RN212

A nurse is teaching a client who has chronic stable angina pectoris and a prescription for sublingual nitroglycerin tablets. What sequence of instructions should the nurse tell the client to use if he experiences chest pain? (Move the steps into the box on the right, placing them in the order of performance. Use all the steps.)

- Stop activity - Place a tablet under the tongue - Wait 5 min - Call 9-1-1 if the pain is not relieved

A nurse is preparing to administer prochlorperazine 2.5 mg IV. Prochlorperazine injection 5 mg/mL is available. How many mL should the nurse administer? (Fill in the blank with the numeric value only, round the answer to the nearest tenth, and use a leading zero if applicable. Do not use a trailing zero.)

0.5 mL

A nurse is preparing to administer atropine 0.6 mg IM preoperatively to a client. The amount available is atropine 0.4 mg/1 mL. How many mL should the nurse plan to administer? (Fill in the blank with the numeric value only, round to the nearest tenth, and use a leading zero if applicable. Do not use a trailing zero.)

1.5 mL

A nurse is preparing to administer fosphenytoin 550 mg via IV bolus to a client who is having a seizure. Fosphenytoin 50 mg/1 mL is available. How many mL should the nurse administer? (Fill in the blank with the numeric value only, round the answer to the nearest tenth, and use a leading zero if applicable. Do not use a trailing zero.)

11 mL

A nurse is preparing to administer verapamil 5.5 mg via IV bolus to a client who has hypertension. The amount available is verapamil 2.5 mg/1 mL. How many mL should the nurse administer? (Fill in the blank with the numeric value only, round to the nearest tenth, and use a leading zero if applicable. Do not use a trailing zero.)

2.2 mL

A nurse is preparing to administer amoxicillin 250 mg liquid suspension PO every 8 hr to an older adult client. The amount available is amoxicillin 50 mg/mL. How many mL should the nurse administer per dose? (Fill in the blank with the numeric value only, round the answer to the nearest whole number, and use a leading zero if applicable. Do not use a trailing zero.)

5 mL

A nurse is preparing to administer an enteral feeding through an NG tube at 250 mL over 4 hr. The nurse should set the pump to deliver how many mL/hr? (Fill in the blank with the numeric value only, round the answer to the nearest whole number, and use a leading zero if applicable. Do not use a trailing zero.)

63 mL/hr

A nurse is providing teaching to a client with a seizure disorder who has a new prescription for carbamazepine. Which of the following statements should the nurse include in the teaching? A. "This medication will decrease the effectiveness of oral contraceptives." B. "Once you are seizure-free for a month, you will be able to stop taking the medication." C. "You can cut the dose in half if gastrointestinal upset occurs." D. "This medication might initially increase the frequency of your seizures."

A. "This medication will decrease the effectiveness of oral contraceptives."

A nurse is administering subcutaneous heparin to a client who is at risk for deep vein thrombosis. Which of the following actions should the nurse take? A. Administer the medication into the client's abdomen B. Inject the medication into a muscle C. Massage the site after administering the medication D. Use a 22-gauge needle to administer the medication

A. Administer the medication into the client's abdomen The heparin should be administered into the client's abdomen.

A. nurse is administering brimonidine eye drops to a client who has glaucoma. Which of the following ocular effects should the nurse expect? A. Decreased intraocular pressure B. Blocked growth of new blood vessels C. Paralysis of accommodation D. Mydriasis

A. Decreased intraocular pressure Brimonidine is an alpha-2 adrenergic agonist used for the long-term treatment of open-angle glaucoma. It decreases intraocular pressure by reducing aqueous humor production.

A nurse is caring for a client who has hyperlipidemia and is receiving simvastatin 40 mg PO daily. Which of the following items should the nurse remove from the client's breakfast tray before it is delivered to the room? A. Grapefruit juice B. Hardboiled eggs C. Coffee D. Oatmeal

A. Grapefruit juice Grapefruit juice is contraindicated taking simvastatin - raises blood levels of the medication significantly by inactivating a liver enzyme that is responsible for metabolism.

A nurse is providing teaching about food-drug interactions to a client who is prescribed sirolimus following a kidney transplant. Which of the following pieces of information should the nurse include in the teaching? A. "Increase your intake of high-fat foods." B. "Avoid eating grapefruit while taking sirolimus." C. "Drink apple juice just before dosing." D. "Reduce your intake of gluten."

B. "Avoid eating grapefruit while taking sirolimus."

A nurse manager is instructing a newly licensed nurse about routes of medication administration. Which of the following routes involves medication absorption through the mucous membranes under the tongue? A. Oral B. Topical C. Parenteral D. Sublingual

D. Sublingual Absorption through the sublingual route occurs by placing the medication under the tongue.

A nurse is preparing to administer levothyroxine 12.5 mcg PO daily to a client who has hypothyroidism. Levothyroxine 25 mcg/1 tablet is available. How many tablets should the nurse administer per dose? (Fill in the blank with the numeric value only, round the answer to the nearest tenth, and use a leading zero if applicable. Do not use a trailing zero.)

