Pharmacology ATI

A nurse is providing teaching to a client with hypertension and type 1 diabetes mellitus who has a new prescription for metoprolol. Which of the following statements by the client indicates an understanding of the teaching?

"I might have difficulty recognizing when my blood sugar is low." Rationale: Because it decreases the heart rate, this common manifestation of hypoglycemia can be masked and may be more difficult to identify. Recognize other manifestations including hunger, nausea, and sweating

Baclofen for multiple sclerosis with spasms. What will client say that will make sure they understand the teaching?

"I should not stop taking this medication suddenly." Rationale: other abrupt withdrawal side effects: visual hallucinations, paranoid ideations, and seizures.

RN teaching a client with a seizure disorder who has a new prescription for carbamazepine. Which statement should the nurse include in the teaching?

"This medication will decrease the effectiveness of oral contraceptives."

A nurse is preparing a discharge teaching plan for a 6-year-old client with asthma who has several prescription medications using metered-dose-inhalers (MDIs). Which of the following interventions should the nurse include in the plan?

Add a spacer to each MDI Rationale: MDIs are difficult to use correctly; even when properly used, only a portion of the medication is delivered to the lungs. A spacer applied to an MDI can make up for a lack of hand-lung coordination by increasing the amount of medication delivered to the lungs.

RN teaching a group of manifestations of progestin deficiency for clients who take a combination oral contraceptive. Which of the following findings should the nurse include in the teaching as an indication of progestin deficiency.

Amenorrhea Rationale: a client who takes a combination OC and has a progestin deficiency can have this. Increasing the OC dose of progestin can result in a more regular menstrual cycle

RN administering timolol eye drops to a client that has primary glaucoma. Prior to administration of the med the nurse should recognize that what condition in the clients history contraindicates this medication

Asthma Rationale: Timolol is a beta-blocker that can cause blocking of the beta-2 receptors, causing bronchospasm.

RN teaching a pt who has hypertension and a new prescription for oral clonidine. What should the teaching include.

Avoid driving until the client's reaction to the medication is known. Rationale: Clonidine can cause drowsiness, weakness, sedation, and other CNS effects.

A nurse is teaching a client who is using topical lidocaine about preventing systemic toxicity. Which of the following pieces of information should the nurse include about the application of topical lidocaine? A) Apply a dressing after covering the affected areas with topical lidocaine. B) Apply topical lidocaine to affected areas that are intact C) Apply topical lidocaine in a thick layer to affected areas D) Apply topical lidocaine frequently to large affected areas

B) Apply topical lidocaine to affected areas that are intact Rationale: Needs intact skin rather than blistered, broken, or irritated

A nurse is caring for a client who is receiving sumatriptan for cluster headaches. Which of the following findings should the nurse expect as an adverse effect?

Chest pressure Rationale: pt who takes sumatriptan can develop sensations of chest pressure and heavy arms. About 50% of clients who take sumatriptan experience chest pressure and heaviness of the arms that are transient and resolve.

A nurse is caring for a client who is experiencing an acute gout attack. The nurse should anticipate a prescription from the provider for which of the following medications?

Colchicine Rationale:

RN caring for a client with a new prescription for meperidine to manage pain. Which of the following actions should the nurse take?

Contact the provider for clarification of the prescription. Rationale: outside of the recommended range of 50 mg every 3-4 hours, not to exceed 600 mg within 24 hrs

RN caring for a client who has a suspected adrenal insufficiency. What med would the nurse anticipate the provider using to determine the presence of adrenal insufficiency?

Cosyntropin Rationale: The client is monitored after the provider injects cosyntropin to see if the cortisol level rises above 20 mcg/dL. If the adrenal response causes the cortisol level to elevate, the response is considered to be within the expected reference range. If the cortisol level does not elevate, the provider should determine that the client has adrenal insufficiency.

A nurse is teaching a client who has a prescription for a combination oral contraceptive (OC) that uses a 28-day cycle. Which of the following instructions should the nurse include in the teaching? A) "If you miss a pill, take the missed pill with your next dose." B) "If you miss 2 pills during the second and third week, discard the inactive placebo pulls and begin a new pack." C) "If you miss 3 pills during the second week, take a pill as soon as possible and continue with your scheduled doses." D) "You can miss up to 7 pills with little risk in getting pregnant as long as you have taken the pills regularly for the previous three weeks."

