Pharmacology EAQ's final

While caring for a client with urinary tract infection, the nurse manager delegated the work of administering oral medications. Which delegated would be appropriate for this task? Select all that apply.

-Licensed practical nurse (LPN) -Licensed vocational nurse (LVN)

A client with type 2 diabetes is taking one glyburide tablet daily. The client asks whether an extra pill should be taken before exercise. What is the nurse's best reply?

"Do not take an extra pill because you may become hypoglycemic when exercising."

A client receiving morphine is being monitored by the nurse for signs and symptoms of overdose. Which clinical findings support a conclusion of overdose? Select all that apply.

-Lethargy -Bradycardia -Slow respirations

What is the priority goal for a client with asthma who is being discharged from the hospital with prescriptions for inhaled bronchodilators?

Demonstrates use of a metered-dose inhaler

A female client with recurring headaches tells the practical nurse (PN) that she has been taking at least 4 grams of acetaminophen a day. Which laboratory studies should the PN review for this client?

Hepatic enzymes.

A client who has a history of osteoporosis and vertebral compression has been coming to the clinic more frequently for prescription refills of hydrocodone/acetaminophen. What inference will the nurse make?

Higher doses are needed to achieve pain relief.

A client has been hospitalized for 3 weeks while receiving a tricyclic medication for severe depression. One day the client says to the nurse, "I'm really feeling better; my energy level is up." After the encounter an aide tells the nurse that the client has given away a favorite jacket. What should the nurse conclude that the client's statement indicates?

Increased risk for suicide

A nurse recalls that the blockage of dopamine by antipsychotic drugs can cause extrapyramidal side effects such as akathisia. Which client behaviors reflect the presence of akathisia?

Motor restlessness, foot tapping, and pacing

A client who had a femoropopliteal bypass graft is receiving clopidogrel (Plavix) postoperatively. What should the nurse teach the client related to the medication?

Report multiple bruises on the extremities

A client is to be discharged on a regimen of lithium carbonate. What will the nurse include in the discharge teaching plan?

Encouraging the client to have the lithium blood level tested regularly

A client is to receive metoclopramide intravenously 30 minutes before initiating chemotherapy for cancer of the colon. The nurse explains that metoclopramide is given for what purpose?

Enhance relaxation of the upper gastrointestinal tract

A child with pulmonary edema is treated with opioids and furosemide. Which nursing interventions should be performed to promote safe drug administration? Select all that apply.

Following the principle of atraumatic care Administering oral drugs with food or snacks Documenting the client's age, weight, and height

What is the role of unlicensed assistive personnel in intravenous (IV) therapy for a client?

Collecting the data to be used in the assessment of the IV site

Hydrocortisone is prescribed for a client with Addison disease. Before discharge, the nurse teaches the client about this medication. What did the nurse include as a therapeutic effect of the drug?

Supports a better response to stress

A nurse evaluates that a client understands the side effects of hydrochlorothiazide (HCTZ) therapy when the client states that he should call the health care provider if he develops what?

Generalized weakness

Which medication does the nurse anticipate will be prescribed to relieve anxiety and apprehension in a client with pulmonary edema?

Morphine

The registered nurse is discussing with a practical nurse about teaching a client regarding the use of morphine as patient-controlled analgesia (PCA). Which statement made by the practical nurse indicates the need for further discussion?

"I should tell the client's family members to operate the morphine PCA pump."

A child who is receiving methotrexate and undergoing cranial radiation is very weak. Her mother asks the nurse whether she may give her daughter vitamins. How does the nurse respond?

"Although I can understand this idea, vitamins interfere with the action of methotrexate."

A client with gastric ulcer disease asks the nurse why the health care provider has prescribed metronidazole (Flagyl). What does the nurse explain?

"Antibiotics are prescribed to treat Helicobacter pylori infection."

A client who is receiving phenytoin to control a seizure disorder questions the nurse regarding this medication after discharge. How will the nurse respond?

"Antiseizure drugs will probably be continued for life."

What is a nurse's responsibility when administering prescribed opioid analgesics? Select all that apply.

-Count the client's respirations. -Document the intensity of the client's pain. -Verify the number of doses in the locked cabinet before administering the prescribed dose.

A lactating woman receives treatment for a medical condition and is taking a prescription medication that cannot be withheld. What type of drugs can the client take to minimize the risk to the neonate? Select all that apply.

-Drugs that are excluded from milk -Drugs consumed immediately after breastfeeding -Drugs that are the least likely to affect the neonate

A nurse is teaching a client about tricyclic antidepressants. Which potential side effects does the nurse include? Select all that apply.

-Dry mouth -Drowsiness -Constipation -Orthostatic hypotension

A 7-year-old child contracts a urinary tract infection. A sulfonamide preparation is prescribed. What is the priority nursing responsibility when the nurse is administering this drug?

Administering the drug at the prescribed times

A client is to receive 0.25 mg of digoxin intramuscularly. The ampule is labeled 0.5 mg = 2 mL. How many mL should the nurse administer? Record your answer using a whole number. ___ mL

1 mL

Nitroglycerin sublingual tablets are prescribed for a client with the diagnosis of angina. The client asks the nurse how long it should take for the chest pain to subside after nitroglycerin is taken. What should the nurse tell the client?

1 to 3 minutes

A healthcare provider prescribes a medication to be administered via a metered dose inhaler (MDI) for a young adult with asthma. List in order the steps the nurse teaches the client to follow when using the inhaler.

1. Shake the inhaler for 30 seconds 2.Exhale slowly and deeply to empty the air from the lungs 3.Hold the inhaler upright in the mouth 4.Start breathing in and press down on the inhaler once

A nurse mixes a short-acting and an intermediate-acting insulin in the same syringe to administer to a client with diabetes. List the actions in the order the nurse should perform them.

1. Don a pair of clean gloves. 2.Put air into the short-acting insulin vial. 3.Put air into the intermediate-acting insulin vial. 4.Withdraw the prescribed amount of short-acting insulin. 5.Withdraw the prescribed amount of intermediate-acting insulin.