0.5 tab

A nurse is preparing to administer heparin 12,000 units subcutaneously to a client every 8 hr. Heparin 20,000 units/1 mL is available. How many mL should the nurse administer per dose? (Fill in the blank with the numeric value only, round the answer to the nearest tenth, and use a leading zero if applicable. Do not use a trailing zero.)

0.6 mL

A nurse is preparing to administer 1 mg of enalapril via IV bolus to a client who is experiencing hypertension. The amount available is enalapril 1.25 mg/mL. How many mL should the nurse plan to administer per dose? (Fill in the blank with the numeric value only, round the answer to the nearest tenth, and use a leading zero if applicable. Do not use a trailing zero.)

0.8 mL

A nurse is preparing to administer digoxin 0.2 mg via IV bolus to a client. The amount available is digoxin 0.25 mg/1 mL. How many mL should the nurse administer? (Fill in the blank with the numeric value only, round the answer to the nearest tenth, and use a leading zero if applicable. Do not use a trailing zero.)

0.8 mL

A nurse is preparing a discharge teaching plan for a 6-year-old client with asthma who has several prescription medications using metered-dose inhalers (MDIs). Which of the following interventions should the nurse include in the plan? A. Add a spacer to each MDI B. Instruct the child to inhale more rapidly than usual when using an MDI C. Ask the provider to change the child's medications from inhaled to oral formulations D. Administer oxygen by facemask along with the MDI

A. Add a spacer to each MDI MDIs are difficult to use correctly; even when properly used, only a portion of the medication is delivered to the lungs. A spacer applied to an MDI can make up for a lack of hand-lung coordination by increasing the amount of medication delivered to the lungs.

A nurse is preparing a continuous IV infusion of erythromycin lactobionate for a client who has a Bordetella pertussis infection. Which of the following actions should the nurse take to minimize the risk of thrombophlebitis? A. Infuse the medication slowly B. Administer half the dosage C. Avoid diluting the solution D. Initiate intermittent dosing

A. Infuse the medication slowly - infuse slowly to minimize the risk of thrombophlebitis - Infusing in a dilute solution is an effective way - A continuous infusion is preferable to intermittent dosing.

A nurse in a community health clinic is assessing a new client who has prescriptions for isoniazid and rifampin. Which of the following disorders should the nurse expect the client to have? A. Tuberculosis B. Hypertension C. Diabetes D. Cirrhosis

A. Tuberculosis Isoniazid and rifampin are first-line antitubercular medications used to treat active tuberculosis. The medications are used in combination therapy.

A nurse is teaching a client who has a new diagnosis of angina and has a prescription for isosorbide mononitrate 10 mg PO twice daily. Which of the following client statements indicates an understanding of the teaching? A. "I can take my second dose of medication no later than 9:00 PM." B. "I should change positions slowly when getting out of bed." C. "If I miss a dose, I should double the next dose." D. "I should notify my provider if I experience a headache while taking this medication."

B. "I should change positions slowly when getting out of bed." The nurse should identify that isosorbide mononitrate is an antianginal medication that produces vasodilation. Therefore, this medication can cause orthostatic hypotension. Clients should change positions slowly upon rising to minimize the effects of orthostatic hypotension.

A nurse is preparing to administer the influenza vaccine to a client. Which of the following allergies should the nurse identify as a contraindication to the client receiving this vaccine? A. Gelatin B. Chicken eggs C. Neomycin D. Prednisone

B. Chicken eggs The nurse should identify that an allergy to chicken eggs is a contraindication to receiving the influenza vaccine. Clients who have this allergy can experience angioedema and severe respiratory distress if this vaccine is administered.

A nurse is caring for a client with multiple sclerosis and neurogenic bladder who is receiving bethanechol. The nurse should identify that which of the following client statements indicates a therapeutic action of the medication? A."My mouth seems very dry lately." B."I've noticed my heart beating faster." C."I am able to urinate more freely." D."I've noticed I can take a deep breath more easily."

C."I am able to urinate more freely."

A nurse is caring for a client and realizes after administering the 0900 medications that she administered digoxin 0.25 mg PO to the client instead of the prescribed digoxin 0.125 mg PO. Which of the following actions should the nurse take first? A. Notify the provider B. Contact the nursing supervisor C. Assess the client's apical pulse D. Complete an incident report

C.Assess the client's apical pulse An assessment will provide the nurse with the knowledge needed to make an appropriate decision.

A nurse is providing teaching to a client who has a new prescription for hydrochlorothiazide 50 mg PO daily to treat hypertension. Which of the following instructions should the nurse include in the teaching? A. "Take hydrochlorothiazide as needed for edema." B. "Check your weight once each week." C. "Take hydrochlorothiazide on an empty stomach." D. "Take hydrochlorothiazide in the morning."

