Prep u pharm test 2 abby

The health care provider has ordered a change of prescription from rapid-acting insulin to an intermediate-acting type. Which adverse effect must the nurse closely monitor for in the client?

Hypoglycemia

How does bethanechol affect bladder emptying?

increasing the muscle tone of the detrusor muscle

The nurse assesses a client's blood glucose level after administering insulin. Which result would the nurse interpret as indicative of severe hypoglycemia?

34 mg/dL

A nurse is giving medication instruction to a client who is taking metoprolol (Lopressor). Which statement by the client would indicate that teaching has been effective?

""I should never stop taking this drug abruptly."

A nurse is providing client education to a 13-year-old girl who was just diagnosed with type 1 diabetes mellitus. Which statement by the client will alert the nurse that special instructions regarding insulin are necessary?

"I am on the middle school track team."

A nurse is caring for a client who has been receiving an adrenergic medication. Which statement by the client alerts the nurse about an adverse effect of the medication and a reason to call the prescriber?

"I feel a "fluttering" feeling in my heart."

Which patient statement indicates to the nurse that the patient is experiencing an adverse effect of hyoscyamine?

"I feel like my heart is going to jump out of my chest."

The nurse has just completed discharge instructions to a client who will be using a pen device to deliver his insulin dose. What statement by the client indicates a need for further instruction?

"If I forget to take my insulin pen, I will be able to use the one that my wife uses."

The nurse is discussing diabetes with a group of individuals who are at risk for the disease. Which statement by a participant indicates an understanding of the role of insulin in the disease?

"Insulin assists glucose molecules to enter the cells of muscle and fat tissues.

A client is using a transdermal application of scopolamine. Which instruction would the nurse include when teaching the client how to use this drug?

"Make sure the area you are using is clean, dry, and free from cuts."

The nurse is teaching a client about safe use of adrenergic drugs. Which statement should be included in the teaching?

"Talk to your health care provider before taking any other medications.

A 50-year-old client received atropine preoperatively. The nurse explains the symptom of dry mouth to client as which effect?

"The medication temporarily decreased your salivation."

A 42-year-old male client is prescribed glargine insulin for management of his type 2 diabetes mellitus. The nurse caring for the client develops a teaching plan regarding glargine insulin therapy. Which statement made by the client indicates that the client needs additional teaching?

"The medication will peak in 3 hours."

When preparing to administer an insulin injection, the nurse would use which sized needle?

25 gauge, ½ inch

Oral anti-diabetic agents can be used in various combinations for what purpose?

Additive effects

A client has been prescribed glucagon for the management of hypoglycemia. Which nursing interventions should the nurse be prepared to provide this client for the management of possible adverse effects? Select all that apply.

Administration of a prescribed suppository for the management of nausea Ready access to supplemental oxygen Implementation of aspiration precautions

A child is brought to the pediatrician's office with trouble breathing. On exam, the child has wheezing in bilateral lung fields. The nurse suspects the provider will order which medication?

Albuterol

A nurse should monitor a client taking donepezil (Aricept) for which adverse effects? (Select all that apply.)

Anorexia Dizziness Headache

A hospitalized adolescent is prescribed an adrenergic blocking medication. Which nursing interventions will the nurse implement recognizing the unique risk such medications have for children? Select all that apply.

Assessing heart rate every 4 hours Having supplemental oxygen available at the bedside

A client has been admitted to the emergency department with sudden nausea, diaphoresis, and shortness of breath. A thorough history has revealed that the client's signs and symptoms are attributable to an accidental overdose of neostigmine (Prostigmin). The nurse who is providing care should anticipate that the client is likely to require what drug?

Atropine

A client is brought to the Emergency Department (ED) and is found to have cholinergic toxicity. What is the drug of choice to treat this condition?

Atropine

A client taking prazosin is experiencing lightheadedness and dizziness when standing up. What are important things to include in teaching the client about the medication? Select all that apply.

Avoid long hot showers. Change positions slowly.

