Pharm pre test TEST questions
Which patients require cautious use of an aminoglycoside? (select all that apply) A. Elderly patients B. Thyroid disease patients C. Renal disease patients D. Mystenia Gravis patients
C. Renal disease patients D. Mystenia Gravis patients
A nurse is caring for client who has sepsis and a prescription for vancomycin 1 g in 250 mL dextrose 5% (D5W) over 2 hr by IV intermittent bolus. The nurse should set the IV pump to deliver how many mL/hr?
125 mL/ hr
The nurse is providing discharge teaching to a client with heart failure who is prescribed digoxin (Lanoxin) Which statement made by a client about digoxin would require further education? "I should be familiar with the symptoms of a low potassium level and talk with my doctor if I have these symptoms." "If I miss a dose of the medication, I should double up on my dose the next day." "I should take my pulse before my dose of digoxin and notify the provider if my pulse is less than 60 beats per minute." "I should see improvement in my shortness of breath when taking this drug."
"If I miss a dose of the medication, I should double up on my dose the next day."
A nurse is preparing to administer lidocaine 50 mg IV bolus. Available is lidocaine 200 mg/mL. How many mL should the nurse administer per dose?
0.3mL
A nurse is caring for a client who has heart failure and a prescription for digoxin 125mcg PO daily. Available is digoxin PO 0.25 mg/tablet. How many tablets should the nurse administer per dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)
0.5 tablet
A nurse is preparing to administer erythromycin ethylsuccinate 800mg PO every 4 hr. Available is erythromycin ethylsuccinate 200mg/5mL. How many mL should the nurse administer?
20 mL
A nurse is providing teaching for a client who has hypertension and a prescription change from metoprolol to metoprolol/hydrochlorothiazide. Which of the following statements by the client indicates an understanding of the teaching? A. "With the new medication, I should experience fewer side effects." B. "The extra letters after the name of medication means it is a stronger dose." C. "Now I will not have to diet to lose weight." D. "I will not have to do anything different because it is the same medication."
A. "With the new medication, I should experience fewer side effects."
Which generation of cephalosporins has the lowest resistance to beta lactamases, low activity against gram negativity, and poor distribution into the CSF? A. 1st gen B. 2nd gen C. 3rd, 4th, and 5th gen D. 5th gen E. 4th gen
A. 1st gen
A nurse in the emergency department is caring for a client who took 3 nitroglycerin tablets sublingually for chest pain. The client reports relief from the chest pain but now he is experiencing a headache. Which of the following statements should the nurse make? A. A headache is an expected adverse effect of the medication. B. A headache indicates tolerance to the medication C. A headache is an indication of an allergy to the medication D A headache is likely due to the anxiety about the chest pain.
A. A headache is an expected adverse effect of the medication.
A nurse is teaching a client who has a new prescription for transdermal nitroglycerin to treat angina pectoris. Which of the following instructions should the nurse include in the teaching. A. Apply the transdermal patch in the morning B. Apply a new transdermal patch once a week C. Apply a new transdermal patch when chest pain is experienced. D. Apply the transdermal patch in the same location as the previous patch.
A. Apply the transdermal patch in the morning
A nurse caring for a client who has hypertension and asks the nurse about a prescription for propranolol. The nurse should inform the client that this medication is contraindicated in clients who have a hx of the following conditions? A. Asthma B. Depression C. Migraines D. Glaucoma
A. Asthma
Cefotetan and ceftriaxone have a higher risk for which of the following side effects? A. Bleeding B. Tachycardia and Diarrhea C. hemolytic anemia and superinfections D. allergies and thrombophlebitis
A. Bleeding
A nurse is caring for a client who asks who albuterol helps his breathing. Which of the following responses should the nurse make. (select all that apply) A. The medication will prevent wheezing B. The medication will open up the airways. C. The medication will stimulate flow of mucus D. The medication will reduce inflammation E. The medication will decrease coughing episodes
A. The medication will prevent wheezing B. The medication will open up the airways. E. The medication will decrease coughing episodes
A nurse is assessing a client who has a peripheral IV with a continuous infusion. Which of the following findings is a manifestation of phelbitis? (Select all that apply) A. Throbbing B. Warmth at insertion site C. Damp dressing D. Streak formation E. Erythema
A. Throbbing B. Warmth at insertion site D. Streak formation E. Erythema
Why are peak and trough levels drawn for patients receiving vancomycin? (select all that apply) A. To monitor kidneys ability to eliminate drug B. To monitor livers ability to eliminate drug C. To prevent renal failure and ototoxicity D. To prevent liver failure
A. To monitor kidneys ability to eliminate the drug C. To prevent renal failure and ototoxicity
Why can't penicillins and aminoglycosides be given in the same IV solution?
Aminoglycosides inactivate penicillin
A client with c- diff infection has a vancomycin infusion and the client has the following clinical manifestations: rash, flushing, tachycardia and hypotension What is the nurses priority action? A. Stop the infusion B. Slow the infusion C. Dilute the infusion D. Administer epinephrine
B. Slow the infusion Vancomycin must be infused over one hour at least
What generations of cephalosporins can cross the blood brain barriers? A. 1st gen B. 2nd gen C. 3rd gen D. 4th gen E. 5th gen
C. 3rd gen D. 4th gen E. 5th gen
A nurse is providing discharge instructions to a client who has asthma and is about to start taking theophylline (Theo-24). The nurse should tell the client that this medication might cause which of the following adverse effects? A. Drowsiness B. Oliguria C. Tachycardia D. Constipation
C. Tachycardia Theophylline can increase cardiac stimulation causing tachycardia as well as insomina, urinary frequency, and diarrhea.
Who determines the flu vaccine strains?
CDC and FDA
What other antibiotics might be given for patients with a penicillin allergy?
Clindomycin Erythromycin Vancomycin
What penicillins are narrow spectrum and penicillinase sensitive? A. carbenicillin, piperacillin B. ampicillin, amoxicillin C. nafcillin, oxacillin D. penicillin G and V
D. (penicillin G) and V These penicillins are less effective against bacteria because they are sensitive to penicillinase; they are given parenterally only because they are not stable in stomach acid and have three different types: potassium, procaine, and benzathine.
