Pharm Review
A nurse is caring for a client who is allergic to penicillin. The nurse should verify which of the following prescriptions with the provider? a. Amoxicillin-clavulanate b. Gentamicin c. Erythromycin d. Amphotericin B
a
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. Check the client for a penicillin allergy b. Monitor the client for constipation c. Store the medication at room temperature d. Avoid shaking the medication before administering
a
A nurse is providing teaching to a client who has a skin infection and a new prescription for gentamicin topical cream. Which of the following instructions should the nurse provide? a. Wash the affected area with soap and water before applying cream b. Increase intake of fluids while using this medication c. The medication might cause temporary blurred vision d. Apply the cream to large areas around the infection
a
A nurse is teaching a client how to mix regular insulin and NPH in the same syringe. Which action, if performed by the client, indicates the need for further teaching? a.Withdraws the NPH insulin first b.Withdraws the regular insulin fist c.injects air into NHP insulin vial first d.Injects an amount of air equal to the desired dose of the insulin into each vial
a
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 an understanding of the teaching? a. The client holds his breath for 10 sec after inhaling the medication b. The client takes a quick inhalation while releasing the medication from the inhaler c. The client exhales as the medication is released from the inhaler d. The client waits 10 min between inhalations
a
A patient receives a prescription for montelukast (Singulair) returns to his providers office after 3 days, complaining that "the drug is not working". She reports mild but continued dyspnea and has had to maintain consistent use to her bronchodilator inhaler, albuterol (Proventil). What does the nurse suspect is the cause of the failure of the montelukast? a. The drug has not had sufficient time of use to have full effects b.The patient is not taking the drug correctly c.The albuterol inhaler is interacting with the montelukast
a
The patient has been prescribed oxymetazoline (Afrin) nasal spray for seasonal rhinitis. The nurse will provide which of the following instructions? a. Limit use of this spray to 5 days or less b. This drug should not be used in conjunction with antihistamines c. This is an OTC drug and may be used as needed for congestion
a
The nurse is monitoring a client receiving levothyroxine sodium (Synthroid) for hypothyroidism. Which findings indicate the presence of a side effect associated with this medication? SELECT ALL THAT APPLY. a. insomnia b. Weight loss c. Bradycardia d. Constipation
a b
The nurse is teaching a community education about the major functions of the upper respiratory tract. What will the best plan by the nursing instructor include? Select all that Apply a. Inward airflow from the trachea branches off to the two bronchi b. The nose warms the air before it reaches the lungs c. The nasal mucosa is the first line of immunological defense d. Activation of the parasympathetic nervous system constricts arterioles in the nose e. Activation of the sympathetic nervous system constricts arterioles in the nose
a d e
A 63 year old patient with type 2 diabetes is admitted to the nursing unit with an infected foot ulcer. Despite previous good control of glyburide (Micronase), his blood glucose has been elevated this past several days, and has been elevated the past several days and he requires sliding-scale insulin. a. He is converting to a type 1 diabetic b. It is a temporary condition related to the stress response with increased glucose release c. The original antidiabetic drug is no longer working for him
b
A patient was admitted with Addison's disease. Assessment now reveals nausea, vomiting, and confusion. The nurse anticipates which urgent intervention? a.Placement of a nasogastric tube b.Administration of intravenous hydrocortisone c.Administration of intravenous diuretic d.Immediate endotracheal intubation
b
The patient is scheduled to receive 5 units of Humalog and 25 units of NPH (Isophane) insulin prior to breakfast. Which nursing intervention is most appropriate for this patient a.Offer the patient a high-carb snack in 6 hours b. Make sure the patient breakfast is available to eat before administering this insulin c. Administer the medication in 2 separate syringes
b
Which of the following drugs is most immediately helpful in treating a severe acute asthma attack? a. Betamethasone (Quar) b. Albuterol (Proventil, Ventolin) c. Salmeterol (serevent diskus)