A nurse is assigned to administer glargine to a patient at a health care facility. What precaution should the nurse take when administering glargine?

Avoid mixing glargine with other insulin.

The nurse is aware that premixed insulins (those that contain both regular and NPH insulin) are least effective in what type of client?

Client who has difficulty controlling his diabetes

What represents the two types of receptors that are found in the adrenergic nervous system? Select all that apply.

Beta receptors Alpha receptors

A client receives a dose of insulin lispro at 8 AM. The nurse would be alert for signs and symptoms of hypoglycemia at which time?

Between 8:30 AM and 9:30 AM

When describing the contraindications associated with direct-acting cholinergic agents to a group of students, what would an instructor include? (Select all that apply.)

Bradycardia Peptic ulcer disease Bladder obstruction Asthma

The nurse is caring for a client who is taking neostigmine and presents to the emergency department with symptoms of respiratory depression. The nurse is aware that this client has developed which severe complication related to the use of neostigmine?

Cholinergic crisis

During ongoing assessment of clients receiving insulin detemir (Levemir), the nurse assesses the client for symptoms of hypoglycemia that include which symptoms? (Select all that apply.)

Confusion Diaphoresis Headache

A client has been noncompliant with the diabetic medication regimen and develops diabetic ketoacidosis. Which would the nurse assess?

Deep respirations

As the nurse caring for a young child is diagnosed with type 1 diabetes (IDDM), you know that they become at high risk for what and you include assessment and management of this in their care plan?

Delayed growth and development

Anticholinergic drugs are used to treat a variety of disease processes. What should the nurse instruct a client about newly prescribed anticholinergic drugs?

Do not drive or operate machinery until you know how the medication affects you.

Which would be the nurse need to keep in mind about the use of dobutamine for treating heart failure?

Does not raise myocardial oxygen demand

A patient suffers from bronchial asthma. Which medication is a mixed-acting adrenergic drug?

Ephedrine

The nurse is providing teaching to a client with type 1 diabetes. The client requires additional teaching when he learns that his insulin needs may increase because of what condition? (Select all that apply.)

Exercise Decreased food intake

What distinguishing characteristic is associated with type 1 diabetes?

Exogenous insulin is required for life.

Clients with type 2 diabetes have nonfunctioning beta pancreatic cells. True False

False

Stress typically results in hypoglycemia. True False

False

Which insulin would the nurse need to administer as a separate injection if the order also included NPH insulin?

Glargine

Diabetic retinopathy is a disorder diabetics develop as a result of a thickening of the basement membrane. What is this caused by?

Inability of oxygen to diffuse across vessel membrane to tissues in the eye

A client with symptomatic bradycardia has been receiving atropine for the past 4 days and the client reports constipation. What is the most important suggestion the nurse could give the client?

Increase bulk in the diet.

The client is prescribed a cholinergic agonist. The nurse who administeres the cholinergic agonist expects it to produce which therapeutic effect? Select all that apply.

Increase in bladder tone Increase in urinary secretion Decrease in intraocular pressure

Which would be appropriate to include in teaching a client with type 2 diabetes?

It is possible with weight loss and exercise to discontinue the use of antidiabetic medication.

A client diagnosed with diabetes is demonstrating slow, deep respirations and is difficult to arouse. Which nursing intervention is directed specifically at treating this serious complication of diabetes?

Maintaining adequate intravenous fluid delivery

After teaching a class about the various drugs used to control blood glucose, the instructor determines that the teaching was successful when the class identifies what as a biguanide?

Metformin

When teaching the client about pyridostigmine, which symptoms would the nurse include as a possible adverse reaction? Select all that apply.

Nausea Skin flushing

A nurse is caring for a patient diagnosed with type 2 diabetes. What should the nurse inform the patient are risk factors associated with type 2 diabetes?

Obesity

A nurse is caring for a patient with diabetes mellitus who is receiving an oral antidiabetic drug. Which of following ongoing assessments should the nurse perform when caring for this patient?

Observe the patient for hypoglycemic episodes.