A nurse is caring for a client who has a bacterial infection and is receiving gentamicin. Which of the following actions should the nurse take to minimize the risk of an adverse effect of the medication? A. Instruct the client to report agitation B. Limit the client's fluid intake C. Administer the medicine with food D. Monitor the serum medication levels
D. Monitor the serum medication levels Gentamicin, an aminoglycoside, is associated with nephrotoxicity and ototoxicity, both of which are a result of elevated trough levels. Monitoring the serum medication levels is an important action to minimize the risk of an adverse effect of gentamicin.
A nurse is assessing a client who has hypercholesterolemia and is receiving simvastatin. Which of the following findings should the nurse recognize as a potential adverse effect? A. orthostatic hypotension B. Urinary retention C. Blurred vision D. Muscle weakness
D. Muscle weakness Myopathy is an adverse effect of this medication
A nurse is caring for a client who has a new prescription for propranolol. The nurse should monitor the client for which of the following adverse reactions to this medication? A. Ototoxicity B. Hypokalemia C. Tachycardia D. Postural hypotension
D. Postural hypotension
Who should not get a flu shot?
Live viral vaccines: immunocompromised pt Pregnant pt, <6mo of age, previous severe allergies, neuro muscular syndrome, pts that are sick and have a fever.
A client with heart failure is taking digoxin 0.125 mg daily. Which clinical findings would alert the nurse that a client may be experiencing digoxin (Lanoxin) toxicity? Orthopnea, jugular vein distention and edema Nausea, anorexia and blurred or yellow vision Dyspnea, tachypnea and hypertension Diarrhea, abdominal cramping, decrease urine output
Nausea, anorexia and blurred or yellow vision
How can nurses reduce the spread of C. diff?
Patient isolation, selective use of antibiotics, wear gloves, wash hands with soap and water, disposable rectal thermometer, and disinfect with chlorine agents
The nurse is administering digoxin (Lanoxin) and furosemide (Lasix) to a client experiencing heart failure. Which lab value would the nurse be most concerned about? Sodium 133 mEq/L Calcium 8 mg/dL Magnesium 2.1 mg/dL Potassium 3.2 mEq/L
Potassium 3.2 mEq/L
How are patients treated that have infusion reactions to amphotericin B?
Pretreated with benedryl and tylenol Dantrolene with severe case of rigors
What adverse cardiac effect does erythromycin have?
QT prolonged can result in sudden cardiac death especially in combination with azole antifungal, CCB, HIV pt that take protease inhibitors
How does nitroglycerin's vasodilation action help patients with angina?
Reduces preload which decreases the work load of the heart
What is key in the treatment plan for CAD pts with chronic stable angina?
Risk factor reduction
How should a long acting preparation be discontinued? Why?
Slow D/C to prevent vasospasms
Why are beta adrenergic antagonists such as metoprolo (Lopressor) and propranolol (Inderal) not used for Variant angina?
These medications do not relax smooth muscle vasculature
Why is imipenem combined with cilastatin?
To increase half life and ability to penetrate tissues by inactivating enzyme in the kidney that breaks down imipenem.
A client has a penicillin allergy, is there any risk of giving her amoxicillin?
Yes- allergic to one type allergic to all types
What is angina?
a symptom of an underlying disease: CAD, coronary artery spasm, platelet aggregation, transient thrombi
In patients with chronic stable angina we try to prevent MI and death with what drugs?
anitplatelets, cholesterol lowering drugs, and ACE inhibitors
How can nurses prevent thrombophlebitis in patients with IV cephalosporin therapies?
insure a patent IV site
In patients with chronic stable angina we try to reduce ischemia and anginal pain with what drugs?
long acting nitrate, CCB or beta blocker
What substances form chelates with tetracyclines?
milk, calcium, magnesium, iron, and zinc
Is penicillin G a narrow or broad spectrum antibiotic?
narrow
Would a nitroglycerin patch be used for acute relief of an anginal attack?
no, because it has a slow onset of 20-60 minutes
A nurse is preparing to administer amoxicillin 30mg/kg/day divided equally every 12 hr to a toddler who weighs 32lb (14.5 kg). Available is amoxicillin 200mg/5mL suspension. How many mL should the nurse adminster?
5.5mL ATI rounds to the nearest whole number after calculating the 12 hour total mg dose to 218 instead of 217.5mg Then rounds again in the answer to the nearest tenth
If IV Nitroglycerin (NTG) is used what administration consideration should be made?
1. Baseline information established prior to administration 2. Continuous infusion--> low dose-->titrate up depending on pain 3. Comes in a glass bottle with vented tubing provided by manufacturer. Do not give in plastic container or tubing.
In an acute attack, how should the nurse instruct the patient to administer sublingual or spray Nitroglycerin (NTG)?
1. Put under tongue, wait 5 minutes 2. Chest pain continues take 2nd dose and call EMS 3. Chest pain continues after 5 minutes take 3rd dose, Get to ER!
A nurse is preparing to administer clindamycin 300 mg by intermittent IV bolus over 30- min to a client who has staphylococci infection. Available is clindamycin premixed in 50 mL 0.90% sodium chloride (NaCl). The nurse should set the IV pump to deliver how many mL/hr?
100mL/hr
A nurse is preparing to administer digoxin 0.25 mg PO daily. The amount available is digoxin 0.125 mg tablets. How many tablets should the nurse administer? (round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)
2 tablets
How long after administration is a person protected?
2-4 weeks to develop antibodies
A nurse is caring for an adolescent client who has pneumonia and a prescription for cefpodoxime 5mg/kg every 12 hr for 5 days. The client weighs 88lb. How many mg should the nurse administer per dose?
200 mg
How is C. diff DX?