b
. A nurse is caring for a client who has a fungal infection and has a new prescription for amphotericin B. which of the following laboratory values should the nurse report to the provider before initiating the medication? a. Sodium 140 mEq/L b. Potassium 4.5 mEq/L c. BUN 55 mg/dL d. Glucose 120 mg/dL
c
A nurse is caring for a client who has diabetes insipidus and is receiving vasopressin. The nurse should identify which of the following findings as an indication that the medication is effective? a. A decrease in blood sugar b. A decrease in blood pressure c. A decrease in urine output d, A decrease in specific gravity
c
The nurse provides instructions to a client who is taking Synthroid. How would the nurse instruct the client to take the medication? a.With food b.At lunchtime c.On empty stomach d.At bedtime with snack
c
. A nurse is caring for a client who has diabetes and a new prescription for 14 units of regular insulin and 28 units of NPH insulin subcutaneously at breakfast daily. What is the total number of units of insulin that the nurse should prepare in the insulin syringe? a. 14 units b. 28 units c. 32 units d. 42 units
d
A male age 67 reports taking diphenhydramine (Benadryl) for hay fever. Considering this patient's age, the nurse assesses for which of the following findings? a. Any recent weight gain b. A history of allergic reaction c. A history of peptic ulcer disease d. A history of prostatic or urinary conditions
d
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. Constipation b. Black colored stools c. Staining of teeth d. Body secretions turning a red-orange color
d
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. Reduced inflammation b. Suppresses the urge to cough c. Dries mucous membranes d. Stimulates secretions
d
A patient with a severe systemic fungal infection is to be given amphotericin B (Fungizone). Before starting the amphotericin infusion, the nurse permedicates the patient with acetaminophen (Tylonal), diphenhydramine (Benadryl), and prednisone (Delasone). What is the purpose of permedicating the patients prior to the amphotericin a. It delays the development of resistant fungal infections b. It prevents hyperthermia reactions from the amphotericin c. It works simultaneously with the amphotericin so a lower dose may be given d. It decreases the risk of hypersensitivity reactions to the amphotericin
d
The nurse teaches a medication class on bronchodilators for clients with asthma. The nurse evaluates that learned has occurred when the clients make which statements? a. The medication widens the airways because it decreases the production of mucous that narrows them b. The medication widens the airways before it decrease the production of histamine that narrows them c. The medication widens the airways because it acts on the parasympathetic nervous system d. The medication widens the airways because it stimulates the fight-or-flight response of the nervous system
d
Which of the following assessment findings would cause the nurse to withhold the patients regularly scheduled dose of levothyroxine (Synthroid)? a. A 1-kg (2lb) weight gain b. A blood pressure reading of 90/62 mmHg c. A temperature of 37.9 cel, (100.2 F) d. A heart rate of 110 beats / min
d
A patient has a prescription for fluticasone (Flonase). Place the following instructions in order in which the nurse will instruct the patient to use the drug. 1. Clear the nose by blowing 2. Prime the inhaler prior to first use 3. Instill one spray directed high into the nasal cavity 4. Spit out any excess liquid that drains into the mouth
1 2 3 4
. A nurse is providing discharge teaching to the parent of a child who is prescribed diphenhydramine 25 mg elixir every 4 hours as needed. The amount available is diphenhydramine elixir 12.5 mg/5mL. How many mL should the nurse administer per dose? (round to the nearest 10th, use leading 0s if it applies. Do not use a trailing zero) Answer: 10 mg
10
A nurse is assessing a client who is taking levothyroxine. The nurse should recognize which of the following findings is a manifestation of levothyroxine overdose? a. Insomnia b. Constipation c. Drowsiness d. Hypoactive deep-tendon reflexes
a
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. Administer a short acting beta 2 agonist (SABA) b. Obtain a peak flow reading c. Administer an inhaled glucocorticoid d. Determine the cause of the acute exacerbation
a
