the health care provider's order of IV morphine?

A 78-year-old with osteoarthritis

What home remedies are effective for mouth dryness and cough? (Select all that apply.)

Adequate fluid intake Humidification of the environment Sucking on hard candy or throat lozenges

The healthcare provider prescribes codeine 20 mg PO q4h as an adjunctive therapy to a client's NSAID. What is the nurse's best action?

Administer the medication as prescribed and monitor the client's pain

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 has administered a dose of naloxone and the client's respiratory depression improved within five minutes. When the nurse reassessed the client two hours later, the client demonstrates symptoms of respiratory depression. Which action should the nurse perform next?

Call the provider as another dose of opioid antagonist may be necessary.

Tuberculosis caused by drug-resistant organisms should be considered in which clients? Select all that apply:

Clients who have no response to therapy Clients who have been treated in the past

Constipation is a frequent problem. The nurse knows that which of these statements regarding constipation is correct?

Constipation is characterized by hard, dry stools.

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

Dextromethorphan works in the medulla to suppress the cough reflex

A new mother required an episiotomy during the birth of her baby. Two days after delivery, the client is in need of a laxative. What will be the most effective drug for the nurse to administer?

Docusate

The use of centrally acting antitussives, such as codeine, increase the risk for injury related to which conditions? (Select all that apply.)

Drowsiness Dizziness

A client diagnosed with impaired renal function has been prescribed morphine. How will the client's underlying condition affect the pharmacokinetics of the drug?

Duration of action will be prolonged.

Determining the cause of diarrhea in a patient is important. It enables choosing the correct treatment. The nurse recognizes that a stool specimen is sometimes necessary to determine correct therapy. The nurse recognizes that a green, liquid stool may be from which of the following?

E. Coli

A nursing instructor is preparing a teaching plan for a nursing class on opioid analgesics. Which body system would the nursing instructor describe as not adapting to and compensating for the secondary effects of this class of drugs?

Gi system

A 12-year-old cancer client is receiving morphine 5-10 mg PO q6 hours. The 12-year-old reports being in pain. The nurse checks the medication record and finds that it has been 5 1/2 hours since the client last received pain medicine. What would the nurse do?

Give the client 5 mg of morphine PO.

A client presents at the clinic with a dry, nonproductive cough. The client is diagnosed with bronchitis, and it is determined that they will need help thinning sputum so that the cough can become productive. What does the nurse expect will be prescribed for the client?

Guaifenesin

You are preparing to administer a saline cathartic when the patient mentions that they have CHF. You know that saline cathartics are contraindicated for clients with congestive heart failure due to what adverse effect?

Hypernatremia

A client has just been diagnosed with tuberculosis (TB). The nurse can expect to start the client on which drug for the initial phase of treatment?

INH, rifampin, pyrazinamide, ethambutol

Although naloxone is given to counter opioid medication side effects such as respiratory depression, what additional issues (if any) may result from administration of an opioid antagonist?

Increase in the client's pain rating

A group of students are reviewing the actions of laxatives on the GI tract. The students demonstrate understanding when they state what about bulk stimulants?

Increase the fluid in the intestinal contents

Which of the following antitubercular drugs are used during the continuation treatment phase of tuberculosis? Select all that apply:

Isoniazid Rifampin

The client tells the nurse that the health care provider described a drug as having "no ceiling effect." How should the nurse respond when the client asks what that means?

It is a valuable drug to use because dosage can be increased to relieve pain when pain increases or tolerance develops

Which should be included when assessing pain? (Select all that apply.)

Location of the pain Intensity of pain What factors cause the pain to improve or worsen What medications client usually takes to relieve the pain

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

Mucolytic

A 1-year-old child is experiencing diarrhea. What should the parents be instructed to administer?

Oral rehydration solutions

A nurse should recognize which situations necessitate the need for an opioid antagonist. Which situations necessitate the need for an opioid antagonist? (Select all that apply.)

Postoperative acute respiratory depression Reversal of opioid induced hypotension Suspected acute opioid overdosage

A client is advised to use a bulk-forming laxative to alleviate constipation. The nurse will recommend:

Psyllium (Metamucil).

The nurse should know that lactulose achieves a therapeutic effect by which means?

Pulling water into the intestinal lumen by osmotic pressure

The nurse is giving instructions to a client who will be having a colonoscopy in the morning. The client will be taking polyethylene glycol-electrolyte solution for bowel cleaning. What information will help increase the palatability of this medication?

Refrigerate the solution until it is cold.

A client has been prescribed a fentanyl patch for chronic pain. What client teaching should the nurse provide to the client and family upon discharge?

Remove the patch every 3 days.

A client is treated for HIV with NNRTIs. The client develops tuberculosis, and the health care provider includes rifampin in the treatment regimen. Why would this be cause for concern?

Rifampin decreases blood levels of anti-HIV drugs.

A 43-year-old man has been diagnosed with active TB. He is prescribed a multiple drug therapy, including INH and rifampin. A priority assessment by the nurse will be to monitor which combination of laboratory test results?

