Pharmacology Practice

Which of the following findings are adverse effects of digoxin? SATA - blurred vision - nausea - hyperactivity - increased appetite - dysrhythmia

Blurred vision, Nausea, Dysrhythmia ; fatigue, weakness, and anorexia are also adverse effects of digoxin

Which of the following conditions is a contraindication for metoprolol? 1. peripheral vascular disease 2. diabetes mellitus 3. bradycardia 4. chronic kidney disease

Bradycardia

A nurse is collecting data from a client who has Parkinson's disease and is taking levodpa/carbidopa. the nurse should identify which of the following findings as an adverse effect of this medication? 1. dark urine 2. hypertension 3. increased salivation 4. bradycardia

Dark urine; it can cause a darkening of the client's urine, sweat, and saliva.

A nurse is caring for a client who has tuberculosis and will begin taking isoniazid. Which of the following actions should the nurse take? 1. determine the client's daily alcohol intake 2. tell the client to expect red-orange colored urine 3. reinforce teaching about a low-calorie diet 4. instruct the client to have a yearly TB skin test

Determine the client's daily alcohol intake ; isoniazid can cause liver damage, so it is important to determine daily alcohol intake

A nurse is reinforcing teaching about the adverse effects of simvastatin. For which of the following adverse effects should the nurse instruct the client to notify the provider? 1. muscle pain 2. fine hand tremors 3. urinary retention 4. double vision

Muscle pain ; muscle pain or tenderness can indicate rhabdomyolysis

A nurse is reinforcing teaching with a client about adverse effects of metformin. The nurse should instruct the client to monitor for which of the following findings as manifestations of lactic acidosis? SATA - muscle pain - hyperventilation - weight gain - constipation - dizziness

Muscle pain, Hyperventilation, Dizziness ; other manifestations are diarrhea and weight loss

A nurse is reinforcing teaching with a client who is using phenylephrine nasal spray three times daily and reports rebound congestion. Which of the following instructions should the nurse include to reduce the effects of rebound congestion? 1. "Decrease the frequency to twice daily 2. "Continue use for one more week 3. "Discontinue use in the left nostril, then in the right nostil 4. "Add oxymetazoline nasal spray to relieve symptoms

"Discontinue use in the left nostril, then in the right nostril"

A nurse is reinforcing teaching with a client who has HIV and a new prescription for zidovudine. Which of the following client statements should indicate to the nurse an understanding of the teaching? 1. "I can have unprotected sex after 6 months of taking this medication 2. "I can expect to have constipation while taking this medication 3. "I will be sure to have my blood tested for anemia 4. "My fingers might feel numb after I start therapy

"I will be sure to have my blood tested for anemia" ; zidovudine can cause severe anemia and neutropenia. It can also cause GI disturbances such as diarrhea, abdominal pain, nausea, and vomiting.

A nurse is reinforcing teaching with a client who has a prescription for vitamin B12 intranasal to treat malabsorption syndrome. Which of the following instructions should the nurse include in the teaching? 1. "Take this medication once per day 2. "Drink a hot liquid after administering the medication 3. "Massage your nose gently after medication administration 4. "Store this medication in the refrigerator

"Massage your nose gently after medication administration" ; this increases absorption of the medication. Administer vitamin B12 intranasally once per week. Oral vitamin B12 is taken daily. Avoid hot liquids 1 hr before administration.

A nurse is reinforcing discharge teaching with a client who has a prescription for a metered-dose inhaler (MDI). Which of the following information should the nurse include in the teaching? 1. "Wait for 15 seconds between each puff of the same medication 2. "Hold your breath for 5 seconds after inhaling the medication 3. "Take a slow, deep breath lasting 3-5 seconds after releasing the medication 5. "Roll the canister between your hands for 10-15 seconds to mix the medication

"Take a slow, deep breath lasting 3-5 seconds after releasing the medication" ; this allows the medication to be distributed deeply into the lungs. The client should wait 20-60 seconds between puffs of the same medication.

A nurse is reinforcing teaching with a female client who has a new prescription for isotretinoin. Which of the following information should the nurse include in the teaching? SATA - "You will need to have your liver enzymes monitored after 1 month - "You can have nosebleeds while taking this medication - "You should report any thought of harming yourself - "You will need to have two negative pregnancy tests prior to starting the medication - "You will need to take a vitamin A supplement twice daily

"You will need to have your liver enzymes monitored after 1 month, You can have nosebleeds on this medication, You should report any thought of harming yourself, You will need to have two negative pregnancy tests prior to starting the medication