3 or more diarrhea, positive culture or toxins for c.diff
A nurse is preparing to administer metoprolol 5 mg IV bolus to a client for heart rate control. Available is metoprolol 1 mg/mL. How many mL should the nurse administer per dose? (Round to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)
5mL
A nurse is caring for a client who has hypertension and asks the nurse about a prescription for propranolol. The nurse should inform the client that this medication is contraindicated in clients who have a history of which of the following conditions? A. Asthma B. Glaucoma C. Depression D. Migraines
A. Asthma Propranolol is a beta blocker, is contraindicated in clients who has asthma because it can cause bronchospasms
A nurse is providing teaching to a client who has emphysema and a new prescription for theophylline. Which of the following instructions should the nurse provide? A. Avoid caffeine while taking this medication B. Administer the medication with food C. consume a high protein diet D. Increase fluids to 1L/day
A. Avoid caffeine while taking this medication
A nurse in a provider's office is reviewing the laboratory results of a client who takes furosemide for hypertension. The nurse notes that the client's potassium level is 3.3 mEq/L. The nurse should monitor for which of the following complications? A. Cardiac dysrhythmias B. Seizures C. Neurogenic shock D. Hypoglycemia
A. Cardiac dysrhythmias
The nurse is caring for a client who has congestive heart failure and is taking digoxin daily. The client refused breakfast and is complaining of nausea and weakness. Which of the following actions should the nurse take first? A. Check the client's vital signs B. Suggest that the client rests before eating the meal. C. Request an order for an antiemetic D. Request a dietitian consult.
A. Check the client's vital signs
Which calcium channel blockers act on Vascular Smooth Muscle (VSM) and decrease heart rate and contractility? (select all that apply) A. Diltiazem B. Verapamil C. Nifidipine
A. Diltiazem B. Verapamil
A nurse is teaching a middle age client about hypertension. Which of the following information should the nurse include in the teaching? A. Diuretics are the first type of medication to control hypertension. B. Limit your alcohol consumption to three drinks a day. C. Plan to lower saturated fats to 10 percent of your daily intake D. Reaching your goal blood pressure will occur within 2 months.
A. Diuretics are the first type of medication to control hypertension
A charge nurse is observing a newly licensed nurse administer medications to a client. Which of the following actions by the newly licensed nurse should prompt the charge nurse to intervene? A. Documents medication administration prior to administering it. B. Checks the provider's orders and confirmed dosage in a medication reference guide C. Verifies the medication against the prescription and medication label. D. Scans the bar code on the medication administration record and the client's arm band.
A. Documents medication administration prior to administering it.
This broadspectrum bactericidal inhibits a DNA enzyme gyrase and can have an adverse on any tendon on the body that can result in tendonitis or tendon rupture? A. Fluoroquinolones B. Sulfonamides C. Aminoglycoside D. Macrolide
A. Fluoroquinolones
A nurse is providing teaching to a cient who has hypertension and a new prescription for verapamil. Which of the following beverages should the nurse tell the client to avoid while taking this medication? A. Grapefruit juice B. Coffee C. OJ D. Milk
A. Grapefruit juice
A nurse is preparing to administer ampicillin and gentamicin sulfate via IV infusion. Which of the following resources should the nurse consult first regarding medication compatibility? A. Hospital pharmacist B. Medication sales representative C. Nurse manager D. Health Care Provider
A. Hospital pharmacist
A nurse is reviewing the medical record of a client who has hypertension and a new prescription for metoprolol. Which of the following findings should the nurse investigate further? A. Hx of left sided heart failure B. Diet controlled Type 2 DM C. Recently treated bilateral pneumonia D. A concurrent prescription for tadalafil
A. Hx of left sided heart failure
A nurse is teaching a client who has a new prescription for amoxicillin clavulanate to treat pharyngitis. Which of the following statements by the client indicates an understanding of the teaching? A. I will stop taking this medication if I develop itching B. I will double my dose, if I miss one. C. I will take this medication until my sore throat goes away. D. I should take this medication on an empty stomach between meals.
A. I will stop taking this medication if I develop itching
This carbapenem is is resistant to almost all beta lactamases and penetrates the gram negative cell envelope. A. Imipenem B. Vancomycin C. Gentamycin D. Ceftriaxone
A. Imipenem
A nurse manager is providing an educational program on antibiotic sensitivity to bacterial infections. The nurse should include in the teaching that vancomycin is indicated for which of the following infections? A. Methicillin-resistant Staphylococcus aureus B. Candida C. Klebsiella D. Pseudomonas aeruginosa
A. Methicillin-resistant Staphylococcus aureus
A nurse is teaching a client who has a new prescription for ciprofloxacin to treat an uncomplicated UTI. Which of the following instructions should the nurse include? A. Monitor the tendon pain B. Expect the urine to turn dark orange C. Take this medication with an antacid D. Drink 1,000 milliliter of fluid daily.
A. Monitor the tendon pain Ciprofloxacin can cause tendinitis and tendon rupture. The client should monitor and report tendon pain or inflammation.
A nurse is reviewing the serum laboratory findings for a client who has hypertension and is prescribed hydrochlorothiazide. Which of the following findings should the nurse report to the provider? A. Potassium 2.3 mEq/L B. Chloride 99 mEq/L C. Sodium 136 mEq/L D. Calcium 19 mg/dL
A. Potassium 2.3 mEq/L
Which form of penicillin G would you avoid in a client that is taking spironolactone? A. Potassium penicillin G B. Procaine penicillin G C. Benzathine penicillin G
A. Potassium penicillin G
A nurse in a coronary care unit is admitting a client who has had CPR following a cardiac arrest. The client is receiving lidocaine IV at 2mg/min. When the client asks the nurse why he is receiving that medication, the nurse should explain that it has which of the following actions? A. Prevents dysrhythmias B. Slows intestinal motility C. Dissolves blood clots D. Relieves pain
A. Prevents dysrhythmias Lidocaine is an antidysrhythmic medication that delays the conduction in the heart and reduces the automaticity of heart tissue.
A nurse is caring for a client who received an injection of penicillin G procaine. The client begins to experience dyspnea and tongue swelling. which of the following actions should the nurse perform first? A. Record the observed data in medical record B Administer epinephrine subcutaneously C. Obtain IV fluids for administration D. Deliver a dose of aminophylline by inhalation.