A 16-year-old adolescent with recently diagnosed type 1 diabetes will receive NPH insulin subcutaneously. The nurse teaches the adolescent about peak action of the drug and the risk for hypoglycemia. If the adolescent injects NPH insulin at 8am, when is the patient most at risk for hypoglycemia?

12:00pm

A healthcare provider prescribes 0.2 mg of cyanocobalamin (vitamin B12) intramuscularly for a client with pernicious anemia. A vial of the drug labeled 100 mcg = 1 mL is available. How much solution should the nurse administer? Record your answer using a whole number. ___ mL

2 mL

A depressed client has been prescribed a tricyclic antidepressant. How long should the nurse inform the client that it will take before the client notices a significant change in the depression?

2 to 4 weeks

A monoamine oxidase inhibitor (MAOI) is prescribed. What should the nurse instruct the client to avoid while taking this drug?

Aged cheeses

On the psychiatric unit a client has been receiving high doses of haloperidol for 2 weeks. The client says, "I just can't sit still, and I feel jittery." Which side effect does the nurse suspect that the client is experiencing?

Akathisia

Which prescription should the practical nurse administer for a client who is experiencing an acute episode of bronchial asthma?

Albuterol (Proventil).

A nurse is caring for an older adult who is taking acetaminophen for the relief of chronic pain. Which substance is most important for the nurse to determine if the client is taking because it intensifies the most serious adverse effect of acetaminophen?

Alcohol

A client on treatment for depression visited the primary healthcare provider with a complaint of blurred vision and constipation. Which drugs are responsible for these adverse effects? Select all that apply.

Amoxapine Desipramine Amitriptyline

An older adult with cerebral arteriosclerosis is admitted with atrial fibrillation and is started on a continuous heparin infusion. What clinical finding enables the nurse to conclude that the anticoagulant therapy is effective?

An activated partial thromboplastin (APTT) twice the usual value

A client being treated for hypertension reports having a persistent hacking cough. What class of antihypertensive should the nurse identify as a possible cause of this response when reviewing a list of this client's medications?

Angiotensin-converting enzyme (ACE) inhibitors

A client asks a nurse why captopril was prescribed. What specific drug classification should the nurse include in the explanation to the client?

Antihypertensive

A client diagnosed with asthma has received a prescription for an inhaler. The nurse teaches the client how to determine when the inhaler is empty, instructing the client to do what?

Count the number of doses taken

The chemotherapy protocol prescribed for a client with tuberculosis includes vitamin B6 and isoniazid. What does the nurse identify as the reason for prescribing vitamin B6?

Counteract the peripheral neuritis that isoniazid may cause

The practical nurse (PN) is reinforcing teaching for a client who is receiving diltiazem (Cardizem), a calcium channel blocker. Which drug action should the practical nurse explain?

Decreased rate of contraction.

Which herbal product is contraindicated when a client is receiving anticoagulant therapy?

Garlic

Alprazolam is prescribed for a client who is anxious. For what therapeutic effect will the nurse monitor the client?

Resting quietly

A nurse is teaching a school-aged child how to use an insulin pump. What is most important for the child to understand?

The pump is an attempt to mimic the way a healthy pancreas works.

A client who has a habit of smoking is on estrogen therapy. What condition is the client at risk of developing?

Thrombosis

A client is taking administering warfarin (Coumadin). The nurse recalls that the antidote for this medication is what?

Vitamin K

A nurse is monitoring a child for toxicity precipitated by digoxin. For what sign of digoxin toxicity will the nurse assess the child?

Vomiting

While receiving an adrenergic beta 2 agonist drug for asthma, the client complains of palpitations, chest pain, and a throbbing headache. What is the most appropriate nursing action?

Withhold the drug and notify the healthcare provider.

An older adult living in a long-term care facility has been receiving lithium 600 mg twice a day for 3 weeks to ease manic behavior. The client is experiencing nausea and vomiting, diarrhea, thirst, polyuria, slurred speech, and muscle weakness. What is the most appropriate nursing intervention?

Withholding the next dose of lithium and drawing blood to test it for toxicity

Which client statement indicates to the practical nurse (PN) that a client understands discharge instructions about a new prescription for digoxin (Lanoxin)?

"I will take my pulse for one-minute every day."

Which side effect may be experienced by a client taking an antianxiety agent?

Ataxia

A nurse teaches a client with asthma about her illness during pregnancy. Which statement by the client indicates that the nurse's teaching has been effective?

"I can use my albuterol inhaler if it's absolutely necessary."

A pharmacy technician arrives on the nursing unit to deliver opioids and, following hospital protocol, asks the nurse to receive the medications. The nurse is assisting a confused and unsteady client back to the client's room. How should the nurse respond to the technician?

"I can't receive them right now. Please wait a few minutes or come back."

The healthcare provider prescribes nitroglycerin ointment for a client who was admitted for chest pain and a myocardial infarction (MI). Which statement, if made by the client, would indicate understanding of the side effects of nitroglycerin ointment?

"I may experience a headache."

A client with rheumatoid arthritis is to begin taking ibuprofen 800 mg by mouth three times a day. The nurse provides education about the medication's side effects. The nurse concludes that the teaching was effective when the client makes which statement?

"I need to have my blood work checked periodically."

A nurse is counseling the caregiver of a client with a personality disorder about antipsychotic medication. Which statement made by the caregiver during evaluation indicates a need for further teaching?

"I should cut down on the salt content in her food."

When talking with a client who has been receiving paroxetine (Paxil), the nurse determines that more clarification is needed when the client says:

"I've been on the medication for 8 days now, and I don't feel any better."

A client who has been taking ibuprofen for rheumatoid arthritis asks the nurse if acetaminophen can be substituted instead. What is the appropriate nursing response?

"Ibuprofen has antiinflammatory properties and acetaminophen does not."

A client who has been taking ibuprofen for rheumatoid arthritis asks the nurse if acetaminophen can be substituted instead. What is an appropriate nursing response?

"Ibuprofen is an anti-inflammatory and acetaminophen is not."

A client with tuberculosis asks the nurse why vitamin B 6 is given with isoniazid. What explanation should the nurse provide?

