Pharmacology Final

A nurse is monitoring a client who is taking propranolol (Inderal LA). Which data collection finding would indicate a potential serious complication associated with propranolol?

The development of audible expiratory wheezes

The HCP prescribes exenatide (Byetta) for a client with type 1 diabetes mellitus who takes insulin. The nurse knows that which of the following is the appropriate intervention?

The medication is withheld and HCP is called to question the prescription for the client

The nurse provides medication instructions to an older hypertensive client who is taking 20 mg of lisinopril (Prinivil, Zestril) orally daily. The nurse evaluates the need for further teaching when the client states which of the following?

"I can skip a dose once a week."

A community health nurse visit the client at home. Prednisone 10 mg orally daily has been prescribed for the client and the nurse reinforced his teaching for the client about the medication. Which statement, it's made by the client, indicates that further teaching is necessary?

"I can take aspirin or my antihistamine if I need it."

A nurse provides instructions to a client regarding the use of tretinoin (Retin-A). Which statement by the client indicates the need for further instructions?

"I should apply a very thin layer to my skin."

Fluoxetine (Prozac) is prescribed for the client. The nurse reinforces instructions to the client regarding the administration of the medication. Which statement by the client indicates an understanding about administration of the medication?

"I should take the medication in the morning when I first arise."

A nurse reinforces discharge instructions to a post-op client who is taking warfarin sodium (Coumadin). Which statement, if made by the client, reflects the need for further teaching?

"I will take Ecotrin (enteric-coated aspirin) for my HA because it is coated."

Phenytoin(Dilantin), 100mg orally TID, has been prescribed for a client for seizure control. The nurse reinforces instructions regarding the medication to the client. Which statement by the client indicated an understanding of the instructions?

"I will use a soft toothbrush to brush my teeth."

A client with a peptic ulcer is diagnosed with a Helicobacter pylori infection. The nurse is reinforcing teaching for the client about the medications prescribed, including Clarithromycin (Biaxin), esomeprazole (Nexium), and amoxicillin (Amoxil). Which statement by the client indicates the best understanding of the medication regimen?

"The medications will kill the bacteria and stop the acid products"

A client with acute muscle spasms has been taking baclofen (Lioresal). The client calls the clinic nurse because of continuous feelings of weakness and fatigue and asks the nurse about discontinuing the med. How should the nurse respond?

"Weakness and fatigue commonly occur and will diminish with continued medication use"

Which of the following herbal therapies would be prescribed for its use as an antispasmodic?

-Chamomile -Peppermint oil

A hospitalized client is started on phenelzine sulfate (Nardil) for the treatment of depression. The nurse instructs the client to avoid consuming which foods while taking this medication?

-Figs -Yogurt -Aged cheese

A nurse is caring for a client who has been prescribed furosemide (Lasix) and is monitoring for adverse effects associated with this medication. Which of the following should the nurse recognize as a potential adverse effect:

-Tinnitus -Hypotension -Hypokalemia

A client is receiving meperidine hydrochloride (Demerol) for pain. Which of the following are side effects of this med?

-tremors -drowsiness -hypotension

A client who is receiving digoxin (Lanoxin) daily has a serum potassium level of 3.0 mEq/L and is complaining of anorexia. A HCP prescribes a digoxin level to rule out digoxin toxicity. A nurse checks the results, knowing the which of following is the therapeutic serum level (range) for digoxin?

0.5-2

A client with CAD complains of substernal chest pain. After checking the clients HR and BP, a nurse adm nitroglycerin, 0.4mg, sublingually. After 5 min, the client states "my chest still hurts" what do you do?

1. Contact the RN 2. Asses the clients pain level 3. Check the BP 4. Adm second dose of nitro

A nurse is caring for a client who is taking phenytoin (Dilantin) for control of seizures. During data collection, the nurse notes that the client is taking birth control pills. Which of the following info should the nurse provide to the client?