B Administer epinephrine subcutaneously
A nurse is monitoring a client who received epinephrine for angioedema after a first dose of losartan. Which of the following data indicates a therapeutic response to the epinephrine? A. Respirations are unlabored B. Client reports decreased groin pain of 3 on a 1 to 10 scale C. The client's blood pressure when arising from resting position is at premedication levels D. The client tolerates a second dose of medication with no greater than 1+ edema
A. Respirations are unlabored
When treating angina symptoms in patients with Unstable angina what is the underlying cause? Treatment goal? Treatment? A. Severe CAD, vasospasm, platelet aggregation, transient thrombi; increase O2 supply and decrease O2 demand; antiischemia, antiplatelet, and anticoagulant medications. B. Coronary Artery Spasm; increase O2 supply; and Vasodilators, CCB C. CAD; Decrease O2 demand; Rest, nitrate, CCB, and BB
A. Severe CAD, vasospasm, platelet aggregation, transient thrombi; increase O2 supply and decrease O2 demand; antiischemia, antiplatelet, and anticoagulant medications.
Which tetracyclines should not be taken with food, are eliminated by the kidneys and have short and intermediate formulations? (select all that apply) A. Tetracycline B. Democlocycline C. Doxycycline D. Monocycline
A. Tetracycline (short formulation 6Qh) B. Democlocycline (intermediate formulation Q12h)
A nurse is establishing health promotion goals for a female client who smokes cigarettes, has hypertension, and a BMI of 26. Which of the following goals should the nurse include? A. The client will walk for 30min 5 days a week. B. The client will increase calorie intake by 200 cal per day. C. The client will replace cigarettes with smokeless tobacco products. E. The client will list foods that are high in calcium, which should be avoided.
A. The client will walk for 30min 5 days a week.
A nurse is reviewing the medication record for a client who has chronic kidney disease. Which of the following medications should the nurse identify as having the potential to cause nephrotoxicity? A. Vancomycin B. Diphenhydramine C. Ondansetron D. Omeprazole
A. Vancomycin
A nurse is providing discharge teaching to a client who has asthma and a new prescription for fluticasone/salmeterol. For which of the following adverse effects should the nurse instruct the client to report to the provider? A. White coating in the mouth B. Sedation C. Increased appetite D. Dry oral mucous membranes
A. White coating in the mouth An adverse effect of the medication is oropharyngeal candidiasis. The nurse shouold instruct the client to gargle after each use, use a spacer to reduce the amount of drug in the mouth and throat, and report any white patches inside the mouth or on the tongue to the provider.
A nurse is teaching a client who has a new prescription for simvastatin. Which of the following instructions should the nurse include? A. You should avoid grapefruit juice. B. You should expect brown-colored urine C. You should monitor for ringing in the ears D. You should take the medication in the moring
A. You should avoid grapefruit juice.
What penicillin are extended spectrum penicillin, antipseudomonal penicillin? A. carbenicillin, piperacillin B. ampicillin, amoxicillin C. nafcillin, oxacillin D. penicillin G and V
A. carbenicillin, piperacillin used for gram negative and positive pseudomonal bacteria
What forms of NTG would be used for an acute attack? A. sublingual tablet B. transdermal patch C. Sublingual isosorbide dinitrate D. Translingual spray E. Topical ointment
A. sublingual tablet C. Sublingual isosorbide dinitrate D. Translingual spray
Which penicillin is considered broad spectrum? A. Nafcillin B. Ampicillin
B. Ampicillin
What medication is so highly toxic that anyone that takes the medication will suffer some form of nephrotoxicity and must be treated with 1 Liter of NS to promote renal perfusion? A. Antivirals B. Antifungal C. Vancomycin D. Influenza vaccine
B. Antifungal
This drug is very toxic to humans and because of the similarities in sterols in humans and the organism? A. Antivirals B. Antifungal C. Vancomycin D. Influenza vaccine
B. Antifungals Amphotericin B
A nurse is providing teaching to a client who has stable angina and a new prescription for transdermal nitroglycerin. Which of the following instructions should the nurse include? (select all that apply) A. Apply the patch to dry skin and cover the area with plastic wrap. B. Apply a new patch each morning C. Apply the patch to a hairless area and rotate sites. D. Remove the patch for 10 to 12 hr daily E. Apply a new patch at the onset of anginal pain.
B. Apply a new patch each morning C. Apply the patch to a hairless area and rotate sites. D. Remove the patch for 10 to 12 hr daily
A nurse is preparing to administer cephalexin oral suspension to an older adult client who has difficulty swallowing pills. which of the following actions should the nurse take? A. Avoid shaking the medication before administering B. Check the client for a penicillin allergy C. Monitor the client for constipation D. Store the medication at room temperature.
B. Check the client for a penicillin allergy Nurse should check the client for a penicillin allergy because cephalexin is a beta lactam antibiotic that is similar in actions and structure to penicillin.
A nurse is caring for four clients. After administering morning medications, she realizes that the nifedipine prescribed for one client was inadvertently administered to another client. Which of the following actions should the nurse take first? A. Fill out an occurrence form B. Check the client's vital signs C. Notify the client's provider D. Administer the medication to the correct client
B. Check the client's vital signs
When treating angina symptoms in patients with Variant angina what is the underlying cause? Treatment goal? Treatment? A. Severe CAD, vasospasm, platelet aggregation, transient thrombi; increase O2 supply and decrease O2 demand; anti ischemia, antiplatelet, and anticoagulant medications. B. Coronary Artery Spasm; increase O2 supply; and Vasodilators, calcium channel blocker (CCB) C. CAD; Decrease O2 demand; Rest, nitrate, calcium channel blocker (CCB), and BB
B. Coronary Artery Spasm; increase O2 supply; and Vasodilators, CCB
A nurse is caring for a client who is taking lisinopril. Which of the following outcomes indicates a therapeutic effect of the medication? A. Increase of HDL cholesterol B. Decrease in blood pressure C. Prevention of bipolar manic episodes D. Improved sexual function
B. Decrease in blood pressure
The nurse is providing discharge instructions to a client who has asthma and a new prescription for montelukast. The nurse should instruct the client to report which of the following adverse effects to the provider? A. palpitations B. Depression C. Blurred vision D. Constipation