"Isoniazid interferes with the synthesis of this vitamin."

A client has been taking escitalopram (Lexapro) for treatment of a major depressive episode. On the fifth day of therapy the client refuses the medication, stating, "It doesn't help, so what's the use of taking it?" What is the best response by the nurse?

"It can take 1 to 4 weeks to see an improvement."

The healthcare provider prescribes isosorbide dinitrate 10 mg for a client with chronic angina pectoris. The client asks the nurse why the isosorbide dinitrate is prescribed. How will the nurse respond?

"It improves oxygen supply to heart tissue."

Famotidine (Pepcid) is prescribed for a client with peptic ulcer disease. The client asks the nurse what this medication does. How does the nurse respond?

"It inhibits gastric acid secretion."

The nurse concludes that a client with glaucoma needs education when the client makes which statement?

"It is dangerous for me to use sedatives."

After surgery for a ruptured appendix, a 12-year-old child is receiving morphine for pain control by way of a patient-controlled analgesia (PCA) infusion. A bolus of morphine can be delivered every 6 minutes. A parent will be staying with the child during the immediate postoperative period. What statement indicates to the nurse that the instructions about the PCA pump have been understood?

"She needs to push the PCA button whenever she needs pain medication."

A client with a seizure disorder is receiving phenytoin and phenobarbital. What client statement indicates that the instructions regarding the medications are understood?

"Stopping the drugs can cause continuous seizures and I may die."

A 15-year-old high school student with hay fever has been taking a prescribed long-acting antihistamine/decongestant every 8 hours for the past 2 days. The adolescent tells the nurse, "This medicine is making me sleepy. Can you change it to something else?" How should the nurse respond?

"The drowsiness usually goes away after several days."

The nurse is providing care for a client who had an endarterectomy one month ago. The nurse explains the reason that clopidogrel (Plavix) is being prescribed. The nurse concludes that the teaching is understood when the client says what?

"The medication will help prevent further clogging of my arteries."

A client is lonely and extremely depressed, and the health care provider prescribes a tricyclic antidepressant. The client asks the nurse what the medication will do. What is the best response by the nurse?

"The medication will increase your appetite and make you feel better."

Tuberculosis is confirmed and isoniazid, rifampin, and pyridoxine are prescribed for a client. The client says, "I've never had to take so many medicines for an infection before." What is the nurse's best reply?

"This type of organism is difficult to destroy."

A client in a hospice care facility is prescribed lorazepam. Which instruction should the hospital pharmacist give to the client?

"You should rise slowly from a supine to a sitting or standing position."

What strategies should the nurse apply during vaccination to reduce pain and anxiety? Select all that apply.

-Applying a topical anesthetic -Injecting the most painful vaccine last -Holding the child upright during the vaccination -Administering intramuscular injections rapidly without prior aspiration

A nurse is preparing to administer an ophthalmic medication to a client. What techniques should the nurse use for this procedure? Select all that apply.

-Clean the eyelid and eyelashes. -Apply clean gloves before beginning of procedure. -Press on the nasolacrimal duct after instilling the solution.

A healthcare provider prescribes aspirin therapy for a client with arthritis, and the nurse provides teaching about the undesirable side effects of this medication. What responses should the client identify as reasons to notify the healthcare provider? Select all that apply.

-Nausea -Easy bruising -Ringing in the ears

A primary healthcare provider prescribes carbamazepine for a client. The nurse teaches the client about effects of the drug that should be reported to the primary healthcare provider. Which effects does the nurse include? Select all that apply.

-Nausea or vomiting -Unusual bleeding or bruising

Antipsychotic drugs can cause extrapyramidal side effects. Which responses should the nurse document as indicating pseudoparkinsonism? Select all that apply.

-Rigidity -Tremors -Bradykinesia

What are the signs associated with serotonin syndrome? Select all that apply.

-Shivering -Mydriasis -Diaphoresis

A client has received instructions to take 650 mg aspirin every 6 hours as needed for arthritic pain. What should the nurse include in the client's medication teaching? Select all that apply.

-Take the aspirin with meals or a snack. -Do not chew enteric-coated tablets. -Report persistent abdominal pain.

A healthcare provider prescribes lithium carbonate for a client with bipolar disorder, depressive episode. What instructions will the nurse include when teaching the client about lithium? Select all that apply.

-Take the medication with food. -It may take several weeks for beneficial results to occur. -You do not have to restrict your intake of dietary sodium.

Which precautions should the nurse follow to minimize medication errors in children? Select all that apply.

-Use authoritative resources such as drug handbooks -Communicate with the parents or caregivers -Confirming information about the client every time a dose is given

Carbidopa-levodopa is prescribed for a client with Parkinson's disease. The nurse monitors the client for which side effects of the medication? Select all that apply.

-Vomiting -Anorexia -Changes in mood

A 30-year-old who began lithium carbonate therapy 3 weeks ago is having blood drawn for a lithium drug level. Which range will the nurse recognize as therapeutic?

0.4 to 1.3 mEq/L (0.4 to 1.3 mmol/L)

A health care provider prescribes 250 mg of a medication. The vial reads 500 mg/mL. How much medication (mL) should the nurse administer? Include a leading zero if applicable. Record your answer using one decimal place. _____ mL

0.5 mL

The physician orders 7,500 units erythropoietin to be administered subcutaneously weekly. The vial reads 10,000 units per milliliter. How much erythropoietin will the nurse give for each weekly dose? Include a leading zero if applicable. Record your answer using two decimal places. _____ mL

0.75 mL

The healthcare provider has prescribed enoxaparin 1 mg/kg for a client who had a total knee replacement. The client weighs 187 pounds (85 kg). This medication is available in a concentration of 30 mg/0.3 mL. What dose will the nurse administer in milliliters?