D. "Take hydrochlorothiazide in the morning."

A nurse is caring for a client who is taking budesonide to treat Crohn's disease. Which of the following findings should indicate to the nurse that the treatment is effective? A. Decreased blood glucose B. Increased potassium C. Increased prostaglandin synthesis D. Decreased inflammation

D. Decreased inflammation For a client who has Crohn's disease, a decrease in inflammation of the gastrointestinal lining of the client's large intestine is a therapeutic effect of taking budesonide. Budesonide is a glucocorticoid that works by suppressing the immune system. Glucocorticoids inhibit the actions of prostaglandins and leukotrienes.

A nurse is providing discharge teaching to a client who is postoperative and has a new prescription for an oral opioid analgesic. Which of the following pieces of information should the nurse include as a rationale for increasing the client's daily intake of fiber? A. Fiber binds with the medication to relieve pain. B. Dietary fiber prevents nausea caused by opioids. C. Fiber promotes the absorption of opioids. D. Dietary fiber helps prevent constipation.

D. Dietary fiber helps prevent constipation. The nurse should inform the client that constipation is an adverse effect of opioids. Increasing dietary fiber consumption can help manage opioid-induced constipation. The nurse should also instruct the client to increase physical activity and fluid intake. A stool softener and a laxative might also be needed to prevent the complications associated with opioid-induced constipation.

A nurse is caring for a client who has a vitamin K deficiency. Which of the following manifestations should the nurse expect? A. Irregular bone formation B. Abnormal movements C. Blurred vision D. Excessive bruising

D. Excessive bruising The nurse should identify that excessive bruising can indicate bleeding under the skin. Vitamin K is needed by clotting factors to coagulate the blood. Therefore, a client who has a deficiency in vitamin K is at risk for excessive bruising and bleeding.

A nurse is caring for a client who has heart failure and is prescribed dobutamine hydrochloride by continuous IV infusion. The nurse should identify that which of the following is the therapeutic effect of this medication? A. Improves oxygen saturation rate B. Decreases elevated blood pressure C. Reduces heart rate D. Improves cardiac output

D. Improves cardiac output The nurse should identify that dobutamine is a vasopressor that improves cardiac output and hemodynamic status in clients.

A nurse is preparing to administer heparin 8,000 units subcutaneously every 8 hr. Heparin 10,000 units/1 mL is available. How many mL should the nurse administer per dose? (Fill in the blank with the numeric value only, round the answer to the nearest tenth, and use a leading zero if applicable. Do not use a trailing zero.)

0.8 mL

A nurse is preparing to administer codeine 30 mg PO every 4 hr PRN to a client for pain. The amount available is codeine oral solution 15 mg/5 mL. How many mL should the nurse plan to administer per dose? (Fill in the blank with the numeric value only, round the answer to the nearest whole number, and use a leading zero if applicable. Do not use a trailing zero.)

10 mL

A nurse is preparing to administer azithromycin 150 mg liquid suspension PO every 12 hr to a client. The amount available is azithromycin 50 mg/5 mL. How many mL should the nurse administer per dose? (Fill in the blank with the numeric value only, round to the nearest whole number, and use a leading zero if applicable. Do not use a trailing zero.)

15 mL

A nurse is preparing to administer metoclopramide 10 mg IM to a client who is postoperative and nauseated. The amount available is metoclopramide 5 mg/1 mL. How many mL should the nurse administer? (Fill in the blank with the numeric value only, round to the nearest whole number, and use a leading zero if applicable. Do not use a trailing zero.)

2 mL

A nurse is preparing to administer benztropine 8 mg PO daily in 2 divided doses to a client who has Parkinson's disease. The amount available is benztropine 2 mg tablets. How many tablets should the nurse administer with each dose? (Fill in the blank with the numeric value only, round the answer to the nearest whole number, and use a leading zero if applicable. Do not use a trailing zero.)

2 tab

A nurse is preparing to administer dextrose 5% in 0.45% sodium chloride 400 mL IV to an older adult client over 8 hr. The nurse should set the IV pump to deliver how many mL/hr? (Fill in the blank with the numeric value only, round the answer to the nearest whole number, and use a leading zero if applicable. Do not use a trailing zero.)

50 mL

A nurse is preparing to administer an IV fluid bolus of 1 L 0.9% sodium chloride over 2 hr to a client who is dehydrated. The nurse should set the IV pump to deliver how many mL/hr? (Fill in the blank with the numeric value only, round the answer to the nearest whole number, and use a leading zero if applicable. Do not use a trailing zero.)

500 m/hr

A nurse is providing discharge teaching to a client who has angina pectoris and a new prescription for verapamil. The client tells the nurse, "My brother takes verapamil for high blood pressure. Do you think the provider made a mistake?" Which of the following responses should the nurse make? A. "Verapamil is used to treat both high blood pressure and angina." B. "You should talk to your provider to make sure the prescription is correct for you." C. "Are you concerned that you might have high blood pressure?" D. "Your provider has prescribed verapamil so that you will not develop high blood pressure."

