Pharm NCLEX study set

A nurse is collecting data from a client with hypertension being treated with diuretic therapy. The nurse would monitor the client for hypokalemia if the client is receiving which diuretic? 1. Bumetanide 2. Triamterene (Dyrenium) 3. Amiloride HCl (Midamor) 4. Spironolactone (Aldactone)

1. Bumetanide

The nurse is caring for a female client receiving chemotherapy and notes that the client has developed myelosuppression. Which of the following laboratory values would support the client's diagnosis of myelosuppression? 1. Hemoglobin 9.4 g/dL, hematocrit 26% 2. Blood urea nitrogen (BUN) 15 mg/dL, creatinine 0.9 mg/dL 3. Protein 7 g/dL 4. Magnesium 1.8 mg/dL

1. Hemoglobin 9.4 g/dL, hematocrit 26%

A licensed practical nurse (LPN) is reviewing laboratory results for a client taking dantrolene sodium (Dantrium). The LPN should suggest to the registered nurse to notify the health care provider if which of the following was noted on the laboratory report sheet? 1. Lactate dehydrogenase (LDH) 600 units/L 2. Platelet count 290,000 cells/mm3 3. Blood urea nitrogen 9 mg/dL 4. Creatinine 0.6 mg/dL

1. Lactate dehydrogenase (LDH) 600 units/L

A urinary analgesic is prescribed for a client with a urinary tract infection. The nurse tells the client that it is best to take the medication: 1. With meals 2. At bedtime 3. One hour before meals 4. In the morning before breakfast

1. With meals

A client who received a kidney transplant is taking azathioprine (Imuran), and the nurse provides instructions about the medication. Which statement by the client indicates a need for further instructions? 1. "I need to watch for signs of infection." 2. "I need to discontinue the medication after 14 days of use." 3. "I can take the medication with meals to minimize nausea." 4. "I need to call the health care provider (HCP) if more than one dose is missed."

2. "I need to discontinue the medication after 14 days of use."

A client informs the nurse that she has been taking acarbose (Precose) as prescribed. The nurse determines that a therapeutic effect of the medication has occurred if which of the following is noted? 1. A serum lipase of 100 units/L 2. A 2-hour postprandial serum glucose of 120 mg/dL 3. A sodium level of 140 mEq/L 4. A blood urea nitrogen (BUN) level of 15 mg/dL

2. A 2-hour postprandial serum glucose of 120 mg/dL

A nurse is providing instructions to a client regarding the administration of lypressin. The nurse instructs the client that the medication will be taken by which of the following routes? 1. Oral 2. Intranasal 3. Subcutaneous 4. Intramuscular

2. Intranasal

A client with a history of simple partial seizures is taking clorazepate (Tranxene). The client asks the nurse whether there is a risk of addiction. The nurse's response is based on the understanding that clorazepate: 1. Is not habit forming either physically or psychologically 2. Leads to physical and psychological dependence with prolonged high dose therapy 3. Leads to physical tolerance, but only after 10 or more years of therapy 4. Can result in psychological dependence only, because of the nature of the medication

2. Leads to physical and psychological dependence with prolonged high dose therapy

A client is being treated for moderate hypertension and has been taking diltiazem (Cardizem) for several months. The client is seen by the health care provider, and Prinzmetal's angina is diagnosed. The nurse planning care for the client understands that which action of the medication will provide a therapeutic effect for this new diagnosis? 1. Increases oxygen demands within the myocardium 2. Increases the force of contraction of ventricular tissues 3. Prevents influx of calcium ions in vascular smooth muscle 4. Leads to an increase in calcium absorption in the vascular smooth muscle

3. Prevents influx of calcium ions in vascular smooth muscle

The health care provider has prescribed silver sulfadiazine (Silvadene) for the client with a partial-thickness burn, which has cultured positive for gram-negative bacteria. The nurse is reinforcing information to the client about the medication. Which statement made by the client indicates a lack of understanding about the treatments? 1. "The medication is an antibacterial." 2. "The medication will help heal the burn." 3. "The medication will permanently stain my skin." 4. "The medication should be applied directly to the wound."