What best describes type 1 diabetes? (Select all that apply.)

Occurs before age 20 Insulin supplementation is required for survival

After teaching a group of nursing students about insulin, the instructor determines that the teaching was successful when the students identify that insulin is produced by which organ in the human body?

Pancreas

A female client is diagnosed with type 1 diabetes. She suddenly reports feeling weak, shaky, and dizzy. What should the nurse's first response be?

Perform a blood sugar analysis.

After the nurse makes an initial assessment of patients, the nurse reviews their medications. What medication order should the nurse question for a diabetic patient who takes insulin to control their diabetes?

Propranolol (Inderal) 10 mg PO t.i.d.

A 27-year-old client has been in the intensive care unit for two weeks following a car accident. The primary nurse is concerned that the client is not getting the rest needed for recovery. Which nursing diagnosis would be appropriate for this problem?

Risk for Disturbed Sleep Pattern related to hospitalization

Which produce their glucose lowering effect by decreasing insulin resistance and increasing insulin sensitivity? (Select all that apply.)

Rosiglitazone (Avandia) Pioglitazone (Actos)

A graduate of a nursing program is scheduled to take the NCLEX today. The test-taker's heart is racing and pupils are dilated. What can the test-taker attribute to this reaction?

Sympathetic nervous system

A 27-year-old male is taking an anticholinergic drug as adjunctive therapy to treat his peptic ulcer disease. The client comes to the clinic and tells the nurse that he "feels his heart beating." What adverse effect is the client experiencing from the anticholoinergic medication?

Tachycardia

A nurse is preparing to administer propranolol. Which are safety concerns that would alert the nurse to hold the medication? Select all that apply.

The pulse is less than 60 beats per minute. The systolic blood pressure is less than 90 mmHg. There is irregularity in the client's heart rate or rhythm.

A student asks the pharmacology instructor to explain the action of anticholinergic agents. What would be the instructor's best response?

They act to block the effects of the parasympathetic nervous system.

A female client has been taking Aricept for several months. The family feels that she is better and wants to stop the medication. What would be an important teaching point?

This medication is a treatment, not a cure. If you stop it, she will lose any benefits that she has gained.

Glycosylated hemoglobin levels provide reliable evidence of blood glucose control. True False

True

Regular insulin may be administered intravenously or intramuscularly in an emergency situation. True false

True

The client is ordered betanechol subcutaneously. After giving the client the injection of bethanechol, the nurse should make sure that what is available?

Urinal, bed pan, and call light

A nurse is preparing to administer an adrenergic agent for shock. Which nursing assessment should be completed quickly and accurately?

Vital signs

The functions of the autonomic nervous system (ANS) can be broadly described as:

activities designed to maintain a constant internal environment, to respond to stress or emergencies, and to repair body tissues.

A client experiencing a serious allergic reaction to a bee sting is brought to the emergency department. The client's right hand is swollen, red, and painful. She is extremely upset, short of breath, and the nurse detects wheezing and stridor. The nurse is ordered to administer epinephrine to relieve which of the clients symptoms?

acute bronchospasm.

A nurse diabetes educator is planning an initial visit to a home care client who was recently diagnosed with diabetes mellitus. Which skills would the nurse help the client learn?

all of the above

The nurse administers intravenous (IV) norepinephrine to the client diagnosed with shock. The nurse would predict which receptor subtypes to be activated resulting in a stimulatory response? Select all that apply.

alpha1 beta1 alpha2

Because of the risk for lactic acidosis, metformin is contraindicated in which client?

an 82-year-old diagnosed with type 2 diabetes

Sympathetic stimulation of the heart causes:

an increased rate and force of myocardial contraction.