A. "Verapamil is used to treat both high blood pressure and angina." Verapamil is a calcium channel blocker that is used for both hypertension and anginal pain because of its ability to dilate arteries and decrease afterload.

A nurse is preparing to administer a sublingual nitroglycerin tablet to a client who is reporting chest pain. For which of the following adverse effects should the nurse monitor after giving this medication? A. Hypotension B. Myalgia C. Diarrhea D. Ototoxicity

A. Hypotension Nitroglycerin is a coronary vasodilator and antianginal agent. A major adverse effect of this medication is hypotension; therefore, blood pressure and pulse must be monitored before and after administration.

A nurse is providing teaching to a group of new parents about medications. The nurse should include that aspirin is contraindicated for children who have a viral infection due to the risk of developing which of the following adverse effects? A. Reye's syndrome B. Visual disturbances C. Diabetes mellitus D. Wilms' tumor

A. Reye's syndrome

A nurse is admitting a client who has unstable angina. Which of the following medications should the nurse anticipate administering to the client? A. Epinephrine B. Nitroglycerin C. Lidocaine D. Atropine.

B. Nitroglycerin The nurse should anticipate administering nitroglycerin to a client who has unstable angina. This medication acts by relaxing or preventing spasms in the coronary arteries along with dilating the arteries, which increases oxygenation and blood flow.

A nurse is assigned to care for several clients who are postoperative. The client taking which of the following medications is at risk of delayed wound healing? A.Nifedipine to treat hypertension B. Prednisone to treat persistent arthritis exacerbations C. Albuterol to treat asthma D. Chlorpromazine to treat schizophrenia

B. Prednisone to treat persistent arthritis exacerbations Prednisone is a corticosteroid that is associated with delayed wound healing. Clients who have arthritis often require high doses of prednisone to help resolve exacerbations.

A nurse is providing teaching about benzodiazepines to a client who is discontinuing long-term alprazolam use. Which of the following pieces of information should the nurse include in the teaching? A. "You might experience somnolence." B. "Plan to taper the dose slowly over several months." C. "Call the provider if you have muscle weakness." D. "Confusion is common during this process."

B. "Plan to taper the dose slowly over several months." The nurse should instruct the client to plan to taper the alprazolam dose slowly over several weeks or months to ease the physiological and psychological manifestations of withdrawal.

A nurse is caring for a client who has been taking isoniazid and rifampin for 3 weeks for the treatment of active pulmonary tuberculosis (TB). The client reports his urine is an orange color. Which of the following statements should the nurse make? A. "Stop taking the isoniazid for 3 days, and the discoloration should go away." B. "Rifampin can turn body fluids orange." C. "I'll make an appointment for you to see the provider this afternoon." D. "Isoniazid can cause bladder irritation."

B. "Rifampin can turn body fluids orange." Rifampin can cause body fluids, such as tears, sweat, saliva, and urine, to turn a reddish-orange color. The nurse should inform the client that this effect does not cause harm.

A nurse is teaching about the adverse effects of morphine with a client who has acute pain. Which of the following statements should the nurse include in the teaching? A. "You might notice that you see better in dim areas." B. "You should increase your fluid intake." C. "You should expect to have excessive urination." D. "You might experience difficulty sleeping."

B. "You should increase your fluid intake." The nurse should inform the client that an adverse effect of morphine is constipation. Therefore, the nurse should encourage the client to increase oral fluids to promote motility of the bowel.

A nurse is monitoring the laboratory values of a male client who has leukemia and is receiving weekly chemotherapy with methotrexate via IV infusion. Which of the following laboratory values should the nurse report to the provider? A. BUN 18 mg/dL B. Platelets 78,000/mm^3 C. Hemoglobin 14.2 g/dL D. Aspartate aminotransferase (AST) 35 units/L

B. Platelets 78,000/mm^3 - monitor the platelet count - very low and puts the client at risk of severe bleeding.- report to provider - monitor the BUN - kidney injury. - monitor the hemoglobin - bone marrow suppression. - monitor the AST - liver damage

A nurse is providing teaching about antiretroviral medication therapy to a client who has a new diagnosis of AIDS. Which of the following statements should the nurse include in the teaching? A. "Your provider will prescribe a single antiretroviral medication at a time." B. "You should take antiretroviral medications on a routine schedule." C. "You should increase your intake of raw fruits and vegetables while taking antiretroviral medications." D. "Your provider will prescribe antiretroviral therapy to kill the HIV."

B. "You should take antiretroviral medications on a routine schedule." The nurse should inform the client of the need to take antiretroviral therapy exactly as prescribed and to avoid delaying or skipping any doses, which can result in medication resistance.

A nurse is preparing to administer meperidine 100 mg IM to a client who has a BMI of 23. Which of the following needle lengths should the nurse use to administer the medication? A. ½ inch B. 1 ½ inch C. 2 ½ inch D. 3 inch

B. 1 ½ inch In general, needle lengths for IM injections are 1 to 1 ½ inches, unless the client is obese. A BMI of 23 is considered to be an optimal weight.