A nurse is planning to reinforce teaching about newborn immunizations with a client who is 24 hr postpartum. Which of the following information should the nurse plan to include? 1. "Your baby will receive the first hepatitis B vaccine before discharge 2. "Your baby will receive the rotavirus vaccine if your blood titer is low 3. "Your baby will receive their influenza vaccine at the 4-week checkup 4. "Your baby will receive the varicella vaccine if you have history of chickenpox

"Your baby will receive the first hepatitis B vaccine before discharge"

The nurse should instruct the client to report which of the following adverse effects of valproic acid to the provider immediately? 1. abdominal pain 2. hair loss 3. weight gain 4. ataxia

Abdominal pain ; the greatest risk to the client is hepatotoxicity and pancreatitis. Notify the provider if there is a decrease in appetite, nausea, abdominal pain, or yellowing of the skin.

A nurse is reinforcing teaching with a client who has a new prescription for cochicine to manage gouty arthritis. Which of the following manifestations should the nurse include as an adverse effect of this medication? 1. abdominal pain 2. wheezing 3. excessive urination 4. tinnitus

Abdominal pain ; this indicates cellular damage to the GI tract. The medication should be discontinued immediately.

A nurse is caring for a client who has genital herpes. Which of the following medications should the nurse expect to administer? 1. levofloxacin 2. acyclovir 3. ceftriaxone 4. metronidazole

Acyclovir ;

Which of the following is an adverse effect for clozapine used for schizophrenia? 1. hypoglycemia 2. iron-deficiency anemia 3. serotonin syndrome 4. agranulocytosis

Agranulocytosis ; the nurse should monitor the client's WBC and notify the provider if it falls below the expected range. The nurse should monitor for hyperglycemia, hyperlipidemia, and tardive dyskinesia.

A nurse is reviewing a client's medical history before administering hydromorphone. The nurse should notify the provider of which of the following findings before administering this medication? 1. benign prostatic hyperplasia 2. history of hypertension 3. rheumatoid arthritis 4. allergy to aspirin

Benign prostatic hyperplasia ; a client with BPH is at increased risk for developing acute urinary retention while taking opioids. Opioids can cause lower blood pressure and hydromorphone is contraindicated in clients with severe pulmonary disease.

Which condition is contraindicated for a prescription of dimenhydrinate to treat motion sickness? 1. major depressive disorder 2. diabetes mellitus 3. benign prostatic hyperplasia 4. Meniere's disease

Benign prostatic hyperplasia ; clients with BPH might have urinary hesitancy and retention and should not take dimenhydrinate d/t anticholinergic adverse effects

A nurse is caring for a client who takes sulfasalazine for RA. Which of the following values should the nurse review prior to the administration of the medication? 1. respirations 2. serum creatinine level 3. blood pressure 4. complete blood count

Complete blood count ; sulfasalazine can cause bone marrow suppression which can lead to agranulocytosis, hemolutic anemia, and macrocytic anemia.

Which of the following manifestations is an adverse effect to oral amoxicillin? 1. hearing loss 2. diarrhea 3. bruising 4. tendonitis

Diarrhea

Which of the following is an expected outcome for theophylline? 1. dilates bronchioles 2. reduces inflammation 3. loosens secretions 4. blocks leukotrienes

Dilates bronchioles

A nurse is caring for a client who is receiving continuous cardiac monitoring. Which of the following medications should the nurse anticipate administering to treat atrial fibrillation? 1. atropine 2. diliazem 3. epinephrine 4. phenytoin

Diltiazem ; calcium channel blocker that is used to slow the ventricular rate in A. fib or flutter.

Which of the following over-the-counter medications is contraindicated while taking oxycodone? 1. docusate sodium 2. famotidine 3. diphenhydramine 4. ibuprofen

Diphenhydramine ; both medications can cause CNS depression.

Which of the following findings should be identified as an adverse effect of baclofen used to treat multiple sclerosis? 1. diarrhea 2. weight loss 3. drowsiness 4. hypertension

Drowsiness ; other adverse effects include dizziness, weakness, fatigue, constipation, weight gain, and hypotension.

Which of the following diagnostic tests should the nurse plan to obtain prior to administering amitriptyline? 1. hearing examination 2. glucose tolerance test 3. electrocardiogram 4. pulmonary function tests

Electrocardiogram ; amitriptyline can cause tachycardia and ECG changes. Amitriptyline can also cause blurred vision.

Which lab test should be obtained before administering risperidone to manage schizophrenia? 1. fasting blood glucose level 2. albumin level 3. CD4 T-cell count 4. blood creatinine level

Fasting blood glucose level ; hyperglycemia is an adverse effect of risperidone. Other adverse effects are anorexia and polyuria.