The potential for decreased effectiveness of the birth control pills exists while taking phenytoin (Dilantin)

The client has been on treatment for rheumatoid arthritis for 3 weeks. During the administration of etanercept (Enbrel), it is most important for the nurse to assess:

The white blood cell counts and platelet counts

A client is admitted to the hospital with complaints of back spasms. The client states, "I have been taking two or three aspirin every 4 hours for the past week and it hasn't helped my back." Aspirin intoxication is suspected. Which of the following complaints would indicate aspirin intoxication?

Tinnitus

A client taking lithium carbonate (Lithobid) reports vomiting, abdominal pain, diarrhea, blurred vision, tinnitus, and tremors. The lithium level is checked as a part of the routine follow-up and the level is 3.0 mEq/L. The nurse knows that this level is

Toxic

A nurse reinforces medication instructions to a client who is taking levothyroxine (Synthroid). The nurse instructs the client to notify the health care provider (HCP) if which of the following occurs?

Tremors

A client who is taking hydrochlorothiazide (HydroDIURIL, HCTZ) has been started on triamterene (Dyrenium) as well. The client asks the nurse why both medications are required. The nurse formulates a response, based on the understanding that:

Triamterene is a potassium-sparing diuretic, whereas hydrochlorothiazide is a potassium-losing diuretic.

Isotretinion is prescribed for a client with severe acne. Before the adm of this medication, the nurse anticipates that which lab test will be prescribed?

Triglyceride level

The home health care nurse is visiting a client who was recently diagnosed with type 2 diabetes mellitus. The client is is prescribed repaglinide (Prandin) and metformin (Glucophage) and asks the nurse to explain these medications. The nurse should reinforce switch instructions to the client?

1. Diarrhea can occur secondary to metformin 2. The repaglinide is not taken if a meal is skipped. 3. The repaglinide is taken 30 min before eating. 4. Candy or other simple sugar is carried and used to treat mild hypoglycemia episodes

A client is taking Humulin NPH insulin daily morning. The nurse reinforces instructions for the client and tells the client that the most likely time for hypoglycemic reaction to occur is:

4-12 hours after adm

Meperidine hydrochloride (Demerol) is prescribed for the client with pain. Which of the following would the nurse monitor for as a side effect of this medication?

Urinary retention

A client with severe acne is seen in the clinic and the HCP prescribes isotretinoin. The nurse reviews the clients medication record and would contact the HCP if the client is taking which medication?

Vitamin A

A nurse is caring for a hospitalized client who has been taking clozapine (Clozaril) for the treatment of a schizophrenic disorder. Which laboratory study prescribed for the client will the nurse specifically review to monitor for an adverse effect associated with the use of this medication?

WBC

The client has been on TX for rheumatoid arthritis for 3wks. During the adm of etanercept (Enbrel), is most important for the nurse to check:

WBC and platelet counts

Disulfiram (Antabuse) is prescribed for a client who is seen in the psychiatric health care clinic. The nurse is collecting data on the client and is providing instructions regarding the use of this medication. Which is most important for the nurse to determine before administration of this medication?

When the last alcoholic drink was consumed

Ibuprofen (Advil) is prescribed for a client. The nurse tells the client to take the medication:

With 8oz of milk

A nurse is caring for a client who is taking metoprolol (Lopressor). The nurse measures the client's blood pressure (BP) and apical pulse (AP) immediately before administration. The client's BP is 122/78 mm/Hg and the AP is 58 beats/min. Based on this data, which of the following is the appropriate action?

Withhold the medication

A health care provider (HCP) writes a prescription for digoxin (Lanoxin), 0.25 mg daily. The nurse teaches the client about the medication and tells the client that it is important to:

Withhold the medication and call the HCP if the pulse is less than 60 beats per minute.

Heparin sodium is prescribed for the client. The nurse expects that the HCP will prescribe which of the following to monitor for a therapeutic effect of the medication?

aPTT

A client who chronically uses nonsteroidal anti-inflammatory drugs has been taking misoprostol (Cytotec). The nurse determines that the medication is having the intended therapeutic effect if which of the following is noted?

Relief of epigastric pain

Colcrys (colchicine) is prescribed for a client with a diagnosis of gout. The nurse reviews the client's medical history in the health record, knowing that the medication would be contraindicated in which disorder?