A nurse is preparing to administer nitroglycerin topical ointment to a client who has angina. Which of the following actions should the nurse take? A. Cover the applied ointment with cotton gauze B. Apply the ointment using a dose-measuring applicator C. Apply the ointment using the index finger D. Massage the ointment into the client's skin

B. Apply the ointment using a dose-measuring applicator The nurse should apply the ointment using a dose-measuring applicator. This allows the nurse to measure the correct dose the client is to receive.

A nurse is teaching a client who is using topical lidocaine about preventing systemic toxicity. Which of the following pieces of information should the nurse include about the application of topical lidocaine? A. Apply a dressing after covering the affected areas with topical lidocaine B. Apply topical lidocaine to affected areas that are intact C. Apply topical lidocaine in a thick layer to affected areas D. Apply topical lidocaine frequently to large affected areas

B. Apply topical lidocaine to affected areas that are intact The nurse should tell the client to apply topical lidocaine to skin that is intact rather than blistered, broken, or irritated to prevent a large amount of medication from being absorbed and to decrease the risk of systemic toxicity.

A nurse is caring for a client who is receiving lidocaine for localized pain. The nurse should recognize that which of the following actions will help prevent systemic toxicity of this medication? A. Applying a heating pad following administration to increase blood flow to the area B. Applying the medication to intact skin C. Applying a large amount of the medication at once to avoid frequent reapplication D. Applying the medication to large areas for maximum spread

B. Applying the medication to intact skin Lidocaine applied to broken or irritated skin can increase the risk of systemic absorption.

A nurse is teaching an assistive personnel (AP) about dietary restrictions for a client who is taking phenelzine to treat depression. The AP's selection of which of the following foods for the client's lunch indicates an understanding of the teaching? A. Bologna on wheat bread B. Chicken salad C. Cheddar cheese and crackers D. Pizza with pepperoni

B. Chicken salad Phenelzine is an MAOI. Clients taking MAOIs must avoid foods that contain tyramine due to the potential for a dangerous food-drug interaction. Foods high in tyramine include those that are processed and aged, such as luncheon meats and cheeses. This menu selection does not contain food high in tyramine and indicates an understanding of the teaching.

A nurse is reviewing the medical record of a client who is requesting a prescription for sildenafil citrate. Which of the following data in the client's record should the nurse identify as a contraindication to the use of this medication? A. Diabetes mellitus B. Current use of isosorbide to treat heart failure C. Eyeglasses for presbyopia D. Osteoarthritis

B. Current use of isosorbide to treat heart failure Taking any nitrates such as isosorbide and nitroglycerin is a contraindication for sildenafil, a medication that treats erectile dysfunction. Taking it concurrently with nitrates can cause life-threatening hypotension.

A nurse is caring for a client who has been taking taken metformin for 6 months. Which of the following findings should the nurse identify as an expected therapeutic effect of the medication? A. Decreased vitamin B12 levels B. Decreased blood glucose level C. Abdominal bloating and diarrhea D. Decreased LDL level

B. Decreased blood glucose level A client who has taken metformin for 6 months should experience the expected therapeutic effect of a decrease in blood glucose levels. Metformin is a non-insulin medication for clients who have type 2 diabetes mellitus.

A nurse is teaching a client who had kidney transplant surgery about immunosuppressive medications. Which of the following adverse effects of these medications should the nurse include in the teaching? A.Increased urinary output B. Increased susceptibility to infection C. Increased hair loss D. Increased risk of autoimmune disorders

B. Increased susceptibility to infection Immunosuppressive medications such as cyclosporine increase the risk of infection. As the medication classification indicates, these medications impair immunity and adversely affect the client's ability to resist and fight infection. - cause nephrotoxicity that can lead to oliguria. - can cause hirsutism, rather than hair loss.

A nurse is preparing to administer meperidine to a client who is postoperative and reports a pain level of 8 on a scale of 0 to 10. Which of the following routes of administration will deliver the medication with the shortest time of onset? A. Oral B. Intravenous C. Intramuscular D. Subcutaneous

B. Intravenous

A nurse is caring for a client who has been in the PACU for more than 1 hr, has a respiratory rate of 9/min, and is difficult to arouse. The nurse should expect a prescription for which of the following medications? A. Pentazocine B. Naloxone C. Naltrexone D. Butorphanol

B. Naloxone The nurse should expect a prescription for naloxone. This medication displaces opiate medications from receptor sites, reversing the respiratory depression, sedation, and analgesia that opiates cause.

A nurse is caring for a client who has unstable angina. The nurse should anticipate a prescription from the provider for which of the following medications? A. Epinephrine B. Nitroglycerin C. Lidocaine D. Atropine

B. Nitroglycerin The nurse should anticipate a prescription for nitroglycerin, which is indicated for a client who has unstable angina. Nitroglycerin is an organic nitrate and a vasodilator that acts by relaxing or preventing spasms in the coronary arteries, thereby decreasing the oxygen demand of the heart along with ventricular filling.