3. "The medication will permanently stain my skin."

A 6-month-old infant receives a diphtheria, tetanus, and pertussis (DTaP) immunization at the well-baby clinic. The mother returns home and calls the clinic to report that the infant has developed swelling and redness at the site of injection. The appropriate suggestion to the mother should be to: 1. Apply a warm pack to the injection site. 2. Bring the infant back to the clinic. 3. Apply an ice pack to the injection site. 4. Monitor the infant for a fever.

3. Apply an ice pack to the injection site.

A client who is taking lithium carbonate (Lithobid) is scheduled for surgery. The nurse informs the client that: 1. The medication will be discontinued a week before the surgery and resumed 1 week postoperatively. 2. The medication is to be taken until the day of surgery and resumed by injection immediately postoperatively. 3. The medication will be discontinued 1 to 2 days before the surgery and resumed as soon as full oral intake is allowed. 4. The medication will be discontinued several days before surgery and resumed by injection in the immediate postoperative period.

3. The medication will be discontinued 1 to 2 days before the surgery and resumed as soon as full oral intake is allowed.

A client with osteoarthritis is receiving diclofenac sodium (Voltaren). The licensed practical nurse (LPN) reviewing the client's medication prescription sheet would plan to verify the prescription with the registered nurse (RN) if which of the following other medications were listed? 1. Primidone (Mysoline) 2. Calcium carbonate (Tums) 3. Warfarin (Coumadin) 4. Vitamin C supplement

3. Warfarin (Coumadin)

Carbidopa-levodopa (Sinemet) is prescribed for a client with Parkinson's disease, and the nurse monitors the client for adverse reactions to the medication. Which of the following indicates that the client is experiencing an adverse reaction? 1. Pruritus 2. Tachycardia 3. Hypertension 4. Impaired voluntary movements

4. Impaired voluntary movements

A client is receiving acetylcysteine (Mucomyst), 20% solution diluted in 0.9% normal saline by nebulizer. The nurse should have which item available for possible use after giving this medication? 1. Ambu bag 2. Intubation tray 3. Nasogastric tube 4. Suction equipment

4. Suction equipment

Mannitol (Osmitrol) is being administered to a client with increased intracranial pressure following a head injury. The nurse assisting in caring for the client knows that which of the following indicates the therapeutic action of this medication? 1. Prevents the filtration of sodium and water through the kidneys 2. Prevents the filtration of sodium and potassium through the kidneys 3. Decreases water loss by promoting the reabsorption of sodium and water in the loop of Henle 4. Induces diuresis by raising the osmotic pressure of glomerular filtrate, thereby inhibiting tubular reabsorption of water and solutes

4. Induces diuresis by raising the osmotic pressure of glomerular filtrate, thereby inhibiting tubular reabsorption of water and solutes

A client with recurrent constipation has begun using psyllium (Metamucil). The nurse tells this client that this medication should be taken with:

4. A full glass of liquid, followed by a second glass of liquid

A client who is receiving carbamazepine (Tegretol) daily has a white blood cell (WBC) count of 2800 cells/mm3, blood urea nitrogen (BUN) of 17 mg/dL, sodium of 141 mEq/L, and uric acid of 5 mg/dL. The nurse makes which interpretation, based on these laboratory values? 1. The uric acid level is elevated, indicating the risk for renal calculi. 2. The sodium level is low, indicating an electrolyte imbalance. 3. The BUN is elevated, indicating nephrotoxicity. 4. The WBC count is low, indicating a blood dyscrasia.