B. Depression Montelukast can cause neuropsychiatric effects such as depression.
A nurse caring for a client who is taking digoxin for heart failure and develops indications of severe digoxin toxicity. Which of the following medications should the nurse prepare to administer? A. acetylchysteine B. Fab antibody fragments D. Naloxone E. Flumazenil
B. Fab antibody fragments Also called digoxin immune Fab, bind to digoxin and block its action. Administer IV to patients who have digoxin toxicity
A nurse is preparing to administer verapamil by IV bolus to a client who is having cardiac dysrhythmias. For which of the following adverse effects should the nurse monitor when giving this medication? A. Muscle pain B. Hypotension C. Hyperthermia D. Ototoxicity
B. Hypotension
A nurse is providing teaching to a client who has a new prescription for trasdermal nitrogylcerin paste. Which of the following statements by the client indicates the need for further teaching? A. I should measure the dosage on the supplied paper. B. I should leave the patch in place until it is time for the next dose C. I might have a headache when I first start taking this medication. D. I should get up slowly when I stand
B. I should leave the patch in place until it is time for the next dose Clients should have a period of 10 to 12 hours without the patch on to reduce the risk for nitrate tolerance.
A nurse is providing teaching to a client who has a new prescription for lisinopril. Which of the following statements by the nurse indicates an understanding of the teaching? A. I should take this medication with food B. I should report a cough to my provider C. I should expect to have facial swelling when taking this medication D. I should increase my intake of potassium rich foods
B. I should report a cough to my provider
A nurse is providing discharge teaching to a client who has asthma and new prescriptions for cromolyn and albuteral, both by nebulizer. Which of the following statements by the client indicates an understanding of the teaching? A. I will use both medications immediately after exercising. B. I will be sure to take the albuterol before taking the cromolyn C. If my breathing begins to feel tight, I will use the cromolyn immediately. D. I will administer the medications 10 minutes apart.
B. I will be sure to take the albuterol before taking the cromolyn The client should always use the bronchodilator (albuterol) prior to using the leukotriene modifier (cromolyn).
A nurse is teaching a client who is taking metronidazole. Which of the following sense alterations should the nurse include as an adverse effect of metronidazole? A. Olfactory changes B. Metallic taste C Alterations in touch D. Hearing loss
B. Metallic taste Metronidazole is an antiprotozoal medication that treats giardiasis and trichomoniasis. It most common adverse effects are headache, dry mouth, and an unpleasant metallic taste in their mouth.
A nurse is teaching a client who has a new prescription for catopril. Which of the following instructions should the nurse include in the teaching? A. Take this medication with food B. Monitor for a cough C. Avoid grapefruit juice D. Hold medication for heart rate less than 60/min
B. Monitor for a cough
A nurse is assessing a client who is taking oxacillin to treat an infection. The nurse should recognize which of the following findings is a manifestation of an allergic reaction? A. Diarrhea B. Pruritus C. Dark urine D. Fever
B. Pruritus
What class of antibiotics inhibits bacterial synthesis of folic acid and has the following adverse effects: Stevens Johnson syndrome -skin rash, skin sloughs off TX as a burn patient hemolytic anemia kernicterus in newborns and renal damage associated with crystal formation A. Fluoroquinolones B. Sulfonamides C. Aminoglycoside D. Macrolide
B. Sulfonamides
A nurse is providing is providing teaching to a client who has stable angina and a new prescription for nitroglycerin oral, sustained release capsules. Which of the following instructions should the nurse include? A. Stop taking the medication if side effects are troublesome B. Swallow the capsules whole C. Take 1 capsule at the onset of anginal pain D. Take the medication with meals.
B. Swallow the capsules whole
A nurse is assessing a client who is taking lisinopril to treat hypertension. Which of the following findings is a priority to report? A. Nasal congestion B. Swelling of the tongue C. Dry cough D. Nausea
B. Swelling of the tongue
A nurse is assessing a client who is receiving dopamine IV to treat left ventricular failure. Which of the following findings should indicate to the nurse that the medication is having a therapeutic effect? A Urine output is reduced. B. Systolic blood pressure is increased C. Cardiac output is reduced D. Apical heart rate is increased.
B. Systolic blood pressure is increased When dopamine has a therapeutic effect, it causes vasoconstriction peripherally and increases systolic blood pressure.
This antibiotic is used only for serious infections: MRSA, clostridium difficile infections, and serious infections in patients allergic to penicillin; it does not have a beta lactam ring and is narrow spectrum. A. Imipenem B. Vancomycin C. Gentamycin D. Ceftriaxone
B. Vancomycin Mechanism of Action: Weakens cell wall and bactericidal
A nurse is teaching a client who has urinary tract infection (UTI) and is takin ciprofloxacin. Which of the following instructions should the nurse give to the client? A. Limit your daily fluid intake while taking this medication B. You should report any tendon discomfort you experience while taking this medication C. This medication can cause photophobia, so be sure to wear sunglasses outdoors D. If the medicine causes and upset stomach, take an antacid at the same time.