A home health nurse is visiting an older adult client who has Alzheimer's disease. His caregiver tells the nurse she has been administering prescribed lorazepam, 1 mg 3 times per day, to the client for restlessness and anxiety over the past few days. For which of the following adverse effects should the nurse assess the client? A. Low-grade fever B. Sedation C. Diuresis D. Tonic-clonic seizures

B. Sedation Lorazepam is a benzodiazepine with anti-anxiety and sedative effects. Older adult clients are especially at risk for central nervous system depression, even with low doses of benzodiazepines. Clients who are 50 years or older can have a more profound and prolonged sedation than younger clients.

A nurse is providing teaching to a client who has a new prescription for sertraline. The client asks the nurse if he should continue to take St. John's wort for depression. Which of the following instructions should the nurse give the client? A. Take the medication and herbal supplement together. B. Stop taking the herbal supplement while taking the medication. C. Take the herbal supplement and the medication at least 2 hr apart. D. Take an antacid with both the herbal supplement and the medication.

B. Stop taking the herbal supplement while taking the medication. Taking the antidepressant sertraline and the herbal supplement St. John's wort increases the client's risk of serotonin syndrome.

A nurse is caring for a client who has a new diagnosis of oral candidiasis after taking tetracycline for 7 days. The nurse should recognize that candidiasis is a manifestation of which of the following adverse effects? A. Allergic response B. Superinfection C. Renal toxicity D. Hepatotoxicity

B. Superinfection A superinfection can develop from fungal overgrowth due to the antibacterial effect of tetracycline. The nurse should monitor the client for manifestations of a superinfection such as soreness of the mouth and a swollen tongue.

A nurse is caring for a client who is experiencing acute pain and is receiving morphine. Which of the following findings should indicate to the nurse the need to withhold the client's next dose of morphine? A. The client reports an inability to void. B. The client's respiratory rate is 10/min. C. The client has hypoactive bowel sounds. D. The client has vomited once in the last 4 hours.

B. The client's respiratory rate is 10/min. The nurse should identify that morphine can cause respiratory depression. Therefore, if the client's respiratory rate is less than 12/min, the nurse should withhold the next dose of morphine and notify the provider.

A nurse is preparing to administer the first injection of the diphtheria, tetanus, and pertussis (DTaP) vaccine to an infant. Which of the following pieces of information should the nurse tell the guardian prior to administering the immunization? A. "Your child might develop diarrhea or vomiting within 24 hours of receiving this vaccine." B. "I can either give your child all of the injections in this series at once or individually." C. "The vaccine will be injected into the infant's thigh." D. "This injection contains a live virus."

C. "The vaccine will be injected into the infant's thigh." The DTaP vaccine is administered intramuscularly (IM) in the deltoid or mediolateral thigh because these are larger muscles that can better diffuse inflammation. Therefore, the nurse should prepare to administer the IM injection in the mediolateral thigh.

A nurse is providing teaching to a client with a new diagnosis of heart failure who has a prescription for furosemide. Which of the following statements should the nurse include in the teaching? A. "You can take ibuprofen for headaches while taking this medication." B. "You may experience increased swelling in your lower extremities while taking this medication." C. "You should eat foods that are high in potassium while taking this medication." D. "You should take this medication at bedtime."

C. "You should eat foods that are high in potassium while taking this medication." The nurse should instruct this client who has a prescription for furosemide to consume foods that are high in potassium. Furosemide is a high-ceiling loop diuretic that depletes potassium, sodium, chloride, magnesium, and water.

A nurse is caring for a client who has multiple medication allergies. During which of the following steps of the nursing process should the nurse identify the client's allergies? A. Planning B. Evaluation C. Assessment D. Implementation

C. Assessment

A nurse is teaching a newly licensed nurse about caring for a client who is receiving patient-controlled analgesia (PCA). Which of the following actions by the newly licensed nurse indicates an understanding of the teaching? A. Assessing the client's vital signs every 6 hr B. Instructing the client's family to press the PCA button when the client is asleep C. Having a second nurse check the PCA setting D. Administering the PCA through a free-flow infusion system

C. Having a second nurse check the PCA setting The nurse should have a second nurse check the PCA settings to ensure the correct amount of medication is being administered to the client.

A nurse is preparing to administer digoxin to a client. Which of the following findings should the nurse identify as a contraindication to the client receiving this medication? A. Blood pressure 180/70 mmHg B. Oxygen saturation rate 94% C. Heart rate 51/min D. Respiratory rate 21/min

C. Heart rate 51/min The nurse should identify that if the client's heart rate is less than 60/min, the medication should be withheld, and the provider should be notified.