0.85 mL

The client reports having taken two Vicodin tablets every 4 hours for several weeks before surgery. If each tablet contains 500 mg of acetaminophen, how much acetaminophen had the client been ingesting per day? Record your answer using a whole number and no punctuation. ________ mg

6000 mg

A practitioner prescribes penicillin G benzathine suspension (Bicillin L-A) 2.45 million units for a client with a sexually transmitted infection (STI). The medication is available in a multidose vial of 10 mL in which 1 mL = 300,000 units. How many milliliters should the nurse administer? Record your answer using one decimal place. ____ mL.

8.2

Acetaminophen 15 mg/kg is prescribed for a child with a temperature of 102° F (38.9° C). How much will the nurse tell the parent to administer if the child weighs 9.6 kg and the acetaminophen strength is 160 mg/5 mL? Record your answer using one decimal place. ___ mL

4.5 mL

Which drug does a nurse anticipate may be prescribed to produce diuresis and inhibit formation of aqueous humor for a client with glaucoma?

AcetaZOLAMIDE (Diamox)

A client with a diagnosis of bipolar I disorder, manic episode, is started on a regimen of an antipsychotic agent and lithium carbonate. The nurse explains to the client that the rationale behind this regimen is that the antipsychotic has which action?

Acts to quiet the client while allowing time for the lithium to reach a therapeutic level

The laboratory international normalized ratio (INR) results of a client receiving warfarin have been variable. The nurse interviews the client to determine factors contributing to the problem. Which is most important for the nurse to identify?

Adherence to the prescribed drug regimen

A client is taking phenytoin to treat clonic-tonic seizures. The client's phenytoin level is 16 mg/L. Which action should the nurse take?

Administer the next dose of the medication as prescribed.

Which action may cause lipohypertrophy in a client who is receiving insulin injections?

Administering insulin into the same site each time

A client who had a tonic-clonic seizure of unknown etiology is to begin taking phenytoin (Dilantin). Which instruction should the nurse reinforce with the client?

Brush the teeth and gums three times daily

A client is admitted to the hospital and benazepril hydrochloride is prescribed for hypertension. Which is an appropriate nursing action for clients taking this medication?

Assess for dizziness.

A client is prescribed ranitidine 150 mg daily to treat peptic ulcer disease (PUD). Which instruction would the nurse give to the client about when to take this medication?

At bedtime

A client is known to be on lithium therapy for the treatment of depression. What is the expected adverse effect of this drug?

Ataxia

A health care provider recently made the diagnosis that a client has glaucoma. The nurse is preparing to administer eye drops to the client. Which ophthalmic solution is contraindicated for this client?

Atropine

A healthcare provider recently made the diagnosis that a client has glaucoma. The nurse is preparing to administer eyedrops to the client. Which ophthalmic solution is contraindicated for this client?

Atropine

A primary healthcare provider prescribes atenolol 20 mg by mouth four times a day for a client who has had double coronary artery bypass surgery. What information is most important for the nurse to include in the discharge teaching plan for this client?

Avoid abruptly discontinuing the medication.

A client with chronic gastritis is being treated with medication and diet. What should the nurse teach the client when discussing the therapeutic regimen?

Avoid using analgesics that contain aspirin

A client admitted for uncontrolled hypertension and chest pain was prescribed a low-sodium diet and started on furosemide. The nurse should instruct the client to include which foods in the diet?

Bananas

A client in the terminal stage of cancer is admitted to the hospital in severe pain. The client refuses the prescribed intramuscular analgesic for pain because it puts her to sleep, and she wants to be awake. One day, despite the client's objection, a nurse administers the pain medication, saying, "You know that this will make you more comfortable." What could the nurse in this situation be charged with?

Battery

A client is receiving hydrochlorothiazide (HCTZ). What should the nurse monitor to best determine the effectiveness of the client's hydrochlorothiazide therapy?

Blood pressure

What should the nurse assess to determine if a client is experiencing the therapeutic effect of valsartan (Diovan)?

Blood pressure

A nurse is providing discharge instructions about digoxin. Which response should a nurse include as a reason for a client to withhold the digoxin?

Blurred vision

An adolescent with a major depressive disorder is prescribed venlafaxine (Effexor). What signs or symptoms related to the medication should the nurse communicate immediately to the prescribing provider? Select all that apply.

Blurred vision Suicidal ideation Difficult urination

Metoprolol (Toprol-XL) is prescribed for a client with hypertension. For which side effect should the nurse monitor the client?

Bradycardia

The laboratory calls to report that a hospitalized client's lithium level is 1.9 mEq/L (1.9 mmol/L) after 10 days of lithium therapy. How will the nurse respond to this information?

By notifying the primary healthcare provider of the findings, because the level is dangerously high

The practical nurse (PN) discusses antihypertensive drug therapy with several clients diagnosed with high blood pressure. To improve client understanding, the PN should emphasize that which medication preserves renal function in a client with diabetes?

Captopril (Capoten).

A beta-blocker, atenolol (Tenormin), is prescribed for a client with moderate hypertension. What information should the nurse include when teaching the client about this medication? Select all that apply.

Change positions slowly Count the pulse before taking the medication Mild weakness and fatigue are common side effects

What should the nurse include in a teaching plan for a client taking calcium channel blockers such as Nifedipine (Procardia)? Select all that apply.

Change positions slowly. Report peripheral edema. Avoid drinking grapefruit juice.

A nurse is aware that after the administration of alprazolam (Xanax) is started, it is important to observe the client for side effects. What is the nurse's initial action?

Checking the client's blood pressure

A client is scheduled to begin chemotherapy 2 weeks after surgery for colon cancer. What explanation does the nurse give to explain the delay following surgery?

Chemotherapy interferes with cell growth and delays wound healing.

A nurse is caring for four clients who are addicted to different drugs. Which client does the nurse anticipate to be most likely to receive sedatives in the treatment program?

Client A- Alcohol

Four clients with cardiac arrhythmias are prescribed different medications. Which client should be monitored for fatigue?

Client C- varapamil

A client who takes high-dose aspirin for arthritis has an acute episode of right ventricular heart failure. The healthcare provider prescribes furosemide and lowers the client's usual dosage of aspirin. The client asks the nurse the reason for the lower dose. On what principle does the nurse base a response?

Competition for renal excretion sites by the drugs causes increased serum levels of aspirin.

