RN Pharmacology Online Practice 2019 A
A nurse at an urgent care clinic is collecting a history from a female client who has a urinary tract infection. The nurse anticipates a prescriptions for ciprofloxacin. The nurse should identify that which of the following client statements indicates a contraindication for administering this medication?
" I have tendonitis, so I haven't been able to exercise" The nurse should identify tendonitis as a contraindication for taking ciprofloxacin due to the risk of tendon rupture.
A nurse is providing teaching to a client who is to start treatment for asthma with beclomethasone and albuterol inhalers. Which of the following instructions should the nurse include in the teaching?
"Rinse your mouth after inhaling the beclomethasone." The client should rinse their mouth after using beclomethasone, a glucocorticoid inhaler, to prevent oropharyngeal candidiasis and hoarseness.
A nurse is caring for a client who received 0.9% sodium chloride 1 L over 4 hr instead of over 8 hr as prescribed. Which of the following information should the nurse enter as a complete documentation of the incident?
0.9% sodium chloride 1 L IV infused over 4 hr. Vital signs stable, provider notified. The nurse should document the type and amount of fluid, how long it took to infuse, provider notification, and the client's physical status.
A nurse is caring for the parent of a newborn. The parent asks the nurse when their newborn should receive the first diphtheria, tetanus and pertussis vaccine (DTaP). The nurse should instruct the parent that their newborn should receive the immunization at which of the following ages?
2 months The CDC recommends that newborns receive the first dose of the five-dose series of the DTaP immunization at 2 months of age.
A nurse is caring for a client who has acute acetaminophen toxicity. The nurse should anticipate administering which of the following medication?
Acetylcysteine Acetylcysteine is a specific antidote for acetaminophen toxicity. It can prevent severe injury when given orally or by IV infusion within 8 to 10 hr.
A nurse in the emergency department is caring for a client who has myasthenia gravis and is in a cholinergic crisis. Which of the following medications should the nurse plan to administer?
Atropine A cholinergic crisis is caused by an excess amount of cholinesterase inhibitor, such as neostigmine. The nurse should plan to administer atropine, an anticholinergic agent, to reverse cholinergic toxicity.
A nurse is planning care for a client who is receiving mannitol via continuous IV infusion. The nurse should monitor the client for which of the following adverse effects?
Bibasilar crackles Mannitol, an osmotic diuretic, can precipitate heart failure and pulmonary edema. Therefore, the nurse should recognize lung crackles as an indicator of a potential complication and stop the infusion.
A nurse is reviewing the medication list of a client who wants to begin taking oral contraceptives. The nurse should identify that which of the following client medications will interfere with the effectiveness of oral contraceptives?
Carbamazepine Carbamazepine causes an accelerated inactivation of oral contraceptives because of its action on hepatic medication-metabolizing enzymes.
A nurse is caring for a client who has cancer and is taking oral morphine and decussate sodium. The nurse should instruct the client that taking the decussate sodium daily can minimize which of the following adverse effects of morphine?
Constipation Constipation is a common adverse effect of morphine that can be minimized by taking docusate sodium, a stool softener that promotes easier evacuation of stool by increasing water and fat in the intestine.
A nurse is teaching a client who is to start taking hydrocodone with acetaminophen tablets for pain. Which of the following information should the nurse include in the teaching?
Decreased respirations might occur. The nurse should instruct the client that hydrocodone with acetaminophen might cause respiratory depression, which is an adverse effect of the medication. The client should avoid taking over-the-counter medications or newly prescribed medications without consulting their provider to avoid increased respiratory depression.
A nurse is assessing a client after administering a second dose of cefazolin IV. The nurse notes the client has anxiety, hypotension and dyspnea. Which of the following medications should administer first?
Epinephrine According to evidence-based practice, the nurse should administer epinephrine first to induce vasoconstriction and bronchodilation during anaphylaxis.
A nurse is assessing a client's vital signs prior to the administration of PO digoxin. The client's BP is 144/86 mmHg, heart rate is 55/min, and the respiratory rate is 20/min. The nurse should withhold the medication and contact the provider for which of the following findings?
Heart Rate Digoxin slows the conduction rate through the SA and AV nodes, thereby decreasing the heart rate. The nurse should withhold the medication and notify the provider for a heart rate of 55/min because this is an early indication of digoxin toxicity.