A nurse is reviewing the laboratory results of a client who is taking a medication and notes that the client's blood tests show an elevated level of the enzymes aspartate aminotransferase (AST) and alanine aminotransferase (ALT). The nurse should recognize that these findings are potential indications of which of the following conditions? A. Renal dysfunction B. Myelotoxicity C. Hepatic toxicity D. Cardiac dysrhythmia

C. Hepatic toxicity The nurse should identify that elevated levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) are indications the client might be at risk for hepatic toxicity. AST and ALT are enzymes that test liver function. Therefore, this should indicate to the nurse that the medication the client is taking is damaging to the liver. The client should undergo liver function tests, and the nurse should notify the provider of this finding.

A nurse is caring for a client who has osteoporosis and has been taking a vitamin D supplement. The nurse notes that the client reports also taking a multivitamin daily. Which of the following findings should indicate to the nurse that the client might be experiencing vitamin D toxicity? A. Hyperkalemia B. Hypermagnesemia C. Hypercalcemia D. Hypernatremia

C. Hypercalcemia The nurse should identify that vitamin D increases plasma calcium levels by increasing reabsorption from bone, decreasing excretion by the kidneys and increasing absorption from the intestines. Clients who take a vitamin D supplement along with a multivitamin daily might be taking too much calcium.

A nurse is reviewing laboratory values for a client who reports fatigue and cold intolerance. The client has an increased thyroid-stimulating hormone (TSH) level and a decreased total T3 and T4 level. The nurse should anticipate a prescription for which of the following medications? A. Methimazole B. Somatropin C. Levothyroxine D. Propylthiouracil

C. Levothyroxine Levothyroxine replaces thyroid hormone for a client who has hypothyroidism. Laboratory values for hypothyroidism include an increased TSH level and decreased total T3 and T4 levels. Clinical manifestations of hypothyroidism include fatigue, cold intolerance, and a decreased body temperature and pulse.

A nurse is caring for a client who reports crushing chest pain. The nurse reviews the client's ECG results and notes ST changes. Which of the following medications should the nurse administer? A. Simvastatin B. Furosemide C. Nitroglycerin D. Sildenafil

C. Nitroglycerin The nurse should identify the need to administer nitroglycerin, which is used to treat angina. Nitroglycerin acts directly on vascular smooth muscle to promote vasodilation.

A nurse is providing teaching to a client who has chronic kidney failure with an AV fistula for hemodialysis and a new prescription for epoetin alfa. Which of the following therapeutic effects of epoetin alfa should the nurse include in the teaching? A. Reduces blood pressure B. Inhibits clotting of fistula C. Promotes RBC production D. Stimulates growth of neutrophils

C. Promotes RBC production Epoetin alfa stimulates erythropoiesis in the bone marrow to increase RBC production and reduce anemia. Anemia is common in clients who have chronic kidney failure since erythropoietin is produced by the kidney. - can cause hypertension - can cause clot formation.

A nurse is preparing to administer medication to a client. The nurse should understand that which of the following abbreviations indicates the greatest frequency of medication administration? A. BID B. TID C. QID D. Q8h

C. QID The abbreviation "QID" indicates the medication should be administered 4 times per day, which is the greatest frequency of the options provided.

A nurse is reviewing laboratory reports for a client who has Clostridium difficile infection and is receiving vancomycin. Which of the following results should the nurse report to the provider before administering the next dose? A. Hematocrit 46% B. Serum glucose 110 mg/dL C. Serum creatinine 2.5 mg/dL D. Serum potassium 4.8 mEq/L

C. Serum creatinine 2.5 mg/dL Vancomycin is nephrotoxic and can result in renal failure, which is indicated by elevated levels of creatinine above the expected reference range of 0.5 to 1.3 mg/dL. The nurse should report this laboratory value to the provider prior to administering any further doses of the medication.

A nurse is caring for a client who is experiencing a seizure while in bed. Which of the following actions should the nurse take? A. Raise the head of the client's bed. B. Restrain the client's arms and legs. C. Turn the client's head to the side. D. Insert a tongue blade in the client's mouth.

C. Turn the client's head to the side. The nurse should turn the client's head to the side during the seizure. This prevents the client's airway from becoming obstructed and keeps the airway patent.

A nurse is assessing a client who has heart failure and is receiving digoxin. Which of the following findings should indicate to the nurse the client is experiencing digoxin toxicity? A. Suppression of dysrhythmias B. Increased atrioventricular (AV) conduction C. Visual disturbances D. Weight gain

C. Visual disturbances The nurse should recognize that nausea, vomiting, abdominal discomfort, fatigue, and visual disturbances are common manifestations that can indicate that the client is experiencing digoxin toxicity.

A nurse is caring for a client who takes warfarin 2.5 mg PO daily and has an INR of 6.2. The nurse should anticipate a prescription from the provider for which of the following medications? A. Protamine sulfate B. Fondaparinux C. Vitamin K D. Bivalirudin

C. Vitamin K The nurse should anticipate the provider to prescribe vitamin K for a client who has an INR of 6.2. Vitamin K antagonizes warfarin's actions, which can reverse warfarin-induced inhibition of clotting factor synthesis.