4. The WBC count is low, indicating a blood dyscrasia.

A client began taking amantadine (Symmetrel) approximately 2 weeks ago. The nurse would evaluate that the medication was having a therapeutic effect if the client exhibited decreased: 1. Voiding 2. Blood pressure 3. Rigidity and akinesia 4. White blood cell count

3. Rigidity and akinesia

A nurse is reviewing the laboratory results of a client receiving chemotherapy. The nurse prepares to initiate neutropenic precautions when the nurse notes which of the following laboratory results? 1. A white blood cell (WBC) count of 2000 cells/mm3 2. A platelet count of 200,000 cells/mm3 3. A clotting time of 10 minutes 4. An ammonia level of 20 mcg/dL

1. A white blood cell (WBC) count of 2000 cells/mm3

Which information would the nurse provide to the client who will be receiving chemotherapy with doxorubicin (Adriamycin)? Select all that apply. 1. Alopecia can occur. 2. Cardiotoxicity can occur. 3. Stool may turn white. 4. Urine and sweat may turn red. 5. The medication is administered by the intravenous route. 6. Promptly report any signs of bleeding to the health care provider.

1. Alopecia can occur. 2. Cardiotoxicity can occur. 4. Urine and sweat may turn red. 5. The medication is administered by the intravenous route. 6. Promptly report any signs of bleeding to the health care provider.

A nurse in the preoperative holding unit administers a dose of scopolamine to a client. The nurse monitors the client for which common side effect of the medication? 1. Dry mouth 2. Pupillary constriction 3. Excessive urination 4. Diaphoresis

1. Dry mouth

A nurse is reinforcing discharge instructions to a client receiving sulfisoxazole. Which of the following would be included in the plan of care for instructions? 1. Maintain a high fluid intake. 2. Discontinue the medication when feeling better. 3. If the urine turns dark brown, call the health care provider immediately. 4. Decrease the dosage when symptoms are improving to prevent an allergic response.

1. Maintain a high fluid intake.

A tricyclic antidepressant is administered to a client daily. The nurse plans to monitor for the common side effects of the medication and includes which of the following in the plan of care? 1. Offer hard candy or gum periodically. 2. Offer a nutritious snack between meals. 3. Monitor the blood pressure every 2 hours. 4. Review the white blood cell (WBC) count results daily.

1. Offer hard candy or gum periodically.

A licensed practical nurse (LPN) is administering medications to a client with chronic rheumatoid arthritis. The client has difficulty swallowing, and the film-coated form of diflunisal is prescribed. Which action by the LPN is most appropriate? 1. Give the client a large glass of water to aid in swallowing. 2. Consult with the registered nurse (RN) about contacting the health care provider (HCP) regarding a medication change. 3. Crush the tablet and mix it with applesauce. 4. Open the tablet and mix the contents with food.

2. Consult with the registered nurse (RN) about contacting the health care provider (HCP) regarding a medication change.

A nurse notes that the result of the serum theophylline level of a client taking theophylline is 15 mcg/mL. The nurse interprets this result as: 1. Below the therapeutic range 2. In the middle of the therapeutic range 3. At the top of the therapeutic range 4. In excess of the therapeutic range

2. In the middle of the therapeutic range

A nurse is assigned to care for a client with a diagnosis of hepatic encephalopathy. Which prescribed medication does the nurse anticipate administering? 1. Phenolphthalein (Ex-Lax) 2. Lactulose syrup (Chronulac) 3. Magnesium hydroxide (Milk of Magnesia) 4. Psyllium hydrophilic mucilloid (Metamucil)

2. Lactulose syrup (Chronulac)

A nurse is planning to administer hydrochlorothiazide (HydroDIURIL) to a client. The nurse understands that which of the following are concerns related to the administration of this medication? 1. Hypouricemia, hyperkalemia 2. Increased risk of osteoporosis 3. Hypokalemia, hyperglycemia, sulfa allergy 4. Hyperkalemia, hypoglycemia, penicillin allergy

3. Hypokalemia, hyperglycemia, sulfa allergy

A nurse is preparing to give instructions to the client who has been given a prescription for diphenoxylate with atropine (Lomotil). The nurse teaches the client to: 1. Expect increased saliva production while taking the medication. 2. Anticipate excitability as a side effect. 3. Not exceed recommended dose because it can be habit forming. 4. Take the medication with a bulk-forming laxative.