A client has been receiving oxycodone (OxyContin) for moderate pain associated with multiple injuries sustained in a motor vehicle collision. The client has returned three times for refills of the prescription. What behavior, in addition to the client's slurred speech, leads the nurse to suspect opioid intoxication?

Constricted pupils

The nurse is preparing discharge instructions for a client who has begun to demonstrate signs of early Alzheimer's dementia. The client lives alone. The client's adult children live nearby. According to the prescribed medication regimen the client is to take medications six times throughout the day. What is the priority nursing intervention to assist the client with compliance of the medication regimen?

Contact the primary healthcare provider and discuss the possibility of simplifying the medication regimen.

A client on the psychiatric unit who is receiving high-dosage risperidone is exhibiting tremors of the hands. What will be the nurse's first intervention?

Contacting the primary healthcare provider

The healthcare provider prescribes an antibiotic for a male adolescent with an upper respiratory tract infection, who asks the practical nurse (PN) how long the prescribed antibiotics should be taken. What information should the PN provide?

Continue the medication until all of the prescription is taken.

A client is diagnosed with myasthenia gravis, and the anticholinesterase medication pyridostigmine is prescribed. When teaching the client about this medication, the nurse explains that the desired effect is to increase what?

Contraction of skeletal muscles

An 18-month-old toddler who stepped on a rusty nail 4 days ago shows signs of generalized tetanus, including neck and jaw stiffness and facial muscle spasms. The toddler is receiving intravenous diazepam as a muscle relaxant every 4 hours. What response to the medication does the nurse anticipate?

Control of laryngospasms and neck and jaw rigidity

Which therapeutic action should the practical nurse (PN) base an explanation to a client who is receiving a cardiac glycoside?

Decreased rate of contraction.

A client with rheumatoid arthritis has been taking a steroid medication for the past year. For which complication of prolonged use of this medication should the nurse assess the client?

Decreased white blood cells

A client is treated with lorazepam for status epilepticus. What effect of lorazepam does the nurse consider therapeutic?

Depresses the central nervous system (CNS).

The primary healthcare provider is concerned that one of the clients receiving haloperidol may be developing neuroleptic malignant syndrome. When assessing the client for this syndrome, for which clinical manifestations does the nurse monitor the client?

Diaphoresis and hyperpyrexia

Amlodipine (Norvasc) is prescribed for a client with hypertension. Which response to the medication should the nurse instruct the client to report to the health care provider?

Difficulty breathing

A client with Attention Deficit Disorder (ADD) is prescribed amphetamine (Adderall). Which side effect should the practical nurse (PN) explain is commonly experienced?

Difficulty sleeping.

The healthcare provider prescribes cycloplegic and mydriatic ophthalmic drops for a client who is having a cataract removal. What explanation about the drug actions should the practical nurse (PN) provide the client?

Dilates the pupil.

A client with hepatic cirrhosis develops hepatic encephalopathy. Neomycin sulfate (Mycifradin) is prescribed. The nurse concludes that the purpose of neomycin is to do what?

Diminish the blood ammonia level

A client with hypertension has received a prescription for metoprolol (Lopressor). Which information should the nurse include when teaching this client about metoprolol?

Do not abruptly discontinue the medication

A health care provider prescribes psyllium (Metamucil) 3.5 g twice a day for constipation. What is most important for the nurse to teach this client?

Each dose should be taken with a full glass of water.

A client is receiving antibiotics and antifungal medications for the treatment of a recurring vaginal infection. What should the nurse encourage the client to do to compensate for the effect of these medications?

Eat yogurt with active cultures daily

After receiving streptomycin sulfate for 2 weeks as part of the medical regimen for tuberculosis, the client states, "I feel dizzy and I can't hear as well as usual." The nurse withholds the drug and promptly reports the problem to the healthcare provider. Which part of the body does the nurse determine is being affected as indicated by the symptom reported by the client?

Eighth cranial nerve's vestibular branch

A nurse is evaluating the results of treatment with erythropoietin (Epogen). Which client response is considered significant?

Elevation in hematocrit level

A woman reports weight gain and hot flashes. The client is also found to have low estrogen levels. Which drug may be prescribed to alleviate hot flashes?

Estradiol

A client is receiving furosemide (Lasix) to relieve edema. The nurse should monitor the client for which response to the medication?

Excessive loss of potassium ions

The nurse reviews a client's medication history, which includes a cholinergic medication. The client states, "I take that for some kind of urinary problem." The nurse recalls that cholinergic medications are prescribed primarily for what type of urinary condition?

Flaccid bladder

To manage heart failure a client has been taking several medications, including furosemide 40 mg by mouth twice a day. The client develops severe muscle cramps and fatigue, and laboratory tests confirm the presence of hypokalemia. Potassium chloride intravenously (IV) and ECG monitoring have been prescribed. Which ECG change associated with hypokalemia should the nurse expect to observe?

Flattened T waves

A client with a diagnosis of schizophrenia is discharged from the hospital. At home the client forgets to take the medication, is unable to function, and must be rehospitalized. What medication may be prescribed that can be administered on an outpatient basis every 2 to 3 weeks?

Fluphenazine

Sildenafil (Viagra) is prescribed for a man with erectile dysfunction. A nurse teaches the client about common side effects of this drug. Select all that apply.

Flushing Headache Dyspepsia

A client is admitted to the psychiatric hospital with a diagnosis of obsessive-compulsive disorder. The client's anxiety level is approaching a panic level, and the client's ritual is interfering with work and daily living. Which selective serotonin reuptake inhibitor (SSRI) does the nurse anticipate that the primary healthcare provider may prescribe?

Fluvoxamine

What side effect should the practical nurse (PN) report to the healthcare provider for a client who is taking prednisone (Deltasone)?

Gastric bleeding.

A nurse has provided teaching to a client with a newly prescribed proton pump inhibitor (PPI). The nurse determines that the teaching is effective when the client states that the medication is used for the treatment of what?

Gastroesophageal reflux (GERD)

After the nurse provides education about hydrochlorothiazide, the client will agree to notify the healthcare provider regarding the development of which symptom?

