Pharm Quiz 1
A nurse is teaching a client about the adverse effects of cisplatin. Which of the following adverse effects should the nurse include in the teaching? -tinnitus -constipation -hyperkalemia -weight gain
- Tinnitus (Tinnitus and hearing loss are adverse effects of cisplatin.)
A nurse is teaching a client who has a new prescription for esomeprazole to manage his GERD. Which of the following statements by the client indicates an understanding of the teaching? -"I won't pass gas as often now that I'm taking this medication." -"I will take this medication each morning with my breakfast/" -" I have an increased risk of getting pneumonia while taking this medication." -"I will need to take a daily stool softener while taking this medication."
-" I have an increased risk of getting pneumonia while taking this medication." (The client taking esomeprazole is at a greater risk for developing pneumonia due to an elevation of gastric pH, especially during the first few days of treatment. The nurse should instruct the client about manifestations of a respiratory infection and to report these findings to the provider if they occur.)
A nurse is providing instructions about bowel cleansing with polyethylene glycol-electrolyte solution (PEG) for a client who is going to have a colonoscopy. Which of the following information should the nurse include? -"to prevent dehydration, drink an additional liter of fluid during preparation time." -"Expect bowel movements to begin 3 hr following completion of solution." -"Abdominal bloating may occur." -"Drink 400mL every our until bowel movements are clear."
-"Abdominal bloating may occur." (While PEG is well-tolerated, adverse effects include nausea, bloating, and abdominal discomfort.)
A nurse is caring for an older adult client who reports taking bisacodyl tablets daily. Which of the following responses should the nurse make? -"irregular bowel movements are an indication of poor intestinal health." -"Excessive laxative use may cause an electrolyte imbalance." -Chronic use of laxatives can lead to a tear in the rectal mucosa." -" Decrease your intake of foods high in fiber."
-"Excessive laxative use may cause an electrolyte imbalance." (Bisacodyl is a stimulant laxative that acts by stimulating intestinal motility and increasing the amount of water and electrolytes within the intestines; therefore, chronic use of laxatives can lead to fluid and electrolyte imbalance.)
A nurse is teaching a client about the side effects of chemotherapy medication. Which of the following statement should the nurse include in the teaching? -"Most clients do not experience nausea." -"Hair loss is common and includes eyebrows and eyelashes." -" Most clients start to gain weight during their treatment." -"Client's lose their hair, but it usually grows back nice and thick."
-"Hair loss is common and includes eyebrows and eyelashes." (This nursing statement is correct, because alopecia occurs as a whole-body hair loss for most clients administered chemotherapy.)
A nurse is providing teaching to a client who has breast cancer about the adverse effects of chemotherapy. Which of the following client statements indicates an understanding of the teaching? -" I will take the antiemetic as soon as the chemotherapy is complete." -"I will run my toothbrush in the dishwasher every month" -"I will call my Dr if I notice any unusual menstrual bleeding." -" I will avoid crowds to keep from infecting others."
-"I will call my Dr if I notice any unusual menstrual bleeding." (Clients should be taught bleeding precautions and to report bruising or excessive bleeding.)
A nurse is teaching a client who has a new prescription for sucralfate to treat a gastric ulcer. Which of the following statements by the client indicates an understanding of the teaching. -"I will take this medication as needed to reduce pain." -"I will reduce my fluid intake with this medication." -" I will take this medication with an antacid." -"I will take this medication 1 hour before meals and at bedtime."
-"I will take this medication 1 hour before meals and at bedtime." (The client should take sucralfate on an empty stomach, 1 hr before each meal and at bedtime to create a protective coating over the ulcer.)
A nurse is providing teaching to a client who takes opioid pain medication and has a new prescription for docusate sodium. Which of the following statements by the client indicates an understanding of the teaching? -"It might take up to 3 days for the medication to work" -"I will take the medication for diarrhea." -" I should drink 4oz of water when I take this medication." -" I can take this medication along with mineral oil."
-"It might take up to 3 days for the medication to work" (The client understands docusate sodium is a stool softener and the therapeutic effect might take up to 3 days to achieve.)
A nurse is instructing a client who is newly diagnosed with pulmonary TB about the use of antitubercular medications. Which of the following information should the nurse include in the teaching? -Medications will need to be taken for the rest of the client's life, even if the client feels better. -Medications will need to be taken until the Mantoux test is negative. -A typical course of treatment involves 6-9 months of consistent medication use. -The client's family will also need to take medications to prevent infection.
-A typical course of treatment involves 6-9 months of consistent medication use. (Pulmonary TB is a contagious bacterial infection caused by Mycobacterium tuberculosis. Active TB is usually treated with the simultaneous administration of a combination of medications to which the organisms are susceptible. Such therapy is continued until the disease is controlled. A 6- to 9-month regimen consisting of two, and often four, different medications is used. The client should not drink alcohol during this time.)