Renal failure

A client is to begin a 6-month course of therapy with isoniazid (INH). A nurse plans to teach the client to:

Report yellow eyes or skin immediately

A client who has been newly diagnosed with diabetes mellitus has been stabilized with daily insulin injections. Which info should the nurse teach when carrying out plans for discharge?

Rotate the insulin sites systematically

A client arrives at the health care clinic and tells the nurse that he has been doubling his daily dosage of bupropion hydrochloride (Wellbutrin) to help him get better faster. The nurse understands that the client is now at risk for which of the following?

Seizure activity

A nurse is reviewing the record of a client who has been prescribed baclofen (Lioresal). Which of the following disorders, If noted in the clients history, would alert the nurse to contact the HCP?

Seizure disorders

In monitoring a client's response to disease-modifying antirheumatic drugs (DMARDs), which findings would the nurse interpret as acceptable responses?

1. Symptom control during periods of emotional stress 2. Normal white blood cell counts, platelet, and neutrophil counts 3. Radiological findings that show nonprogression of joint degeneration 4. An increased range of motion in the affected joints 3 months into therapy

A client is taking phenytoin (Dilantin) for seizure control and a sample for a serum drug level is draw. What is the therapeutic serum drug level range?

10-20 mcg/mL

A client received 20 units of NPH insulin subcutaneously at 8:00 AM. The nurse should check the client for a potential hypoglycemic reaction at what time?

5pm

A client with trigeminal neuralgia tells the nurse that acetaminophen (Tylenol) is taken on a frequent daily basis for relief of generalized discomfort. The nurse reviews the client's laboratory results and determines that which of the following indicates toxicity associated with the medication?

A direct bilirubin level of 2 mg/dL

A child is brought to the emergency department for treatment of an acute asthma attack. The nurse prepares to administer which of the following medications first?

A β2 agonist

A client is taking lansoprazole (Prevacid) for the chronic management of Zollinger-Ellison syndrome. The nurse advises the client to take which of the following products if needed for a headache?

Acetaminophen (Tylenol)

A nurse has a prescription to give a client albuterol (Proventil HFA) (two puffs) and beclomethasone dipropionate (Qvar) (nasal inhalation, two puffs), by metered-dose inhaler. The nurse administers the medication by giving the:

Albuterol first and then the beclomethasone dipropionate

Glimepiride (Amaryl) is prescribed for a client with diabetes mellitus. The Nurse reinforces instructions for the client and tells the client to avoid which of the following while taking this medication?

Alcohol

Prednisone is prescribed for a client with diabetes mellitus who is taking Humulin neutral protamine Hagedorn (NPH) insulin daily. Which of the following prescription changes does the nurse anticipate during therapy with the prednisone?

An increased amount of daily Humulin NPH insulin

A client receiving a tricyclic antidepressant arrives at the mental health clinic. Which observation indicates that the client is correctly following the medication plan?

Arrives at the clinic neat and appropriate in appearance

A health care provider has written a prescription for ranitidine (Zantac), once daily. The nurse should schedule the medication for which of the following times?

At bedtime

A nurse is reinforcing discharge instructions to a client receiving baclofen (Lioresal). Which of the following would the nurse include in the instructions?

Avoid the use of alcohol

A client with epilepsy is taking the prescribed dose of phenytoin (Dilantin) to control seizures. A phenytoin blood level is drawn, and the results reveal a level of 35 mcg/ml. Which of the following symptoms would be expected as a result of this laboratory result?

Slurred speech

A nurse provides dietary instructions to a client who will be taking warfarin sodium (Coumadin). The nurse tells the client to avoid which food item?

Spinach

A client with angina pectoris is experiencing chest pain that radiates down the left arm. The nurse administers a sublingual nitroglycerin tablet to the client. The client's pain is unrelieved, and the nurse determines that the client needs another nitroglycerin tablet. Which of the following vital signs is most important for the nurse to check before administering the medication?

BP

A nurse is collecting data from a client about medications being taken, and the client tells the nurse that he is taking herbal supplements for the treatment of varicose veins. The nurse understands that the client is most likely taking which of the following?

Bilberry

A clinic nurse prepares to administer an MMR (measles, mumps, rubella) vaccine to a child. How is this vaccine best administered?