B. You should report any tendon discomfort you experience while taking this medication
What penicillins are broad spectrum penicillin, aminopenicillins? A. carbenicillin, piperacillin B. ampicillin, amoxicillin C. nafcillin, oxacillin D. penicillin G and V
B. ampicillin, amoxicillin action against gram negative bacteria
Why should neonates not receive calcium and ceftriaxone (Rocephin) at the same time? A. ceftriaxone displaces the calcium causing cardiac dysfunction and death B. ceftriaxone and calcium causes precipitants in the lung and kidney causing death C. certriaxone and calcium causes liver cirrhosis and death D. certriaxone and calcium causes hemolytic anemia and death
B. ceftriaxone and calcium causes precipitants in the lung and kidney causing death must be given more than 48 hours apart
A nurse is caring for a client who has TB and new prescriptions for rifampin and pyrazinamide. Which if the following laboratory tests should the nurse instruct the client will be required while on this medication regimen? A. blood glucose levels B. liver function tests C. gallbladder studies D thyroid function tests
B. liver function tests
A patient that has an allergy to penicillin that causes anaphylaxis should not to take these antibiotics? (select all that apply) A. gentamycin B. piperacillin C. ceftriaxone D. vancomycin
B. piperacillin- b/c it is a penicillin C. ceftriaxone- b/c pt will anaphylaxis reactions to penicillin should not receive cephalosporins
A nurse is caring for a client who has streptococcal pneumonia and a prescription for penicillin G by intermittent IV bolus. 10 minutes into the infusion of the third dose, the client reports that the IV site itches and he feels dizzy and short of breath. Which of the following actions should the nurse take first? A. Auscultate the client's breath sounds B. stop the infusion C. elevate the head of the bed D. call the client's provider
B. stop the infusion
What formulation of Nitroglycerin (NTG) should be used for prophylaxis against angina? A. sublingual tablet B. transdermal patch C. Sublingual isosorbide dinitrate D. Translingual spray E. Topical ointment
B. transdermal patch E. Topical ointment
What antibiotics are commonly assoicated with C. diff?
Broad spectrum antibiotics: cllindomycin, 2nd/3rd gen cephalosporins, fluroquinolones
What are the sx's of an anaphylactic penicillin reaction?
Bronchoconstriction, vasodilation (massive), laryngeal edema
A nurse is planning to administer ceftriaxone IM to an adult client. Which of the following actions should the nurse plan to take? A. Administer the medication at a 45 degree angle B. Administer the medication using a 5/8 inch needle C. Administer the medication using a Z track technique D. Administer the medication in the deltoid muscle.
C. Administer the medication using a Z track technique The Z track technique is used to reduce pain and prevent medication to leak into subcutaneous tissue
A nurse is teaching a client who has a new diagnosis of asthma. Which of the following medications should the nurse instruct the client to use to abort an acute asthma attack? A. Salmeterol B. Formoterol C. Albuterol D. Beclomethasone
C. Albuterol Albuteraol is an inhaled short acting beta2 agonist used as a rescue medication to relieve an acute asthma attack.
A nurse is assessing a client after administration of a dose of losartan. The client has a hoarse voice, and swollen lips and tongue. In which order should the nurse take the following actions? A. Initiate IV access. B. Call the emergency response team C. Assess the client's airway D. Administer IV epinephrine E. Administer IV antihistamines F. Apply high-flow oxygen
C. Assess the client's airway B. Call the emergency response team F. Apply high-flow oxygen A. Initiate IV access. D. Administer IV epinephrine E. Administer IV antihistamines
A nurse is assessing a client after administering IV vancomycin. Which of the following is the nurse's priority to report to the provider? A. Client report of headache B. Client report of tinnitus C. Audible inspiratory stridor D. Localized redness at the catheter insertion site
C. Audible inspiratory stridor ABC's approach to client care: client at risk for bronchospasms, hypotension and circulatory collapse due to anaphylaxis. Nurse should contact the rapid response team and D/C vancomycin, administer epinephrine
A nurse is caring for a client who has active pulmonary tuberculosis (TB) and is to be started on intravenous rifampin therapy. The nurse should instruct the client that this medication can cause which of the following adverse effects? A. Black colored stools B. Staining of teeth C. Body secretions turning a red orange color D. Constipation
C. Body secretions turning a red orange color Rifampin will cause the urine, stool, saliva, sputum, and tears to turn reddish orange to reddish brown.
When treating angina symptoms in patients with stable angina what is the underlying cause? Treatment goal? Treatment? A. Severe Coronary artery disease (CAD), vasospasm, platelet aggregation, transient thrombi; increase O2 supply and decrease O2 demand; anti ischemia, antiplatelet, and anticoagulant medications. B. Coronary Artery Spasm; increase O2 supply; and Vasodilators, CCB C. CAD; Decrease O2 demand; Rest, nitrate, CCB, and BB
C. CAD; Decrease O2 demand; Rest, nitrate, CCB, and BB
Why is it important to use soap and water to clean hands instead of alcohol based hand gels?
C. Diff spores are removed by the friction of soap and water and alcohol based hand gels only spread around the spores
A nurse is providing teaching to a client who has hypertension and a new prescription for captopril. Which of the following instructions should the nurse provide? A. Take the medication with food. B. Count your pulse rate before taking this medication C. Do not use salt substitutes while taking this medication D. Expect to gain weight while taking this medication
C. Do not use salt substitutes while taking this medication
A nurse is providing discharge teaching for a client who has pulmonary edema and is about to start furosemide. Which of the following instructions should the nurse include? A. Take aspirin if headaches develop B. Expect some swelling in the hands and feet C. Eat foods that contain plenty of potassium D. Take the medication at bedtime.
C. Eat foods that contain plenty of potassium
A nurse is preparing to administer digoxin to a client who has heart failure. Which of the following actions is appropriate? A. Withholding the medication if the heart rate is above 100/min B. Instructing the client to eat foods that are low in potassium C. Evaluating the client for nausea, vomiting, and anorexia D. Measuring apical pulse rate for 30 seconds before administration
C. Evaluating the client for nausea, vomiting, and anorexia
A client has a prescription for nafcillin and tobramycin to be administered IV at 0800. what is the nurses priority action? A. Call HCP to clarify the prescription B. Hold the tobramycin C. Flush IV line between administration D. Obtain a trough at 0730
C. Flush IV line between administration
The nurse is caring for a client who has a heart failure and a prescription for digoxin. Which of the following statements by the client indicates an adverse effect of the medication? A. I am urinating more frequently. B. I can walk a mile a day. C. I feel nauseated and have no appetite D. I've had a backache for several days.