A nurse on an oncology unit is preparing to administer doxorubicin to a client who has breast cancer. Prior to beginning the infusion, the nurse verified the client's current cumulative lifetime dose of the medication. For which of the following reasons is this verification necessary? -an excess amount of doxorubicin can lead to myelosuppression -exceeding the lifetime cumulative dose limit of doxorubicin might cause extravasation. -An excess amount of doxorubicin can lead to cardiomyopathy. -exceeding the lifetime cumulative dose limit of doxorubicin might produce red-tinged urine and sweat.
-An excess amount of doxorubicin can lead to cardiomyopathy. (Doxorubicin is an antineoplastic antibiotic used in the treatment of various cancers. Irreversible cardiomyopathy with congestive heart failure can result from repeated doses of doxorubicin, and prolonged use can also cause severe heart damage, even years after the client has stopped taking it. The maximum cumulative dose a client should receive is 550 mg/m2 or 450 mg/m2 with a history of radiation to the mediastinum.)
A nurse is caring for a client who has a fungal infection and a new prescription for amphotericin B. Which of the following laboratory values should the nurse report to the provider before initiating the medication? -Sodium 140 mEq/L -Potassium 4.5mEq/L -BUN 55 mg/dL -Glucose 120 mg/dL
-BUN 55 mg/dL (This BUN level is above the expected reference range (10-20 mg/dL). Amphotericin B is nephrotoxic and is contraindicated if BUN is > 40mg/dL. The nurse should report this laboratory value to the provider before initiating the medication.)
A nurse is completing a medication history for a client who reports using over the counter calcium carbonate antacid. Which of the following recommendations should the nurse make about this medication? -Decrease bulk in the diet to counteract the adverse effect of diarrhea -Take this medication with dairy products to increase absorption -Reduce sodium intake -Drink a glass of water after taking this medication.
-Drink a glass of water after taking this medication. (Calcium carbonate is a dietary supplement used when the amount of calcium taken in the diet is not enough. Calcium carbonate may also be used as an antacid to relieve heartburn, acid indigestion, and stomach upset. The client should drink a full glass of water after taking an antacid to enhance its effectiveness.)
A nurse is caring for a client who has cancer and a new prescription for ondansetron to treat chemotherapy induced nausea. For which of the following adverse effects should the nurse monitor? -Headache -dependent edema -polyuria -photosensitivity
-Headache (Headache is a common adverse effect of ondansetron. Analgesic relief is often required.)
A nurse is caring for a client who has prostate cancer. The nurse should expect the provider to prescribe which of the following medications for this client? -Leuprolide -Cyclophosphamide -Finasteride -Tamoxifen
-Leuprolide (Leuprolide treats cancer of the prostate hormonally. It antagonizes the androgens that androgen-dependent neoplasms require.)
A nurse is planning care for a client who has immunosuppression following chemotherapy. Which of the following interventions should the nurse include in the plan of care? -Insert and indwelling catheter to monitor sediment in the urine. -Take the client's temperature once per shift. -Provide the client with fresh fruit to avoid constipation. -Limit the number of heath care workers entering the room
-Limit the number of heath care workers entering the room (The nurse should limit the number of health care workers entering the client's room to prevent possible overexposure to microorganisms that can lead to an infection.)
A nurse is caring for a client who has tuberculosis and new prescriptions for rifampin and pyrazinamide. Which of the following laboratory tests should the nurse instruct the client will be required while on this medication regimen? -Liver function tests -Gallbladder studies -Thyroid Function studies -Blood Glucose Levels
-Liver function tests (Pyrazinamide and rifampin can both cause hepatotoxicity, thus the provider will monitor liver function regularly.)
A nurse is teaching about adverse effects of anastrozole with a client who has advanced breast cancer and is postmenopausal. Which of the following adverse effects should the nurse recommend the the client report to the provider? -Weight Gain -Stomatitis -Cough -Musculoskeletal Pain
-Musculoskeletal Pain (The client who is experiencing musculoskeletal pain should notify the provider. Musculoskeletal pain is a common adverse effect that affects 50% of clients that is possibly caused from estrogen deprivation.)
A nurse in a clinic is collecting a history from a client who reports that a member of his family just received a diagnosis of pulmonary TB. The nurse should expect the provider will prescribe which of the following diagnostic tests first? -Sputum culture for acid-fact bacillus (AFB) -Nucleic acid amplification test (NAAT) -CT Scan -Chest X-ray
-Nucleic acid amplification test (NAAT) (The CDC recommends that the NAAT test replace other diagnostic screening tests for tuberculosis. The test is performed on a client's sputum.)
A nurse is preparing for the admission of a client who has suspected active tuberculosis. Which of the following precautions should the nurse plan to implement to safely care for this client? -have staff and visitors wear gowns, masks, and gloves while in the room. -Place the client in a private room with a special ventilation system. -Assign the client to a room with other clients who require droplet precautions -modify the protocol for donning and removing personal protective equipment before entering or leaving the client's room.