Serum alanine transaminase, aspartate transaminase, and bilirubin

The client has been prescribed diphenoxylate with atropine (Lomotil) for diarrhea. The nurse recognizes that this drug is effective against diarrhea because of which action?

Slows peristalsis by acting on the smooth muscles of the intestine

A family member asks the nurse why a second dose of an opioid antagonist is needed. Which response by the nurse is correct?

The opioid medication that was given may last longer than the opioid antagonist medication.

The parent of a toddler asks about giving an over-the-counter (OTC) cough and cold product containing pseudoephedrine to the child. What information regarding safety and efficacy should the nurse offer?

There are concerns among health professionals about how safe and effective these medications are.

When teaching a client about the action of an opioid antagonist, what should the nurse include in the education?

This medication competes with the opioid pain medication, binding to the cell receptors instead.

A client is taking pseudoephedrine to reduce nasal congestion. The nurse should caution the client against use of this decongestant if the client is currently taking what other type of drug?

Thyroid preparations

The nursing instructor is discussing over-the-counter cold remedies. According to the instructor, these products typically combine

a decongestant, an analgesic, and an antihistamine

The nurse is preparing to administer bismuth subsalicylate to a client. What assessment is most important to make before administration?

allergy to aspirin

The nurse should question an order for bismuth salts for a client with what condition?

allergy to aspirin

The nurse is providing client teaching about a prescribed opioid analgesic. When monitoring the client for potential adverse effects, what assessment should the nurse prioritize?

blood pressure

A client has just been admitted for an overdose of pseudoephedrine. The nurse's assessment of the client should prioritize what system?

cardiovascular

Repeated lab work shows positive cultures for a client prescribed drug therapy for tuberculosis (TB) over 4 weeks ago. What are the likely reasons for this failure to achieve treatment goals? Select all that apply.

client has been nonadherent with medication therapy a delay in the initial diagnosis of the client infecting strain of TB is drug resistant

Which agent acts directly on the medullary cough center?

codeine

A nurse is teaching a group of older adults about nonpharmacologic strategies for preventing constipation. The nurse should recommend what practices? Select all that apply.

consuming a high-fiber diet engaging in frequent physical exercise drinking 6 to 10 glasses of fluid each day

The nurse is caring for a client with diarrhea who has been prescribed diphenoxylate with atropine and is observing the client for which adverse effects of this drug?

dizziness

Gary is a construction worker who is diagnosed with leprosy and is prescribed rifampin. Gary is married, an alcoholic, and wears contact lenses. At the time of initiating the therapy, the nurse should inform the client:

he should wear glasses during the therapy.

A health care provider orders diphenoxylate to treat a client who has severe hepatorenal disease. The nurse calls the provider to question this order because it may precipitate:

hepatic coma

The nursing instructor is teaching their lab students the best position for the administration of nasal sprays. What position would the instructor teach the students?

high fowlers

The nurse is explaining to a client about the analgesic and its possible adverse effects. The client is receiving an opioid analgesic. What would be important to teach this client is a possible adverse effect of this drug?

hypotension

A male client newly diagnosed with tuberculosis (TB) asks the nurse if medications will make him better. The nurse informs the client that sometimes treatment fails and why this happens. What are some reasons for treatment failure? (Select all that apply.)

inadequate initial drug treatment noncompliance with the therapeutic regimen

nurse is preparing a community teaching program about tuberculosis. When describing the individuals who are susceptible, who would the nurse include? Select all that apply.

individuals living in crowded conditions individuals with human immunodeficiency virus (HIV)

A client is prescribed an antidiarrheal that acts directly on the muscle wall of the bowel to slow motility. The nurse would identify which drug as being prescribed?

loperamide

A 75-year-old client is prescribed magnesium hydroxide for constipation. The nurse's assessment reveals that the client is being treated for rheumatoid arthritis and hypertension. The client is in assisted living and is on a low-sodium diet. Before the magnesium hydroxide therapy begins, it will be most important for the nurse to assess the client's:

medication history.

The nurse is caring for a client newly admitted for chronic opioid abuse. What medication does the nurse expect to be prescribed to the client?

methadone

A male client who has been on a drug regimen for tuberculosis (TB) for the last 2 months says he has lost his appetite and 10 pounds. What should the nurse suggest to the health care provider for this client to help in the area of nutrition?

pyridoxine (vitamin B6)

A 43-year-old man is taking pseudoephedrine (Sudafed) for sinusitis. He calls the clinic to report that it feels like his heart is racing and that he can "feel his heart beating fast." The nurse will instruct him to

stop taking the medication and come to the clinic as ordered by the health care provider

An 80-year-old man has been prescribed oxycodone for severe, noncancer, chronic pain. He tells the nurse that he has difficulty swallowing and asks if he can crush the tablet before swallowing. The nurse will advise the client that:

there is risk of an extremely high dose available all at once if the tablet is crushed.