D) "You can miss up to 7 pills with little risk in getting pregnant as long as you have taken the pills regularly for the previous three weeks." Rationale: RN needs to instruct the client that up to 7 days can be missed with little to no increase in the chance of getting pregnant, provided that the client took the pills continuously for the previous three weeks

A nurse is caring for a female adult client who is experiencing menopause and has a prescription for estrogen along with progestin. The nurse should identify that the provider has prescribed these medications for which of the following reasons? A) Long term use to reduce the risk of breast cancer B) Short-term use to stimulate the endometrium C)Long term use to prevent osteoporosis D) Short term use to control urogenital atrophy

D) Short term use to control urogenital atrophy Rationale: These meds can be prescribed to assist with managing the manifestations of menopause like urogenital atrophy

RN is caring for a client who takes Ginkgo biloba to take at home. Which of the effects should the nurse expect to see

Decreased platelet aggregation

RN is monitoring a client who is receiving lactulose for cirrhosis. What lab value related to this medication should indicate to the nurse that the treatment is effective?

Decreased serum ammonia Rationale: lactulose is a laxative that can be used for chronic liver disorders. Lactulose improves the client's condition by decreasing ammonia levels through enhancing intestinal secretion of ammonia so that it can be eliminated from the body.

Client has a medical history of spasticity due to multiple sclerosis and a new prescription for tizanidine. What comorbidities increase the clients risk for adverse effects

Hepatitis Rationale: Tizanidine can cause urinary rhinitis however, a history of pneumonia does not increase the client's risk of developing adverse effects.

A nurse is reviewing the lab results of a client taking warfarin for a-fib. What lab result should be reported.

INR 5.5

RN is teaching a client who has type 2 diabetes mellitus about a prescription for insulin lispro. What is the following teaching?

Insulin lispro has an onset of about 15 minutes

RN is assessing a client who has multidrug-resistant tuberculosis and takes ethambutol. Adverse effect?

Loss of red/green discrimination

RN caring for a client who has a prescription for chlorothiazide to treat hypertension. The nurse should plan to monitor the client for which of the following adverse effects?

Muscle weakness Chlorothiazide is a thiazide diuretic used to treat hypertension and congestive heart failure. It promotes the excretion of water, sodium, and potassium and can cause hypokalemia. Manifestations of hypokalemia: muscle weakness, muscle cramps, and dysrhythmias

RN is teaching the parent of a child who has severe reactive airway disease about glucocorticoid therapy. The parent asks why her child has to inhale the medication instead of orally?

Oral glucocorticoids are more likely to slow linear growth in children

RN is reviewing the medical record of a client who is scheduled for induction of labor and has a prescription for misoprostol. Which of the following conditions should the nurse identify as a contraindication to administering this medication?

Past c-sections Misoprostol is used for cervical ripening and induction of labor. It causes a higher incidence of uterine tachysystole. Therefore, it is contraindicated in clients who have a hx of major uterine surgery or cesarean delivery with past pregnancies because of the risk of uterine rupture.

RN is teaching a client who has cirrhosis and has a new prescription for lactulose. What is a therapeutic effect of lactulose?

Reduces ammonia levels rationale: lactulose is a laxative that promotes the excretion of ammonia in a client who has hepatic encephalopathy from cirrhosis of the liver.

RN evaluating a 20-month old child who received a hepatitis A immunization three days ago. The parent reports that the child exhibited a loss of appetite following the immunization. What should the nurse do?

The nurse should tell the parents that a loss of appetite is a mild reaction in response to the hepatitis A vaccine and will usually last 1-2 days.

Rifampin

can turn body fluids orange

metoclopramide

reduces nausea and vomiting by increasing gastric motility and promoting gastric emptying. It is contraindicated for a client who has an intestinal obstruction or perforation

parenteral thiamine

the nurse should identify that the client who has a hx of alcohol and displays ataxia, altered LOC, and nystagmus is exhibiting manifestations of Wernicke-Korsakoff syndrome due to thiamine deficiency