Generalized weakness

A client is started on tetracycline antibiotic therapy. What should the nurse do when administering this drug?

Give the medication an hour before milk products are ingested.

A client with asthma is pregnant. Which nursing intervention is advisable to ensure the safe delivery of the baby?

Have the client continue the asthma treatment

A hospice client who has severe pain asks for another dose of oxycodone. The nurse's primary consideration when responding to the client's request is to do what?

Help reduce the client's pain immediately

The practical nurse (PN) is reviewing the discharge plan for a client with mania who is receiving lithium carbonate (Eskalith). To achieve a stable serum level, which information should the PN reinforce with the client?

How to recognize symptoms of toxicity.

The nurse suspects serotonin syndrome in a client prescribed second-generation antidepressants for depression. Which assessment findings observed by the nurse would be beneficial in diagnosing the severity of the syndrome? Select all that apply.

Hyperthermia Rhabdomyolysis

At 4:30 PM, a client who is receiving human insulin (Humulin N) every morning states, "I feel very nervous." The nurse observes that the client's skin is moist and cool. What is the nurse's most accurate interpretation of what the client is likely experiencing?

Hypoglycemia

A client is taking furosemide. At each clinic visit, the nurse should assess for what adverse effect?

Hyporeflexia

The healthcare provider prescribes atenolol for a client with angina. What potential side effect will the nurse mention when instructing the client about this medication?

Hypotension

A lactating woman takes fluoxetine to treat depression. Her newborn developed tremors, seizures, and fever. Which drug-induced physiologic alterations may be responsible for the central nervous system effects of the drug on the neonate?

Immature blood-brain barrier

A client's tissue culture results indicate the wound is infected with methicillin-resistant Staphylococcus aureus (MRSA). What action should the practical nurse (PN) implement first?

Implement contact isolation precautions.

A 12-month-old infant is to receive ferrous sulfate for iron-deficiency anemia. How should the nurse administer the medication?

In a syringe directed toward the back of the mouth

A 13-year-old-child with type 1 diabetes is receiving 15 units of Novolin R insulin and 20 units of Novolin N insulin at 7 am each day. At what time should the nurse anticipate a hypoglycemic reaction from the Novolin N to occur?

In the afternoon

A client will be taking nitrofurantoin 50 mg orally every evening at home to manage recurrent urinary tract infections. What instructions should the nurse give to the client?

Increase the intake of fluids.

After being hospitalized for a transient ischemic attack (TIA) related to hypertension, a client is discharged with a prescription of hydrochlorothiazide. What should the nurse instruct the client to do when taking this medication?

Increase the intake of potassium

A client is receiving dexamethasone to treat acute exacerbation of asthma. For what side effect should the nurse monitor the client?

Increased blood glucose

A health care provider prescribes simvastatin 20 mg daily for elevated cholesterol and triglyceride levels for a female client. Which is most important for the nurse to teach when the client initially takes the medication?

Inform the health care provider if the client wishes to become pregnant.

The nurse reinforces instructions about how to use a nebulizer to a client with chronic obstructive pulmonary disease (COPD). The nurse concludes that additional teaching is needed when the client does what?

Inhales with the lips tightly sealed around the mouthpiece of the nebulizer

Ranitidine (Zantac) has been prescribed to help treat a client's gastric ulcer. The nurse expects this drug to act specifically by doing what?

Inhibiting the histamine H 2 receptors

Valsartan (Diovan), an angiotensin II receptor antagonist, is prescribed for a client. For which possible side effects should the nurse monitor the client? Select all that apply.

Irregular pulse rate Orthostatic hypotension

Valsartan, an angiotensin II receptor antagonist, is prescribed for a client. For which possible side effects should the nurse monitor the client? Select all that apply.

Irregular pulse rate Orthostatic hypotension

A nurse concludes that a client has a hypoglycemic reaction to insulin. Which clinical findings support this conclusion? Select all that apply.

Irritability Heart palpitations

A nurse prepares to administer metformin (Glucophage XR) to an older adult who has asked that it be crushed because it is difficult to swallow. The nurse explains that this drug cannot be crushed because of what reason?

It is released slowly.

A client with arthritis, "Can I take Tylenol instead of aspirin? Aspirin irritates my stomach." The nurse explains what about acetaminophen (Tylenol)?

It lacks an anti-inflammatory action

When teaching the parents of an 8-year-old child who is taking a high dose of prednisone (Meticorten) for asthma, what critical information about prednisone should be included?

It should be stopped gradually.

An agitated, acting-out, delusional client is receiving large doses of haloperidol, and the nurse is concerned because this drug can produce untoward side effects. Which clinical manifestations will alert the nurse to stop the drug immediately? Select all that apply.

Jaundice Tachycardia

A client is admitted to the hospital with the diagnosis of Parkinson disease. What medication should the nurse expect the health care provider to prescribe to relieve the client's physiological responses to this disease?

Levodopa

A nurse is caring for a 15-year-old adolescent who was admitted to the hospital after taking an acetaminophen overdose. The result of which diagnostic study is most important for the nurse to monitor at this time?

Liver function tests

A client starting her second trimester asks a nurse in the prenatal clinic whether she can safely take an over-the-counter medicine. The nurse explains why she should consult with her primary healthcare provider before taking any oral medications. What physiologic alteration associated with pregnancy may change the client's response to medication?

Longer gastrointestinal emptying time

A health care provider prescribes daily docusate sodium (Colace) for a client. The nurse determines that the action of this drug in the gastrointestinal (GI) tract is to do what?

Lower the surface tension of feces

A client is taking furosemide (Lasix) and digoxin (Lanoxin) for heart failure. Why does the nurse advise the client to drink a glass of orange juice every day?

Maintaining potassium levels

A pain scale of 1 to 10 is used by a nurse to assess a client's degree of pain. The client rates the pain as an 8 before receiving an analgesic and a 7 after being medicated. What conclusion should the nurse make regarding the client's response to pain medication?

Medication is not adequately effective.