Subcutaneously in the outer aspect of the upper arm

Alendronate (Fosamax) is prescribed for a client with osteoporosis. The client taking this medication is instructed to:

Take the medication with a full glass of water after rising in the morning

The client with acquired immunodeficiency syndrome has begun therapy with zidovudine (Retrovir, Azidothymidine, AZT, ZDV). The nurse carefully monitors which of the following laboratory results during treatment with this medication?

CBC

A client has begun therapy with theophylline (Theo-24). The nurse tells the client to limit the intake of which of the following while taking this medication?

Coffee, cola, and chocolate

An older client recently has been taking cimetidine (Tagamet). The nurse monitors the client for which most frequent CNS side effect of this med?

Confusion

A client with chronic renal failure is receiving ferrous sulfate (Feosol). The nurse monitors the client for which common side effect associated with this medication?

Constipation

Baclofen (Lioresal) is prescribed for the client with MS. The nurse assists in planning care, knowing that the primary therapeutic effect of this med is what?

Decreased muscle spasms

A client complaining of not feeling well is seen in a clinic. The client is taking several medications for the control of heart disease and hypertension. These medications include a β-blocker, digoxin (Lanoxin), and a diuretic. A tentative diagnosis of digoxin toxicity is made. Which of the following assessment data would support this diagnosis?

Double vision, loss of appetite, and nausea

A client with multiple sclerosis is receiving diazepam (Valium), a centrally acting skeletal muscle relaxant. Which of the following would indicate that the client is experiencing a side effect related to this medication?

Drowsiness

A nurse is monitoring a client receiving baclofen (Lioresal) for SE related to the med. which of the following would indicate the client is experiencing a side effect?

Drowsiness

A nurse administers a dose of scopolamine (Transderm-Scop) to a postoperative client. The nurse tells the client to expect which of the following side effects of this medication?

Dry mouth

A daily dose of prednisone is prescribed for a client. A nurse reinforces instructions to the client regarding administration of the medication and instructs the client that the best time to take this medication is:

Early morning

A nurse is caring for a client receiving morphine sulfate subcutaneously for pain. Because morphine sulfate has been prescribed for this client, which nursing action would be included in the plan of care?

Encourage the client to cough and deep breathe.

The client who is human immunodeficiency virus seropositive has been taking stavudine (d4t, Zerit). The nurse monitors which of the following most closely while the client is taking this medication?

Gait

A nurse is performing a follow-up teaching session with a client discharged 1 month ago who is taking fluoxetine (Prozac). What information would be important for the nurse to gather regarding the adverse effects related to the medication?

Gastrointestinal dysfunctions

Cyclobenzaprine (Flexeril) is prescribed for a client to treat muscle spasms, and the nurse is reviewing the client's record. Which of the following disorders, if noted in the client's record, would indicate a need to contact the health care provider regarding the administration of this medication?

Glaucoma

A nurse performs an admission assessment on a client who visits a health care clinic for the first time. The client tells the nurse that propylthiouracil (PTU) is taken daily. The nurse continues to collect data from the client, suspecting that the client has a history of:

Graves' Disease

A nurse is preparing to administer digoxin (Lanoxin), 0.125 mg orally, to a client with heart failure. Which vital sign is most important for the nurse to check before administering the medication?

HR

A nurse is assisting in caring for a pregnant client who is receiving intravenous magnesium sulfate for the management of preeclampsia and notes that the client's deep tendon reflexes are absent. On the basis of this data, the nurse reports the finding and makes which determination?

The client is experiencing magnesium toxicity.

The client has been taking omeprazole (Prilosec) for 4 weeks. The ambulatory care nurse evaluates that the client is receiving optimal intended effect of the medication if the client reports the absence of which symptom?

Heartburn

A client with chronic renal failure is receiving epoetin alfa (Epogen, Procrit). Which laboratory result would indicate a therapeutic effect of the medication?

Hematocrit of 32%

A nurse is collecting medication information from a client, and the client states that she is taking garlic as an herbal supplement. The nurse understands that the client is most likely treating which of the following conditions?