A nurse is caring for a client who has streptococcal pneumonia and a prescription for penicillin G by intermittent IV bolus. 10 min into the infusion of the third dose, the client reports that the IV site itches and that he feels dizzy and short of breath. Which of the following actions should the nurse take first? a. Stop the infusion b. Call the client's provider c. Elevate the head of the bed d. Auscultate the client's breath sounds
a
A 32 year old female has been started on amoxicillin (Amoxil, Trimox), for a severe UTI. before sending her home with this prescription, the nurse will provide which instruction? a. Ask her about oral contractive use and recommended an alternative method for the duration of the ampicillin course b. Teach her to wear sunscreen c. Assess for hearing loss d. Recommend taking the pill with some antacid to prevent GI upset
a
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 history of which of the following conditions? a. Asthma b. Glaucoma c. Depression d. Migraines
a
A patient has been prescribed fluticasone (flonase) to use with oxymetazoline (Afrin). How should the patient be taught to use these drugs? a. Use the oxymetazoline first, then the fluticasone after waiting 5 min b. Use the fluticasone first, then the oxymetazoline after waiting 5 min c. The drugs may be used in either order
a
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 store the medication at room temperature' b. "I will take the medicine every morning on an empty stomach" c. " i will spit the medication out after switching it around my mouth" d. "I will only need to take this medication for a few days"
a
A nurse is teaching a client who has a new prescription for regular insulin and NPH insulin. Which of the following instructions should the nurse include in the teaching? a. Keep the open vial of insulin at room temperature b. Inject the insulin into a large muscle c. Aspirate the medication prior to administration d. Administer the insulin in two separate injections
a
A patient is being treated with propylthiouracil (PTU) for hyperthyroidism, pending thyroidectomy. While the patient is taking this drug, what symptoms will the nurse teach the patient to report to the health care provider? a. Sore throat, chills, low-grade fever b. Tinnitus, altered taste, thickened saliva c. Insomnia, nightmares, night sweats d. Dry eyes, decreased blinking, reddened conjunctiva
a
A patient was prescribed chloroquine (Aralen) prior to a trip to an area where malaria is known to be endemic. The nurse will instruct the patient to remain on the drug for up to 6 weeks after returning and the patient asks why this is necessary. What is the nurse's best response a. "It continues to kill any remaining malarial parasites that may have been acquired during the trip that are in your red blood cells" b. "You may be carrying microscopic malaria parasites back with you on clothes or other personal articles" c. "It helps prevent transmission of to any of your family members"
a
Superinfections are an adverse effect common to all antibiotic therapy. Which of the following best describes a superinfection? a. The overgrowth of normal body flora or of opportunistic organisms such as viruses and yeast no longer held in check by normal, beneficial flora b. Bacterial resistance that creates infections that are difficult to treat and are often resistant to multiple drugs c. Infections requiring high-dose microbial therapy with increased chance of organ toxicity d. The overgrowth of normal body flora or of opportunistic organisms such as viruses and yeast no longer held in check by normal, bacterial flora
a
The nurse is talking with the parents of a child who will receive somatropin (Nutropin) about the drug therapy. Which important detail with the nurse includes in the teaching for these parents? a. The drug must be given by injection b. The drug must be given regularly to prevent mental retardation c. Daily lab monitoring will be required during the first weeks of therapy
a
Metronidazole (flagyl) is being used to treat a patient Giardia lamblia infection, a protozoan infection of the intestines. Which of the following are appropriate to teach this patient? a. Metronidazole may lead to a metabolic taste in the mouth b. The urine may turn dark amber brown while on the medication c. Taking the metronidazole with food reduces GI upset d.The metronidazole may be discontinued once the diarrhea subsides to minimize A/E e. Current sexual partners do not require treatment for this infection
a b c e
The client has an allergic rhinitis and asks the nurse what causes this. How should the nurse respond? a. It can occur after exposure to animal dander b. Tobacco smoke causes it in some people c. Exposure to pllens from weeds and grass cause an allergic response in some people d. It is caused by asthma e. You inherited the predisposition for this