C. I feel nauseated and have no appetite
A nurse is teaching a client who has a new prescription for hydrochlorothiazide for management of hypertension. Which of the following instructions should the nurse include? A. Avoid grapefruit juice B. Take the medication before bedtime C. Monitor for leg cramps D. Reduce intake of potassium rich foods
C. Monitor for leg cramps
What drug has a primary action on Vascular Smooth Muscle (VSM)? A. metoprolol B. propranolol C. nifedipine D. verapamil E. diltiazem
C. Nifedipine--> treats variant angina adverse effect: reflex tachycardia
A nurse is caring for a client who has hypertension and has a potassium level of 6.8 mEq/L. Which of the the following actions should the nurse take? A. Obtain a blood sample for a serum sodium level B. Advise the client to add citrus juices and bananas to her diet. C. Obtain a 12 lead ECG D. Suggest that the client use a salt substitute.
C. Obtain a 12 lead ECG
A nurse is teaching a client about taking an expectorant to treat a cough. The nurse should explain that this type of medication has which of the following actions? A. Suppress the urge to cough B. Reduces inflammation C. Stimulates secretions D. Dries mucous membranes
C. Stimulates secretions Expectorants act by increasing secretions to improve a cough's productivity
A nurse is providing teaching to a client who has hypertension and a new prescription for hydrochlorothiazide. Which of the following instructions should the nurse provide? A. Weigh weekly to monitor therapeutic effect. B. Muscle pain is an expected adverse effect. C. Take the medication early in the day. D. Take the medication on an empty stomach
C. Take the medication early in the day.
A nurse is teaching a client who has a new prescription for colesevelam to lower his low-density lipoprotein level. Which of the following instructions should the nurse include? A Reduce fluid intake B. Chew tablets before swallowing C. Take this medication 4 hours after other medications D. Take this medication on an empty stomach.
C. Take this medication 4 hours after other medications
Which class antibiotic should never be given to pregnant women, lactating women, or children under the age of 8 years of age because of permanent staining of the teeth? A. Oxazolidinones B. Aminoglycosides C. Tetracyclines D. Sulfonamides
C. Tetracyclines
A nurse is reviewing the health history for a client who has angina pectoris and a prescription for propranolol hydrochloride PO 40 mg twice daily. Which of the following findings in the history should the nurse report to the provider? A. The client has a history of hypertension B. The client has a history of hypothyroidism C. The client has a history of bronchial asthma D. The client has a history of migraine headaches.
C. The client has a history of bronchial asthma Beta-adrenergic blockers can cause bronchospasm in clients who have bronchial asthma; therefore, this is a contraindication to the use of the medication.
A nurse is teaching a client who has asthma about how to use an albuterol inhaler. Which of the following actions by the client indicates and understanding of the teaching? A. The client waits 10 min between inhalations B. The client exhales as the medication is released from the inhaler C. The client holds his breath for 10 seconds after inhaling the medication D. The client takes a quick inhalation while releasing the medication from the inhaler.
C. The client holds his breath for 10 seconds after inhaling the medication
A nurse is completing a medical interview with a client who has elevated cholesterol levels and takes warfarin. The nurse should recognize that which of the following actions by the client can potentiate the effects of warfarin? A. The client sprinkles flax seeds on food 1 hr before taking the anticoagulant. B. The client drinks a glass of grapefruit juice every day. C. The client uses garlic to lower cholesterol levels. D. The client follows a low fat diet to reduce cholesterol.
C. The client uses garlic to lower cholesterol levels.
A nurse in a provider's clinic is assessing a client who takes sublingual nitroglycerin for stable angina. The client reports getting a headache each time he takes the medication. Which of the following statements should the nurse make? A. There's nothing that can be done to relieve the headaches that nitroglycerin causes. B. Take only one dose of nitroglycerin to reduce the risk of getting a headache C. Try taking a mild analgesic to relieve the headache. D. Well will ask the provider to prescribe a different medication for you.
C. Try taking a mild analgesic to relieve the headache.
A nurse is caring for a client who has hypertension and is afraid to take his blood pressure medication. Which of the following nursing statements is an example of the therapeutic communication response of reflection? A. Did your symptoms occur before or after you took the medication B. Why do you fell afraid to take your medication? C. You seem upset about taking your blood pressure medication. D. You won't get better until you take your medication.
C. You seem upset about taking your blood pressure medication.
What penicillins are narrow spectrum, penicillinase resistant, antistaphylococcal pencillins? A. carbenicillin, piperacillin B. ampicillin, amoxicillin C. nafcillin, oxacillin D. penicillin G and V
C. nafcillin, oxacillin More effective against bacteria because they are resistant to penicillinase
What antianginal drugs are used to treat Variant angina?(select all that apply) A. metoprolol B. propranolol C. nifedipine D. verapamil E. diltiazem
C. nifedipine D. verapamil E. diltiazem
A nurse is teaching a client about taking diphenhydramine. The nurse should explain to the client that which of the following is an adverse effect of this medication? A. constipation B. hypertension C. sedation D. bradycardia
C. sedation
What are the storage recommendations for Nitroglycerin (NTG) sublingual tablets?