An infertile client is found to have a hormonal deficiency at the pituitary level. Which fertility drug may be prescribed to treat infertility?

Menotropins

The postoperative prescriptions for a client who had repair of an inguinal hernia include docusate sodium (Colace) daily. Before discharge, what does the nurse teach the client that an intermittent side effect of this medication may be?

Mild abdominal cramping

A school-aged child with a seizure disorder has been taking carbamazepine (Tegretol) for 3 years. What nursing intervention is most important at this time?

Monitoring the child's complete blood cell counts

Carbidopa-levodopa is prescribed for a client with Parkinson disease. The nurse assesses for which adverse responses that are associated with this medication? Select all that apply.

Nausea Emotional changes

A caregiver fails to give medications on time to an older adult. Which type of abuse is this?

Neglect

The count of hydrocodone is incorrect. After several minutes of searching the medication cart and medication records, no explanation is found. Who should the primary nurse notify about the discrepancy?

Nursing unit manager

A nurse is teaching clients about dietary restrictions during monoamine oxidase inhibitor (MAOI) therapy. What response does the nurse tell them to anticipate if they do not follow these restrictions?

Occipital headaches

An 8-year-old child is being given insulin glargine (Lantus) before breakfast. What is the most appropriate information for the nurse to give the parents concerning a bedtime snack?

Offer a snack to prevent hypoglycemia during the night.

A pregnant client is prescribed heparin to prevent the risk of thromboembolism. Which adverse effects should the nurse anticipate with this medication? Select all that apply.

Osteoporosis Compression fractures of the spine

A male client who is receiving prolonged steroid therapy complains of always being thirsty and urinating frequently. What is the nurse's best initial action?

Perform a finger stick to test the client's blood glucose level.

Which action should the practical nurse implement when administering a buccal medication?

Place the medication between the upper molar teeth and cheek.

A client receives a prescription for nitroglycerin sublingual as needed for anginal pain. What should the nurse include in the teaching about this medication?

Place the tablet under the tongue or between the cheek and gum.

A client with a partial occlusion of the left common carotid artery is to be discharged while still receiving warfarin (Coumadin). Which clinical adverse effect should the nurse identify as a reason for the client to seek medical consultation?

Presence of blood in urine

For what client response must the nurse monitor to determine the effectiveness of amiodarone (Cordarone)?

Presence of cardiac dysrhythmias

A child recovering from a severe asthma attack is given oral prednisone 15 mg twice daily. What is the priority nursing intervention?

Preventing exposure of the child to infection

Selegiline is prescribed for a client with Parkinson disease who is having an inadequate response to levodopa therapy. What information does the nurse include when teaching the client about the addition of this drug to the regimen?

Primary healthcare provider should be contacted immediately if a severe headache occurs.

A client who is taking lithium arrives at the mental health center for a routine visit. The client has slurred speech, has an ataxic gait, and complains of nausea. The nurse knows that these signs and symptoms are what?

Probably associated with a toxic level of lithium

A client is receiving penicillin G and probenecid for syphilis. What rationale should the nurse give for the need to take these two drugs?

Probenecid delays excretion of penicillin, thus maintaining blood levels for longer periods.

A school-aged child is receiving 45 units of intermediate-acting insulin at 7:00 AM and 7:00 PM. What will the nurse tell the parents regarding a bedtime snack?

Provide a bedtime snack to prevent hypoglycemia during the night.

Enoxaparin (Lovenox) 40 mg subcutaneously daily is prescribed for a client who had abdominal surgery. The nurse explains that the medication is given to do what?

Provide prophylaxis against postoperative thrombus formation

A health care provider prescribes an antihypertensive medication. Which over-the-counter medication should the nurse teach the client to avoid because it has the potential to counteract the effect of the antihypertensive?

Pseudoephedrine (Sudafed)

A client begins fighting and biting other clients. The practitioner prescribes a stat injection of haloperidol (Haldol). How should the nurse implement this prescription?

Quickly, with an attitude of concern

After an acute episode of gastrointestinal (GI) bleeding, a client is diagnosed with gastric ulcer. The client receives a prescription for ranitidine (Zantac) 150 mg twice a day to be taken with meals. Why does the nurse contact the health care provider about the prescription?

Ranitidine can be administered by a variety of routes.

A health care provider prescribes ranitidine (Zantac) for a client with heartburn. During a teaching session, which information will the nurse share with the client about how this drug works?

Ranitidine reduces gastric acidity in the stomach.

A client has been prescribed lithium. What important nursing intervention must be implemented while this medication is being administered?

Regularly testing the level of the drug in the client's blood

A client using fentanyl transdermal patches for pain management in late-stage cancer dies. What should the hospice nurse who is caring for this client do about the patch?

Remove and dispose of the patch in an appropriate receptacle.

A client is diagnosed with Parkinson disease and receives a prescription for levodopa therapy. The nurse concludes that the medication is appropriate for this client because it does what?

Restores the dopamine levels in the brain

A client who takes four 325-mg tablets of buffered aspirin four times a day for severe arthritis complains of dizziness and ringing in the ears. Which complication does the nurse conclude that the client probably is experiencing?

Salicylate toxicity

A client admitted to the hospital with a diagnosis of chronic obstructive pulmonary disease (COPD) has received a prescription for a medication that is delivered via a nebulizer. When teaching about use of the nebulizer, what should the nurse teach the client to do?

Seal the lips around the mouthpiece and breathe in and out taking slow, deep breaths

A female client has severe cramping, pain, backache, and a migraine headache that presents with anxiety and mood swings. Which medication does the nurse think will be prescribed first to reduce the symptoms?

Sertraline

Metoprolol is prescribed for a client. Which condition in the client's electronic medical record will cause the nurse to question the prescription?

Sinus bradycardia

What should the nurse teach a client who is taking antihypertensives to do to minimize orthostatic hypotension?

Sit on the edge of the bed for 5 minutes before standing.

A client who recently started receiving oral corticosteroids for a severe allergic reaction is instructed that the dosage will be reduced gradually until all medication is stopped at the end of two weeks. What reason does the nurse provide for this gradual reduction in dosage?