3. Not exceed recommended dose because it can be habit forming.

A health care provider tells the nurse that a potassium-sparing diuretic is being prescribed for the client with congestive heart failure. The nurse reviews the health care provider's prescriptions, expecting that which of the following medications will be prescribed? 1. Furosemide (Lasix) 2. Ethacrynic acid (Edecrin) 3. Spironolactone (Aldactone) 4. Hydrochlorothiazide (HydroDIURIL)

3. Spironolactone (Aldactone)

A client with myasthenia gravis becomes increasingly weak. The health care provider prepares to identify whether the client is reacting to an overdose of the medication (cholinergic crisis) or increasing severity of the disease (myasthenic crisis). An injection of edrophonium (Enlon) is administered. Which of the following indicates that the client is in cholinergic crisis? 1. No change in the condition 2. Complaints of muscle spasms 3. An improvement of the weakness 4. A temporary worsening of the condition

4. A temporary worsening of the condition

A client is being discharged home, and the health care provider has prescribed spironolactone (Aldactone) for the client. The nurse teaches the client about the medication. Which statement by the client would require further teaching by the nurse? 1. "My doctor told me that I should sit on the side of the bed in the morning before standing up." 2. "I know I should contact my doctor if I develop a rash while taking this medication." 3. "I know I need to weigh myself every day when I get home because of the medication." 4. "I know I need to eat foods that are high in potassium because of the diuretic effect of the medication."

4. "I know I need to eat foods that are high in potassium because of the diuretic effect of the medication."

A nurse reinforces discharge instructions to a postoperative client who is taking warfarin sodium (Coumadin). Which statement, if made by the client, reflects the need for further teaching? 1. "I will take my pills every day at the same time." 2. "I will be certain to avoid alcohol consumption." 3. "I have already called my family to pick up a Medic-Alert bracelet." 4. "I will take Ecotrin (enteric-coated aspirin) for my headaches because it is coated."

4. "I will take Ecotrin (enteric-coated aspirin) for my headaches because it is coated."

A client who was started on anticonvulsant therapy with clonazepam (Klonopin) tells the nurse of increasing clumsiness and unsteadiness since starting the medication. The client is visibly upset by these manifestations and asks the nurse what to do. The nurse's response is based on the understanding that these symptoms: 1. Usually occur if the client takes the medication with food 2. Are probably the result of an interaction with another medication 3. Indicate that the client is experiencing a severe untoward reaction to the medication 4. Are worse during initial therapy and decrease or disappear with long-term use

4. Are worse during initial therapy and decrease or disappear with long-term use

A client who has developed atrial fibrillation that is not responding to medication therapy has begun taking warfarin (Coumadin). The nurse is performing dietary discharge teaching with the client. The nurse would plan to teach the client to avoid which of the following foods while taking this medication? 1. Cherries 2. Potatoes 3. Spaghetti 4. Broccoli

4. Broccoli

Tamoxifen is prescribed for the client with metastatic breast carcinoma. The nurse understands that the primary action of this medication is to: 1. Increase DNA and RNA synthesis. 2. Promote the biosynthesis of nucleic acids. 3. Increase estrogen concentration and estrogen response. 4. Compete with estradiol for binding to estrogen in tissues containing high concentrations of receptors.

4. Compete with estradiol for binding to estrogen in tissues containing high concentrations of receptors.

The client has a PRN prescription for ondansetron (Zofran). For which condition should this medication be administered to the postoperative client? 1. Paralytic ileus 2. Incisional pain 3. Urinary retention 4. Nausea and vomiting

4. Nausea and vomiting

A nurse is assisting with caring for a client with cancer who is receiving cisplatin. Select the adverse effects that the nurse monitors for that are associated with this medication. Select all that apply. 1. Tinnitus 2. Ototoxicity 3. Hyperkalemia 4. Hypercalcemia 5. Nephrotoxicity 6. Hypomagnesemia

1. Tinnitus 2. Ototoxicity 5. Nephrotoxicity 6. Hypomagnesemia

A nurse is reading the laboratory results for a client being treated with carbamazepine (Tegretol) for prophylaxis of complex-partial seizures. The nurse interprets that which of the following values is consistent with an adverse reaction to this medication? 1. White blood cell count 3200/mm3 2. Blood urea nitrogen 19 mg/dL 3. Sodium 136 mEq/L 4. Platelet count 350,000/mm3

1. White blood cell count 3200/mm3

A nurse is providing instructions to a mother of a child with atopic dermatitis (eczema) regarding the application of topical cortisone cream to the affected skin sites. Which of the following statements, if made by the mother, indicates an understanding of the use of this medication? 1. "I need to wash the sites gently before I apply the medication." 2. "The medication is applied everywhere except the face." 3. "I need to apply the medication generously and allow it to absorb." 4. "I shouldn't rub the medication into the skin."