Check expiration dates= loose effectiveness over time Tightly capped, dark container, room temperature= chemically unstable
A nurse is caring for a child who is experiencing status asthmaticus. Which of the following interventions is the priority for the nurse to take? A. Obtain a peak flow reading B. Determine the cause of the acute exacerbation C. Administer an inhaled glucocorticoid D. Administer a short acting beta 2 agonist (SABA)
D. Administer a short acting beta 2 agonist (SABA)
What antibiotic can cause neuromuscular blockade and must have serum peak and trough levels checked to monitor kidney function and help prevent ototoxicity? A. Sulfonamides B. Fluoroquinolones C. Penicillins D. Aminoglycoside
D. Aminoglycoside
A nurse is assessing an older adult client who is receiving digoxin. The nurse should recognize that which of the following findings is a manifestation of digoxin toxicity? A. Photosensitivity B. Ataxia C. Jaundice D. Anorexia
D. Anorexia
What is the mechanism of action of penicillins? A. Bacteriostatic; inhibits protein synthesis B. Bactericidal; disrupt protein synthesis C. Bacteriostatic; inhibits bacterial synthesis of folic acid D. Bactericidal; disrupt cell wall synthesis
D. Bactericidal; disrupt cell wall synthesis Penicillins all contain beta lactam ring; primarily act against gram positive bacteria and some gram negative bacteria:
A nurse is providing dietary teaching for a client who takes furosemide. The nurse should recommend which of the following foods as the best source of potassium? A. Cooked carrots B. 2% milk C. cheddar cheese D. Bananas
D. Bananas
A nurse is teaching a client who has hypertension and a new prescription for atenolol. Which of the following findings should the nurse include as adverse effects of this medication. A. Tremor B. Cough C. Constipation D. Bradycardia
D. Bradycardia
A nurse is assessing a client who is receiving IV vancomycin. The nurse notes a flushing of the neck and tachycardia. Which of the following actions should the nurse take? A. Document that the client experienced an anaphylactic reaction to the medication. B. Apply cold compress to the neck area C. Change the IV infusion site D. Decrease the infusion rate on the IV
D. Decrease the infusion rate on the IV The client is experiencing Red Man syndrome...this can lead to an anaphylactic reaction if the IV infusion rate is not slowed down to run greater than 1 hour
A nurse is caring for a client who has an infection and a prescription for gentamicin intermittent IV bolus every 8 hour. A peak and trough is required with the next dose. Which of the following actions should the nurse take to obtain an accurate gentamicin serum level? A. Draw a peak at 0900 and a trough at 2100 B. Draw a trough level at 0900 and a peak level at 2100 C. Draw a peak level 90 min prior to administering the medication and a trough level 90 min after the dose. D. Draw a trough level immediately prior to administering the medication and a peak level 30 min after the dose.
D. Draw a trough level immediately prior to administering the medication and a peak level 30 min after the dose.
A nurse is assessing a client prior to administering atenolol. Which of the following findings should prompt the nurse to withhold the medication? A. Blood pressure 160/94 mm Hg B. Respiratory rate 18/min C. Oxygen saturation 95% D. Heart rate 46/min
D. Heart rate 46/min
A nurse is providing teaching to a client who has oral candidiasis and a new prescription for nystatin suspension. Which of the following statements by the client indicates an understanding of the teaching? A. I will spit the medication out after swishing it around my mouth B. I will only need to take this medication for a few days C. I will take the medication every morning on an empty stomach D. I will store the medication at room temperature
D. I will store the medication at room temperature
A nurse is providing discharge teaching to a client who has a new prescription for verapamil for angina. Which of the following instructions should the nurse include? A. Limit your fluid intake to meal times. B. You can expect swelling of the ankles while taking this medication C. Do not take this medication on an empty stomach D. Increase your daily intake of fiber.
D. Increase your daily intake of fiber. The nurse should instruct the client to increase his daily intake of dietary fiber to reduce the risk of constipation associated with verapamil.
A nurse is caring for a client who has atrial fibrillation and receives digoxin daily. Before administering this medication, which of the following actions should the nurse take? A. weigh the client B. Measure the client's blood pressure C. Offer the client a light snack D. Measure the client's apical pulse
D. Measure the client's apical pulse
A patient that has been treated several times for C diff infection but continues to be reinfected may need to have the route of medication changed to: A. PO B. IV C. Intranasal D. Rectal
D. Rectal To locally treat the C-Diff infection
A nurse is providing instruction to a new nurse about caring for clients who are receiving diuretic therapy to treat heart failure. The nurse should explain that which of the following medications puts the clients at risk for both hyperkalemia and hyponatremia? A. Metolazone B. Furosemide C. Hydrochlorothiazide D. Spironolactone
D. Spironolactone
A nurse is teaching a client who has angina pectoris about starting therapy with SL nitroglycerin tablets. The nurses should include which of the following instructions regarding how to take the medication? A. Take this medication with 8 ounces of water. B. Take one tablet every 15 min during an acute attack. C. Take this medication after each meal and at bedtime D. Take one tablet at the first indication of chest pain.
D. Take one tablet at the first indication of chest pain.
What are the two most common side effects of cephalosporins? A. Bleeding B. Tachycardia and Diarrhea C. hemolytic anemia and superinfections D. allergies and thrombophlebitis
D. allergies and thrombophlebitis
This class of antibiotic has five generations classes and its mechanism of action is bactericidal and disrupts the cell wall? A. carbapenems B. sulfonylureas C. fluroquinolones D. cephalosporins
D. cephalosporins
The nurse administers an IV infusion of oxacillin and within minutes the client begins to show signs of anaphylaxis. What should the nurse do first? A. administer a beta 2 bronchodilator B. administer epinephrine C. tell the charge nurse D. stop the infusion
D. stop the infusion
The nurse anticipates a positive inotropic effect after the administration of which medication? Digoxin (Lanoxin) Captopril (Capoten) Propranolol (Inderal) Candesartan (Atacand)
Digoxin (Lanoxin)
Which generation of cephalosporins has the highest activity against gram negative bacteria such as pseudomonas bacteria? A. 1st gen B. 2nd gen C. 3rd, 4th, and 5th gen D. 5th gen E. 4th gen
E. 4th gen
A patient has MRSA what generation cephalosporin would you anticipate for the patients prescription? A. 1st gen B. 2nd gen C. 3rd gen D. 4th gen E. 5th gen
E. 5th gen ceftaroline (Teflaro)
Azithromycin (Zithromax) is a macrolide with an extended half life. How does this drug property promote compliance with administration?
Easier to take and take less often Loading dose and 1x/day dosing after
Doxycycline is often prescribed from the tetracycline class of drugs. what advantages might this drug have over other tetracyclines?
Excreted hepatically, long acting, can take with food and can be given IV
A client is hospitalized for heart failure and is receiving digoxin (Lanoxin) IV push. Which assessment finding is an indicator that the nurse should withhold the digoxin? Heart rate of 50 beats per minute. Respiratory rate of 16. Blood pressure of 110/80 mm Hg Rales upon lung auscultation.
Heart rate of 50 beats per minute.
What is the primary action of nitroglycerin?
vasodilation of the veins small action on the arterioles