Slow reduction of the drug will prevent a physiologic crisis because the adrenal glands are suppressed.

A health care provider prescribes bisacodyl (Dulcolax) for a client with cardiac disease. The nurse explains to the client that this drug acts by doing what?

Stimulating peristalsis

Which information should be included in the teaching plan for the elderly client with peptic ulcer disease who is taking an antacid and sucralfate?

Sucralfate should be taken on an empty stomach one hour before meals.

A 5-month-old infant is admitted with a diagnosis of respiratory syncytial virus (RSV) infection. The infant's condition suddenly deteriorates and a dose of epinephrine is prescribed to relieve bronchospasm. What side effect to this medication will the nurse monitor?

Tachycardia

A 5-month-old infant is admitted with a diagnosis of respiratory syncytial virus (RSV) infection. The infant's condition suddenly deteriorates and a dose of epinephrine is prescribed to relieve bronchospasm. Which side effect of the medication should the nurse monitor?

Tachycardia

A nurse administers albuterol to a child with asthma. For what common side effect should the nurse monitor the child?

Tachycardia

A nurse administers albuterol to a child with asthma. For what common side effect will the nurse monitor the child?

Tachycardia

A nurse is assessing an adolescent after the administration of epinephrine. What side effect is most important for the nurse to identify?

Tachycardia

A client has been taking prescribed risperidone (Risperdal) 3 mg twice a day for the past 8 days. A friend brings the client to the outpatient clinic. The client reports tremors, shortness of breath, a fever, and sweating. What should the nurse do?

Take the client's vital signs and arrange for immediate transfer to a hospital

A client is experiencing diplopia, ptosis, and mild dysphagia. Myasthenia gravis is diagnosed and an anticholinergic medication is prescribed. The nurse is planning care with the client and spouse. What direction is the priority?

Take the medication according to a specific schedule

A nurse provides instruction when the beta-blocker atenolol is prescribed for a client with moderate hypertension. What action identified by the client indicates to the nurse that the client needs further teaching?

Take the medication before going to bed.

A client who is taking an oral hypoglycemic daily for type 2 diabetes develops the flu and is concerned about the need for special care. What should the nurse advise the client? Select all that apply.

Take the oral medication. Drink fluids throughout the day. Monitor capillary glucose levels.

The practical nurse (PN) should reinforce what time frame with a client about self-administration of lispro insulin (Humalog)?

Take within 15 minutes of beginning a meal.

A client with depression is to be given fluoxetine (Prozac). What precaution should the nurse consider when initiating treatment with this drug?

The blood level may not be sufficient to cause noticeable improvement for 2 to 4 weeks.

A recently married 22-year-old woman is brought to the trauma center by the police. She has been robbed, beaten, and sexually assaulted. The client, although anxious and tearful, appears to be in control. The health care provider prescribes alprazolam (Xanax) 0.25 mg for agitation. When should the nurse administer this medication?

The client requests something to calm her

A nurse is reviewing a newly admitted client's medication administration record (MAR). The nurse identifies that it is incomplete when the record is lacking regarding what information?

The client's allergies

Haloperidol 100 mg intramuscularly (IM) stat has been prescribed for a client who is battered and agitated after a street brawl. What does the nurse conclude after reviewing the prescription?

The dose is more than recommended.

A client diagnosed with gastroesophageal reflux disease (GERD) is being treated with antacid therapy. When teaching the client about the therapy, the nurse reinforces what about antacid tablets?

They are known to interfere with the absorption of other drugs.

A client has primary open-angle glaucoma. The nurse expects that the client will receive a prescription for which eye drops?

Timolol maleate

Several hours after administering insulin, the nurse is assessing a client for an adverse response to the insulin. Which client responses are indicative of a hypoglycemic reaction? Select all that apply.

Tremors Confusion Diaphoresis

A client has been taking levothyroxine (Synthroid) for hypothyroidism for three weeks. The nurse suspects that a decrease in dosage is needed when the client exhibits which clinical manifestations? Select all that apply.

Tremors Heat intolerance

A client is receiving albuterol to relieve severe bronchospasms caused by asthma. For which clinical indicators should the nurse monitor the client? Select all that apply.

Tremors Palpitations

Amitriptyline (Elavil) is an antidepressant medication used to treat anxiety disorders. Which class of antidepressant medications does it belong to?

Tricyclics

A nurse concludes that the simvastatin (Zocor) being administered to a client is effective. A decrease in what clinical finding supports this conclusion?

Triglycerides

Which antiepileptic drug can cause photophobia?

Trimethadione

For a client with difficulty swallowing, the nurse should crush which medication?

Tylenol ES

The nurse is caring for a 6-year-old child admitted from the emergency department after an acute asthma attack. The child has a new order for fluticasone (Flovent). What instructions must the family be given about this drug before the child's discharge?

Watch for white patches in the mouth and report them to the primary care provider.

A client is taking an antithyroid medication for hyperthyroidism. The nurse provides education about serious health problems that may develop if the medication is not effective and tachycardia continues. The nurse instructs the client to seek medical attention immediately if any of the problems occur. Which should be included in the teaching? Select all that apply.

Weight gain Pedal edema

A client who has a long leg cast for a fractured bone is to be discharged from the emergency department. When discussing pain management, the nurse should advise the client to take the prescribed as needed oxycodone and acetaminophen when?

When the discomfort begins

A client who has a long leg cast for a fractured bone is to be discharged from the emergency department. When discussing pain management, when does the nurse advise the client to take the prescribed as-needed oxycodone?

When the discomfort begins

A nurse administers trimethoprim-sulfamethoxazole (Bactrim) to a client diagnosed with a urinary tract infection. What should the nurse monitor to determine the therapeutic effectiveness of the drug?

White blood cell (WBC) count

A client with laryngeal cancer is receiving chemotherapy. Which laboratory report is most important for the nurse to monitor when considering the effects of chemotherapy?

White blood cell count

A client who is immunosuppressed is receiving filgrastim (Neupogen). When the nurse evaluates the client's response to this medication, the finding that is most expected is an increase in what?

White blood cells