a b c e
A patient has been diagnosed with tuberculosis and is prescribed Rifatar (pyrazinamide with isoniazid and rifampin). While the patient is on this medication, what teaching is essential. (select all that apply) a. It is critical to continue therapy for at least 6-12 months b. Two or more drugs are used to prevent tuberculosis bacterial resistance c. No special precautions are required d. After 1 month of treatment, the medication will be discontinued e. These drugs may also be used to prevent tuberculosis
a b e
A client taking Humulin NPH and regular insulin every morning. The nurse should provide which instruction to the client? Select all that apply. a. Hypoglycemia may be experienced before dinnertime b.The insulin dose should be decreased if illness occurs c.The insulin be administration at room temperature d.The insulin vial needs to be shaken vigorously to break up precipitates e.The NPH insulin should be drawn into the syringe first, then the regular insulin
a c
A patient is receiving treatment for asthma with albuterol (Proventil). The nurse teaches the patient that while serious adverse effects are uncommon, the following may occur. a. Tachycardia b. Sedation c. Nervousness d. Temporary dyspnea e. Headache
a c e
What patient education should the nurse provide to the patient with diabetes who is planning an exercise program? (select all that apply) a. Monitor blood glucose levels before and after exercise b. Exercise may increase insulin needs c. Withhold insulin prior to engaging in strenuous exercise d. Eat a complex carb prior to strenuous exercise
a d
A nurse is preparing the teaching plan for a patient who will be discharged on methylprednisolone (Medrol Dosepak) after a significant response to poison ivy. The nurse will include instruction on reporting adverse effects to the healthcare provider. Which of the following should the patient report? Select all that apply a. Edema b. Tinnitus c. Dizziness upon standing d. Eye pain or visual changes e. Abdominal pain
a d e
A 32 year old female patient is starting on metronidazole (Flagyl) for treatment of a trichomonas vaginal infection. What must the patient eliminate from her diet for the duration she is on this medication a. Caffeine b. Alcohol c. Acific juice d. Anacids
b
A nurse is caring for a child who has asthma and a prescription for montelukast granules. Which of the following instructions should the nurse provide the client's parents on administering the mediation? a. Give the medication in the morning daily b. Administer the medication 2 hr before exercise c. Give the medication at the onset of wheezing d. Administer the granules mixed with 20 oz of water
b
A nurse is providing discharge teaching to a client who has asthma and new prescriptions for cromolyn and albuterol, both by nebulizer. Which of the following statements by the client indicates an understanding of the teaching? a. "If my breathing begins to feel tight, i will use the cromolyn immediately" b. "I will be sure to take the albuterol before taking the cromolyn" c. "I will use both medications immediately after exercising" d. "I will administer the medications 10 min apart"
b
A nurse is providing teaching for a client who is newly diagnosed with type 2 diabetes mellitus and has a prescription for glipizide. Which of the following statements by the nurse best describe the action of glipizide? a. "Glipizide absorbs the excess carbohydrates in your system" b. "Glipizide stimulates your pancreas to release insulin" c. "Glipizide replaces insulin that is not being produced by your pancreas" d. "Glipizide prevents your liver from destroying your insulin"
b
A patient has been using a fluticasone (Flovent) inhaler as a component of his asthma therapy. He returns to his health care provider's office complaining of a sore mouth. On inspection, the nurse notices white patches in the patient's mouth. What is a possible explanation for these findings? a. The patient has limited his fluid intake, resulting in dry mouth b. The patient has developed trust as a result of fluticasone c. The patient has been consuming hot beverages after the use of the inhaler
b
A patient will be discharged after surgery with a prescription for penicillin. When planning at-home instructions, what will the nurse include? a. Penicillins can be taken while breast-feeding b. The entire prescription must be finished c. All penicillins can be taken without regard to eating d. Some possible side effects include abdominal pain and constipation
b