Hyperlipidemia

A nurse is planning to adm hydrochlorothiazide (HydroDURIL) to a client. The nurse understands that which of the following are concerns r/t the adm of this med?

Hypokalemia, hyperglycemia, sulfa allergy

carbidopa-levodopa (Sinemet) Is prescribed for a client with Parkinson's disease, and the nurse monitors the client for adverse reactions to the medication. Which of the following indicates that the client has experienced an adverse reaction?

Impaired voluntary movements

A nurse prepares to reinforce instructions to a client who is taking allopurinol (Zyloprim). The nurse plans to include which of the following in the instructions?

Instruct the client to drink 3000 mL of fluid per day.

A client with tuberculosis is being started on antituberculosis therapy with isoniazid (INH). Before giving the client the first dose, a nurse ensures that which of the following baseline studies has been completed?

Liver enzyme levels

A client with diabetes mellitus who has been controlled with daily insulin has been placed on atenolol (Tenormin) for the control of angina pectoris. Because of the effects of atenolol, the nurse determines that which of the following is the most reliable indicator of hypoglycemia?

Low blood glucose level

A nurse is assisting in preparing to administer acetylcysteine (Mucomyst) to a client with an overdose of acetaminophen (Tylenol). The nurse prepares to administer the medication by:

Mixing the medication in a flavored ice drink and allowing the client to drink the medication through a straw

A client is diagnosed with an acute MI and is receiving tissue plasminogen activator, alteplase (Activase, tPA). Which action is a priority nursing intervention?

Monitor for signs of bleeding.

The client has a PRN prescription for ondansetron (Zofran). For which condition should this medication be adm to the post-op client?

Nausea & vomiting

A client taking buspirone (BuSpar) for 1 month returns to the clinic for a follow-up visit. Which of the following would indicate medication effectiveness?

No rapid heartbeats or anxiety

Insulin glargine (Lantus) is prescribed for a client with diabetes mellitus. The nurse tells the client that it is best to take the insulin:

Once daily, at the same time each day

The client with the gastric ulcer has a prescription for sucralfate (Carafate), 1g PO four times a day. The nurse schedules the medication for which times?

One hour before meals and at bedtime

Oral iron supplements are prescribed for a 6-year old child with iron deficiency anemia. The nurse instructs the mother to adm the iron with which best food item?

Orange juice

A client has been taking isoniazid (INH) for 2 months. The client complains to the nurse about numbness, paresthesias, and tingling in the extremities. The nurse interprets that the client is experiencing:

Peripheral neuritis

A nurse is preparing to administer furosemide (Lasix) to a client with a diagnosis of heart failure. The most important laboratory test result for the nurse to check before administering this medication is:

Potassium level

A client with diabetes mellitus visits a health care clinic. The clients diabetes mellitus previously had been well controlled with glyburide (DiaBeta) daily, but recently the fasting blood glucose level has been 180-200mg/dL. Which medication, if added to the clients regimen, may have been contributed to the hyperglycemia?

Prednisone

A nurse preparing a client for surgery reviews the client's medication record. The client is to be nothing per mouth (NPO) after midnight. Which of the following medications, if noted on the client's record, should the nurse question?

Prednisone

Intravenous heparin therapy is prescribed for a client. While implementing this prescription, a nurse ensures that which of the following medications is available on the nursing unit?

Protamine sulfate

A nurse is preparing to administer eardrops to an infant. The nurse plans to:

Pull down and back on the ear and direct the solution toward the wall of the canal.

A home care nurse visits a client recently diagnosed with diabetes mellitus who is taking Humuilin NPH insulin daily. The client asks the nurse how to store the unopened vials of insulin. The nurse tells the client to:

Refrigerate the insulin

A nurse reinforces instructions to a client who is taking levothyroxine (Synthroid). The nurse tells the client to take the medication:

on an empty stomach

A client is receiving baclofen (Lioresal) for muscle spasms caused by a spinal cord injury. The nurse monitors the client, knowing that which of the following is a side effect of this medication?

slurred speech

A client with a prescription to take theophylline (Theo-24) daily has been given medication instructions by the nurse. The nurse determines that the client needs further information about the medication if the client states that he or she will:

take dose daily at bedtime