What nursing actions should be taken for a client prescribed medication that is expected to block the sympathetic nervous system? Select all that apply.

assessment of physiological response to sexual function monitoring for presence of urinary urgency administering a PRN anti-diarrhea medication implementing interventions to minimize risks associated with dizziness

Prior to administration of adrenergic blocking drug for hypertension, which should the nurse assess first?

blood pressure

Older clients taking anticholinergic drugs are more likely to have which symptoms?

blurred vision constipation confusion

Adrenergic drugs increase the potential risk for what adverse effect?

cardiac dysrhythmias

What is the expected outcome when phenylephrine is administered? Select all that apply.

decreased renal perfusion increased systolic blood pressure increased diastolic blood pressure

A nurse is preparing to administer a rapid-acting insulin. Which medication would the nurse most likely administer?

insulin lispro

A 58-year-old male client, diagnosed with diabetes at age 14, reports having pain in both feet and hands. What is this pain most likely a result of?

peripheral neuropathy

Another name for adrenergic drugs is:

sympathomimetic drugs.

The nurse is caring for a client taking insulin. The nurse realizes the client is experiencing symptoms of hypoglycemia when the client displays

weakness, sweating, and decreased mentation.

A resident of a long-term care facility receives 12.5 mg metoprolol (Lopressor) at 8 AM and 8 PM daily. Before administering this drug, the nurse should perform and document what assessment findings?

Heart rate and blood pressure

After the nurse administers an adrenergic medication to the client, the nurse would provide which interventions because of the drug's actions on the body? Select all that apply.

Provide sunglasses to wear. Increase fluid intake.

The nurse is educating a newly diagnosed diabetic who must learn how to give himself insulin injections. The nurse tells the client that insulin is absorbed fastest from which area of injection?

Abdomen

A client is brought to the Emergency Department (ED) with severe hypoglycemia. What drug would the nurse prepare to administer intravenously?

Glucagon (GlucaGen)

The sympathetic and the parasympathetic nervous systems are continuously at work in our bodies. This continual action provides a sense of balance to all parts of the body. What is the term used to represent this sense of balance?

Homeostasis

A nurse is preparing to administer guanidine to a client. The nurse will administer this medication cautiously if which disorder is noted in the client's record? Select all that apply.

Hypertension Megacolon Hypersensitivity

The nurse who has admited a client with diabetic ketoacidosis should look for what assessment findings that are consistent with this diagnosis? (Select all that apply.)

Ketones in the urine Flushed, dry skin

A patient receives 25 units of NPH insulin at 7 AM. At what time of day should the nurse advise the patient to be most alert for a potential hypoglycemic reaction?

Late afternoon

The two major classifications of diabetes are type 1 and type 2. What is a distinguishing characteristic of type 1 diabetes?

Lifelong exogenous insulin is required.

The nurse would contact the health care provider before administering an adrenergic drug to a client who is also taking which drug?

MAO inhibitor

Before administering a beta-adrenergic blocker, the nurse should be aware of what information about the client?

Pulse and blood pressure

When assessing a client, what finding would the nurse interpret as indicating stimulation of the parasympathetic nervous system? (Select all that apply.)

Pupil constriction Bronchoconstriction Decreased heart rate

A client is treated in the emergency department for suspected atropine toxicity. Which nursing assessment data support the suspicion that the client's signs and symptoms are suggestive of a 2.0 mg atropine dose? Select all that apply.

Tachycardia Dilated pupils Blurred vision

The nurse is providing discharge instructions to a client who has just been diagnosed with type 1 diabetes. What instructions are most important for the client to follow related to diet? (Select all that apply.)

Read food labels carefully to look for hidden sources of sugar. Avoid drinking beer, wine, or liquor. Use artificial sweeteners instead of sugar in tea and coffee.

A client is admitted to the intensive care unit with diabetic ketoacidosis. The nurse knows that the client will be placed on an intravenous insulin drip. The only type of insulin that can be administered intravenously is:

Regular

A client has been have angina and has been prescribed propranolol. The nurse should assess the client for which adverse effects? Select all that apply.

Sleep disturbance Sexual dysfunction Bronchospasm Gastric pain

A nurse is caring for a patient who is having a sympathetic response. A sympathetic response involves:

an increase in blood pressure, bronchi dilation, and decreased bowel sounds