A patient will be started on desmopressin (DDAVP) for treatment of diabetes insipidus. Which instruction should the nurse include in the teaching plan? a. Drink plenty of fluids, especially those high in calcium b. obtain and record your weight daily c. Avoid close contact with children or pregnant women for 1 week after administration of the drug d. Wear a mask if around children and pregnant women
b
A patient with type 2 diabetes treated with an oral antidiabetic medication is receiving oral fluconazole (Diflucan) for treatment of chronic tinea cruris (jock itch). The nurse instructs the patient to monitor blood glucose levels more frequently because of what potential drug effect? a. Fluconazole (Dufucan) antagonizes the effects of many antidiabetic medications, causing hyperglycemia b. Fluconazole (Dufucan) interacts with certain antidiabetic drugs, causing hypoglycemia c. Fluconazole (Dufucan) causes hyperglycemia d. Fluconazole (Dufucan) causes hypoglycemia
b
The client receives diphenhydramine (Benadryl) to control allergic symptoms. Which common symptom does the nurse teach the client to report to the physician? a. Sedation b. Urinary hesitancy c. Projectile vomiting d. Diarrhea
b
Which of the following is the best advice the nurse can give a patient with viral rhinitis who intends to purchase an OTC combination cold remedy? a. Dosage in these remedies provide precise dosing for each symptom that you are experiencing b. It is safer to use a single-drug reparation if you are experiencing only one symptom c. These drugs are best used in conjunction with an antibiotic
b
. A nurse is providing teaching to a client who has breast cancer about the adverse effects of chemotherapy. Which of the following client statements indicated an understanding of the teaching? a. "I will take the antibiotic as soon as the chemotherapy infusion is complete" b. "I will run my toothbrush in the dishwasher every month" c. "Ill call my doctor if I notice any unusual menstrual bleeding" d. "I will avoid crowds to keep from infecting others"
c
A 65 year old patient is prescribed ipratropium (Atrovent) for the treatment of asthma. Which of the following conditions should be reported to the healthcare provider before going to this patient the ipratropium? a. A history of intolerance to albuterol (Proventil) b. A reported allergy to chocolate c. A reported allergy to peanuts
c
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. Sedation b. Increased appetite c. White coating in the mouth d. Dry oral mucous membranes
c
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. Consume a high-protein diet b. Administer the medication with food c. Avoid caffeine while taking this medication d. Increase fluids to 1L / per day
c
A nurse is reviewing the medication list for a client who has a new diagnosis of type 2 diabetes mellitus. The nurse should recognize which of the following medications can cause glucose intolerance? a. Ranitidine b. Guaifenesin c. Prednisone d. Atorvastin
c
A nurse is teaching a client who has a new prescription for erythromycin. Which of the following information should the nurse include? a. "Take this medication with a glass of grapefruit juice" b. "Expect your skin to turn yellow" c. "Monitor for ringing in your ears" d. "Increase fiber intake to prevent constipation"
c
A nurse is teaching a client who has diabetes mellitus and a new prescription for glimepiride. The nurse should teach the client to avoid which of the following drinks while taking this medication? a. Grapefruit juice b. Milk c. Alcohol d. Coffee
c
A patient has been diagnosed with a fungal nail infection. The health care provider has prescribed griseofulvin (fulvicin). The nurse will include which of the following in her teaching to the patient? a. Drug therapy will be for a very short time, probably 2 to 4 weeks b. Carefully inspect all intramuscular injection sites for bruising c. Notify the provider if symptoms of infection woren d. Limit fluid intake to approximately 1,000 mL/day
c
A patient has been prescribed a tetracycline. When providing information regarding this drug, the nurse should include what information about tetracycline? a. It is classified as a narrow-spectrum antibiotic with minimal adverse effects b. It is used to treat a wide variety of disease processes c. It is contraindicated in children younger than 8 years old d. It has been identified to be safe during pregnancy
c
A patient received NPH and regular insulin every morning. The nurse is verifying that the patient understands that there are 2 different peak times to be aware of for this insulin regimen. Why is this an important concept for the nurse to stress? a. The patient needs to plan the next insulin injection around the peak times b. Additional insulin may be needed at peak times to avoid hyperglycemia c. This risk of hypoglycemia is greatest around the peak of insulin activity d. The risk of hypoglycemia is greatest around the peak of insulin activity