-Place the client in a private room with a special ventilation system. (Clients who have active tuberculosis should be assigned to private rooms with negative-pressure airflow via HEPA filtration systems. In these rooms, the air is not returned to the inside ventilation system but is filtered and exhausted directly to the outside.)
A nurse is reviewing the CBC findings for a female client who is receiving combination chemotherapy for breast cancer. Which of the following findings should the nurse report to the provider? -WBC 2300/mm3 -RBC 5 million/mm3 -Hgb 12g/dL -Plt 155,000/mm3
-WBC 2300/mm3 ( This WBC finding is below the expected reference range. Chemotherapy treatment can cause leukopenia; the nurse should report this finding to the provider and implement precautions to protect the client from infection.)
A nurse is preparing a client who is to receive chemotherapy for treatment of ovarian cancer. Which of the following actions should the nurse plan to take? -tell the client to expect dark stools following chemotherapy. -have the client floss 4 times daily -have the client swish with commercial mouthwash before therapy -administer an antiemetic prior to the procedure.
-administer an antiemetic prior to the procedure. (The nurse can help prevent nausea and vomiting by administering an antiemetic prior to chemotherapy, and to tell the client to continue taking medication until nausea and vomiting resolve.)
A nurse is reviewing the medical record of a client who has a peptic ulcer. which of the following should the nurse recognize as a risk factor for this condition. -history of bulimia -history of NSAID use -drinks green tea -has a glass of wine with dinner each day
-history of NSAID use (The nurse should recognize that long-term use of NSAIDs is a risk factor for peptic ulcer disease. NSAIDs break down the mucosal barrier and cause production of prostaglandins to decrease, which results in local gastric mucosal injury.)
A nurse is providing teaching to a client who has a new prescription for tamoxifen to treat breast cancer. The nurse should include that which of the following is an adverse effect of this medication. -hot flashes -insomnia -increased appetite -constipation
-hot flashes (Hot flashes are a common adverse effect of tamoxifen. Other adverse effects include fluid retention and vaginal discharge. The nurse should advise the client these effects should subside when therapy is discontinued.)
A nurse is teaching a client who has chronic kidney disease and a new prescription for epoetin alpha. The nurse should instruct the client to increase dietary intake of which of the following substances? -iron -protein -potassium -sodium
-iron (Epoetin alfa is a synthetic form of erythropoietin, a substance produced by the kidneys that stimulates the bone marrow to produce red blood cells. Increased iron is needed for the production of hemoglobin and red blood cells by the bone marrow.)
A nurse is planning care for a client who has leukemia and a platelet count of 130,000/mm3. Which of the following interventions should the nurse include in the plan of care? -check the IV site for bleeding every 8hrs -limit IM injections -Obtain a rectal temperature every 8 hrs -Check the client for proteinuria
-limit IM injections (The nurse should plan to limit IM injections or venipunctures to prevent harm to the client. If venipuncture is necessary, the nurse should hold pressure to the site for 10 min afterward.)
A nurse is teaching a client who has a new prescription for dimenhydrinate. Which of the following instructions should the nurse include in the teaching? -monitor for dizziness -observe for diarrhea -administer 24hr before effects are desired -expect an increase in salivation
-monitor for dizziness (The client should monitor for dizziness and avoid activities that require alertness because dimenhydrinate can cause dizziness and drowsiness.)
A nurse is caring for a client who has active pulmonary TB and a new prescription for IV rifampin. The nurse should instruct the client that they should expect to experience which of the following manifestations while taking this medication. -constipation -black-colored stools -staining of teeth -red-colored urine
-red-colored urine (Rifampin is used in combination with other medicines to treat TB. Rifampin will cause the urine, stool, saliva, sputum, sweat, and tears to turn reddish-orange to reddish-brown.)
A nurse is reviewing the medication list for a client who has a new diagnosis of a small bowel obstruction. The nurse should withhold which of the following medications -senna -ibuprofen -omeprazole -zolpidem
-senna (Laxatives are contraindicated in clients who have fecal impaction, bowel obstruction, and acute abdominal surgery to prevent perforation. Because the bowel does not allow for any passage of stool with a complete small bowel obstruction, laxatives will cause increased abdominal cramping and discomfort.)
A nurse is providing teaching to a client who has renal failure and an elevated phosphorous level. The provider instructed the client to take aluminum hydroxide 300 mg PO three times daily. For which of the following adverse effects should the nurse inform the client. -constipation -metallic taste -headache -muscle spasms
Constipation (Constipation is a common side effect of aluminum-based antacids. The nurse should instruct the client to increase fiber intake and that stool softeners or laxatives may be needed.)
A nurse is caring for a client who is experiencing severe nausea and vomiting after a course of chemotherapy. The nurse should monitor the client for which of the following clinical manifestations? -metabolic Acidosis -metabolic alkalosis -respiratory acidosis -respiratory alkalosis
Metabolic Alkalosis (Metabolic alkalosis can occur in clients who have excessive vomiting because of the loss of hydrochloric acid.)