A nurse is caring for a client who has benign prostatic hyperplasia (BPH). Which of the following prescriptions should the nurse expect? 1. fluoxymesterone 2. methyltestosterone 3. finasteride 4. sildenafil

Finasteride ; administered to reduce the size of the prostate within 3-6 months of therapy.

A nurse is reinforcing teaching with the parent of a preschooler who has otitis media. The child has had a low-grade fever and irritability for 2 days. Which of the following instructions should the nurse include in the teaching? 1. administer amoxicillin twice a day for 3 days 2. apply cold packs every 4 hours for relief of pain 3. give acetaminophen as needed for discomfort and fever 4. return to the office in 72 hours for a follow-up appointment

Give acetaminophen as needed for discomfort and fever.

A client is taking celecoxib for treatment of joint pain. Which of the following findings is a contraindication to receiving celecoxib? 1. hyperglycemia 2. allergy to penicillin 3. history of myocardial infarction 4. peptic ulcer disease

History of myocardial infarction ; celecoxib increases the risk for MI caused by increased vasoconstriction and unimpeded platelet aggregation.

A nurse is evaluating a client who is receiving amphotericin B via intermittent IV bolus. Which of the following findings indicates an adverse reaction to this medication? 1. serum potassium 5.6 2. hematocrit 55% 3. polyuria 4. hypotension

Hypotension ; other adverse effect are nephrotoxicity, hypokalemia, and cardiac dysrhythmias

Which of the following is a therapeutic effect of epoetin? 1. decreased BUN 2. increased Hgb 3. decreased leukocyte production 4. increased platelet production

Increased Hgb ; epoetin is used to elevate the erythrocyte count for clients who have kidney failure.

A nurse is caring for a client who is experiencing an acute gout attack. The nurse should anticipate a prescription for which of the following medications? 1. naproxen 2. pegloticase 3. probenecid 4. allopurinol

Naproxen ; this NSAID is recommended as first choice of treatment for acute gout. Pegloticase and allopurinol are for chronic gout.

A nurse is collecting data from a client who is taking tobramycin. Which of the following findings should the nurse report to the provider immediately? 1. report of nausea 2. fever 3. oliguria 4. report of headache

Oliguria ; this indicates the client is at greatest risk for nephrotoxicity

The nurse is assessing a client who has been taking linezolid to treat a Staph infection. Which of the following findings should the nurse report to the provider? 1. nausea 2. headaches 3. paresthesias 4. insomnias

Paresthesias ; it is rare to develop irreversible peripheral neuropathy and reversible optic neuropathy. Nausea, headaches, and insomnia are typical adverse effects of linezolid and do not need to be reported.

Which of the following manifestations is an adverse effect of metoprolol? 1. tachycardia 2. tinnitus 3. peripheral edema 4. urinary retention

Peripheral edema ; this can indicate heart failure. Also monitor for bradycardia, blurred vision, and urinary frequency

A nurse is collecting data from a client who has a new diagnosis of fibromyalgia. Which of the following medications should the nurse expect the provider to prescribe? 1. pregabalin 2. ibuprofen 3. phenelzine 4. baclofen

Pregabalin ; pregabalin is 1 of 3 anticonvulsants specifically approved for the treatment of fibromyalgia. Adverse effects include dizziness, sleepiness, blurred vision, weight gain, altered thinking, headache, peripheral edema, and dry mouth.

A nurse is collecting data from a client who has hyperthyroidism and a prescription for propylthiouracil. The nurse should monitor for which of the following manifestations as an adverse effect of this medication? 1. sore throat 2. metallic taste 3. mania 4. urinary retention

Sore throat ; sore throat and fever are early indications of agranulocytosis. Also monitor for loss of taste, drowsiness, and glomerulonephritis.

A nurse is reinforcing teaching with a client who has a new prescription for omeprazole oral capsules. Which of the following instructions should the nurse include? 1. take the medication at bedtime 2. swallow the medication whole 3. take the medication with food 4. avoid antacids when taking this medication

Swallow the medication whole ; Omeprazole, a proton pump inhibitor, blocks the secretion of gastric acid.

A nurse is preparing to administer metoclopramide to a client who has GERD. For which of the following manifestations should the nurse monitor as an adverse effect of the medication? 1. urinary retention 2. tardive dyskinesia 3. blurred vision 4. photosensitivity

Tardive dyskinesia ; this involves involuntary movements or repetitive movements of the arms, legs, and facial muscles.

A nurse is caring for a client who is receiving methylprednisolone. Which of the following lab values should the nurse plan to monitor? SATA - WBC - serum potassium - creatine phosphokinase - blood glucose - amylase

WBC, Serum potassium, Blood glucose ; methylprednisolone can cause leukocytosis, hypokalemia, and can increase blood glucose levels.