c
A patient with asthma has a prescription for 2 inhalers, albuterol (Proventil) and beclomethasone (Quar). How should the nurse instruct this patient on the proper use of the inhalers? a. Use the beclomethasone inhaler, and use the albuterol only if symptoms are not relieved b. Use the beclomethasone inhaler, wait 5-10 min, and then use the albuterol inhaler c. Use the albuterol inhaler, wait 5-10 minutes, then use the beclomethasone inhaler
c
The client has been diagnosed with Cushing's syndrome. What will the nurse's assessment likely reveal? a.Low blood pressure and hypoglycemia b.Well-healed scars on the upper body c.Upper body obesity d.Thin, gaunt appearance of the face
c
The nurse is assisting a patient with chronic adrenal insufficiency to plan for medication consistency while on a family vacation trip. He is taking hydrocortisone (Cotef) and fludrocortisone (Florinef) as replacement therapy. What essential details does this patient need to remember to do? a. Take his blood pressure once or twice daily b. Avoid crowded indoor areas to avoid infections c. Carry an oral and injectable form of both drugs with him on his trip d. Have his vision checked before he leaves
c
The nurse is initiating discharge teaching with the newly diagnosed patient with diabetes which of the following statements indicates that the patient needs additional teaching? a. "If I am experiencing hypoglycemia I should drink ½ cup of apple juice" b. "My insulin needs may increase when I have an infection" c. "I must draw the NPH insulin first if i am mixing it with regular insulin"
c
The nurse is instructing a client regarding intranasal desmopressin (DDAVP). The nurse should tell the client that which occurrence is a side effect of the medication? a.Headache b.Vulval pain c.Runny nose d.Flushed skin
c
The nurse is teaching the patient about the use of dextromethorphan with guaifenesin (Robitussin-DM) syrup for a cough accompanied by thick mucus. Which instruction should be included in the patient's teaching? a. Lie supine for 30 min after taking the liquid b. take the drug with food for best results c. Avoid drinking fluids immediately after the syrup but increase overall fluid intake throughout the day
c
A nurse is caring for a client who has diabetes and plans to administer his regular insulin subcutaneously before he eats breakfast at 0800. After checking the client's morning glucose level, which of the following actions should the nurse take? a. Give the insulin at 0700 b. Give the insulin when the breakfast arrives c. Give the insulin 30 min after breakfast with the clients other routine medications d. Give the insulin at 0730
d
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 using a ⅝ inch needle b. Administer the medication at a 45 degree angle c. Administer the medication in the deltoid muscle d. Administer the medication using a Z-track technique
d
A nurse is teaching a client who has a new diagnosis of asthma. Which of the following medications should the nurse instruct the clients to use to abort an acute asthma attack? a. Beclomethasone b. Salmeterol c. Formoterol d. Albuterol
d
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. Pseudomonas aeruginosa b. Klebsiella c. Candida d. Methicillin-resistant Staphylococcus aureus
d
A patient with type 2 diabetes has had nothing by mouth (NPO) since midnight for surgery in the morning. He has been on a combination of oral type 2 antidiabetic drugs. What would be the best action for the nurse to take concerning the administration of his medications? a. Hold all medications as per the NPO order b. Give him the medication with a sip of water c. Give him half to original dose d. Contact the health care provider for further orders
d
The nurse is preparing a medication for a client and observes the date of expiration on the vial occurred 2 months ago. Which of the following actions should the nurse take? a. Give the medication b. Discard the medication c. Notify the provider d. Return the medication to the pharmacy
d
What important information should be included in the patient's education regarding taking ciprofloxacin (Cipro)? a. The drug can cause discoloration of the teeth b. Fluid intake should be decreased to prevent urine retention c. The drug should be taken with an antacid to reduce gastric effects d. Any heel or lower leg pain should be reported immediately
d