A nurse is teaching a client who is to begin taking tamoxifen for the treatment of breast cancer. Which of the following adverse effects should the nurse include in the teaching?
Hot flashes The estrogen receptor blocking action of tamoxifen commonly results in the adverse effect of hot flashes.
A nurse is collecting a medication history from a client who has a new prescription for lithium. The nurse should identify that the client should discontinue which of the following over-the-counter medications?
Ibuprofen Most NSAIDs can significantly increase lithium levels. Therefore, the client should not take ibuprofen and lithium concurrently.
A nurse is preparing to administer PO sodium polystyrene sulfonate to a client client who has hyperkalemia. Which of the following action should the nurse plan to take?
Monitor the client for constipation. The nurse should monitor the client for the adverse effect of constipation and report it to the provider because this can lead to fecal impaction.
A nurse is preparing to administer medication to a client who has gout. The nurse discovers that an error was made during the previous shift and the client received atenolol instead of allopurinol. Which of the following actions should the nurse take first?
Obtain the client's blood pressure. When using the nursing process, the first action the nurse should take to prevent injury to the client is to assess the client for adverse effects of atenolol, such as hypotension.
A nurse is caring for a 20 year old female client who has a prescription for isotretinoin for severe nodulocystic acne vulgarism. Before the client can obtain a refill, the nurse should advise the client that which of the following tests is required?
Pregnancy test The nurse should instruct the client that isotretinoin has teratogenic effects; therefore, pregnancy must be ruled out before the client can obtain a refill. The client must provide two negative pregnancy tests for the initial prescription and one negative test before monthly refills.
A nurse is reviewing the ECG of a client who is receiving IV furosemide for heart failure. The nurse should identify which of the following findings as an indication of hypokalemia?
Presence of U-waves The nurse should identify the presence of U-waves as a manifestation of hypokalemia, an adverse effect of furosemide.
A nurse is providing teaching to a client who has a gastric ulcer and a new prescription for famotidine. Which of the following instructions should the nurse include?
Report yellowing of the skin. Famotidine can be hepatotoxic and cause jaundice. The nurse should instruct the client to monitor for and report yellowing of the skin or eyes to the provider.
A nurse at a clinic is providing follow-up care to a client wo is taking fluoxetine for depression. Which of the following findings should the nurse identify as an adverse effect of the medication?
Sexual dysfunction Sexual dysfunction, including a decreased libido, impotence, and delayed orgasm, or anorgasmia, is a common adverse effect of fluoxetine and occurs in about 70% of clients who take this SSRI antidepressant.
A nurse is providing discharge instructions to a client who has heart failure and a new prescription for captopril. Which of the following client statements indicates an understanding of the teaching?
"I should take naproxen if I develop joint pain." Naproxen and other NSAIDs can interact with captopril, which can decrease the effect of the antihypertensive and increase the risk of kidney dysfunction.
A nurse receives a verbal order from the provider to administer morphine five milligrams every 4 hours subcutaneously for severe pain as needed. The nurse should identify which of the following entries as the correct format for the medication administration record (MAR)?
Morphine 5 mg subcut every 4 hr PRN severe pain The nurse should identify this entry as the correct format for the MAR. The medication name is spelled out and there are not any abbreviations from The Joint Commission's "Do Not Use" list included in the transcription.
A nurse is planning to teach about the use of a spacer to a child who has a new prescription for a fluticasone inhaler to treat chronic asthma. the nurse should include that the spacer deceases the risk for which of the following adverse effect of the medication?
Oral candidiasis Dysphonia and oral candidiasis are adverse effects of inhaled corticosteroids. Using a spacer and rinsing the mouth after inhalation will minimize the amount of medication remaining in the oropharynx, preventing the development of these adverse effects.
A nurse is assessing a client who has schizophrenia and is taking halperidol. The nurse should report which of the following findings to the provider as a manifestation of nueroletpic malignant syndrome (NMS)?
Temperature of 39.7 C (103.5 F) The nurse should report fever to the provider as an indication of NMS, an acute life-threatening emergency. Other manifestations can include respiratory distress, diaphoresis, and either hyper- or hypotension.