1. "I need to wash the sites gently before I apply the medication."

A nursing student is asked about the medication latanoprost (Xalatan) and how this medication helps glaucoma. The student responds correctly by identifying that the medication's mechanism of action is to: 1. Promote pupil mydriasis. 2. Paralyze the ciliary muscles. 3. Facilitate the outflow of aqueous humor. 4. Decrease the production of aqueous humor.

3. Facilitate the outflow of aqueous humor.

Cyclobenzaprine (Flexeril) is prescribed for a client to treat muscle spasms, and the nurse is reviewing the client's record. Which of the following disorders, if noted in the client's record, would indicate a need to contact the health care provider regarding the administration of this medication? 1. Glaucoma 2. Emphysema 3. Hyperthyroidism 4. Diabetes mellitus

3. Hyperthyroidism

A client with eczema has a prescription for a topical corticosteroid. The nurse cautions the client to use the product carefully in which of the following areas where the risk of systemic absorption is greater? 1. Palms of the hands 2. Soles of the feet 3. Back 4. Face

4. Face

A client who was started on anticonvulsant therapy with clonazepam (Klonopin) tells the nurse of increasing clumsiness and unsteadiness since starting the medication. The client is visibly upset by these manifestations and asks the nurse what to do. The nurse's response is based on the understanding that these symptoms: 1. Indicate that the client is experiencing a severe untoward reaction to the medication 2. Are severe during initial therapy and decrease or disappear with long-term use 3. Are probably the result of an interaction with another medication 4. Usually occur when the client takes the medication with food

2. Are severe during initial therapy and decrease or disappear with long-term use

A client is admitted to the emergency department with a diagnosis of drug-induced anxiety related to overingestion of his prescribed antipsychotic medication. The important piece of information the nurse should obtain initially is the: 1. Name and phone number of the nearest relative 2. Name of the ingested medication and the amount ingested 3. Reason for the suicide attempt and whether he will attempt it again 4. Length of time on the medication and symptom control information

2. Name of the ingested medication and the amount ingested

When teaching a client who is being started on imipramine hydrochloride (Tofranil), the nurse would inform the client that the desired effects of the medication may: 1. Start during the first week of administration 2. Not occur for 2 to 3 weeks of administration 3. Start during the second week of administration 4. Not occur until after a month of administration

2. Not occur for 2 to 3 weeks of administration

A nurse provides dietary instructions to a client who will be taking warfarin sodium (Coumadin). The nurse tells the client to avoid which food item? 1. Grapes 2. Spinach 3. Watermelon 4. Cottage cheese

2. Spinach

Isotretinoin is prescribed for a client with severe acne. Before the administration of this medication, the nurse anticipates that which laboratory test will be prescribed?

2. Triglyceride level

A nurse is employed in a newborn nursery. The nurse is aware that medication toxicity is more likely to occur in the neonate than in an adult because: 1. The lungs are not developed. 2. The kidneys are smaller than those of adults. 3. Cerebral function is not fully developed. 4. The liver is immature.

4. The liver is immature.

A client has been prescribed cyclobenzaprine (Flexeril) in the treatment of painful muscle spasms accompanying a herniated intervertebral disk. The nurse would withhold the medication and question the prescription if the client had concurrent prescriptions to take: 1. Furosemide (Lasix) 2. Valproic acid (Depakene) 3. Ibuprofen (Motrin) 4. Tranylcypromine (Parnate)

4. Tranylcypromine (Parnate)