A nurse is preparing to administer medication to a preschooler. The nurse should use which of the following measurements to calculate the medication dosage for this client? A. Body mass index (BMI) B. Height C. Weight D. Rule of 9s

C. Weight The nurse should use the child's weight to calculate the medication dose. Children's doses are generally written in units of measure per body weight, such as mg/kg.

A nurse is administering ciprofloxacin and phenazopyridine to a client who has a severe urinary tract infection (UTI). The client asks why both medications are needed. Which of the following responses should the nurse make? A. "Phenazopyridine decreases the adverse effects of ciprofloxacin hydrochloride." B. "Combining phenazopyridine with ciprofloxacin hydrochloride shortens the course of therapy." C. "The use of phenazopyridine allows the doctor to prescribe a lower dosage of ciprofloxacin hydrochloride." D. "Ciprofloxacin hydrochloride treats the infection, and phenazopyridine treats pain."

D. "Ciprofloxacin hydrochloride treats the infection, and phenazopyridine treats pain." Ciprofloxacin hydrochloride is a broad-spectrum quinolone antibiotic, and phenazopyridine is a bladder analgesic/anesthetic that relieves burning and pain in the bladder mucosa caused by bladder spasm and inflammation.

A nurse is caring for a client who is pregnant and inquiring about alternative, non-pharmacological therapies for nausea and vomiting of pregnancy (NVP). Which of the following options should the nurse recommend? A. "Be sure to eat at least 3 large meals each day." B. "If you're experiencing nausea when you wake up, wait to eat until lunchtime." C. "You may need to take additional supplements to alleviate nausea." D. "Ginger is effective in the treatment of nausea and vomiting."

D. "Ginger is effective in the treatment of nausea and vomiting." The nurse should recommend seasoning foods with ginger to alleviate the client's nausea and vomiting. Ginger is derived from the ginger root and is an alternative treatment to prescribed medication for treating nausea and vomiting during pregnancy.

A nurse is providing teaching to a client who is scheduled to start taking hydrochlorothiazide for hypertension. The nurse instructs the client to eat foods that are rich in potassium. Which of the following statements by the client indicates an understanding of the teaching? A."This medication will not work unless I have enough potassium." B. "Potassium will increase the therapeutic effect of my blood pressure medication." C. "Potassium will lower my blood pressure." D. "This medication can cause a loss of potassium."

D. "This medication can cause a loss of potassium." Hydrochlorothiazide can result in hypokalemia caused by excessive potassium excretion from the kidneys. The client should supplement his diet with potassium-rich foods to avoid the occurrence of hypokalemia. Foods that are high in potassium include bananas, raisins, baked potatoes, pumpkins, and milk.

A nurse is providing teaching to the parents of a school-age child with asthma about medications for bronchospasm. Which of the following inhaled medications should the nurse instruct the parents to use to relieve an acute asthma attack? A. Salmeterol B. Cromolyn C. Fluticasone D. Albuterol

D. Albuterol Albuterol is a short-acting beta-2 adrenergic agonist that is used to provide immediate relief for an acute asthma attack. One or two puffs every 4 to 6 hours PRN is the usually prescribed dose for a school-age child. If higher or more frequent doses are needed, the provider should evaluate the client for worsening asthma.

A nurse in a provider's office is assessing a client who has been taking amoxicillin for 10 days and reports diarrhea and cramping. The nurse should recognize that these manifestations occur secondary to which of the following adverse effects? A. Development of gastric ulcers B. Development of milk intolerance C. Allergic reactions to the medication D. Alterations in gastrointestinal flora

D. Alterations in gastrointestinal flora The typical gastrointestinal flora are often destroyed by broad-spectrum antibiotics like amoxicillin, causing poor digestion and possible superinfection with other bacteria.b

A nurse is providing teaching to a client who has cirrhosis and a new prescription for lactulose. The nurse should instruct the client that lactulose has which of the following therapeutic effects? A. Increases blood pressure B. Prevents esophageal bleeding C. Decreases heart rate D. Reduces ammonia levels

D. Reduces ammonia levels Lactulose is a laxative that promotes the excretion of ammonia in a client who has hepatic encephalopathy from cirrhosis of the liver.

A nurse is assessing a client who is receiving a continuous morphine IV infusion and finds the client's respiratory rate has decreased from 20/min to 12/min. Which of the following actions should the nurse take? A.Flush the IV line with saline B. Administer flumazenil C. Lower the head of the bed D. Slow the rate of the infusion

D. Slow the rate of the infusion The nurse should decrease the infusion rate to reduce the amount of morphine the client receives and limit the risk of respiratory depression.

A nurse is teaching a client who has type 2 diabetes mellitus about storing unopened vials of insulin. Which of the following pieces of information should the nurse include in the teaching? A. Store the vials in the freezer B. Store the vials at room temperature C. Store the vials by a window D. Store the vials in the refrigerator

D. Store the vials in the refrigerator The nurse should tell the client to store unopened vials of insulin in the refrigerator. The client can use the unopened vials of insulin up to the printed expiration date.