Test 6 - Final (In-class questions)

The community health nurse is preparing an education session that will include information on hepatitis B. The nurse should describe what routes of transmission?

-Sexual activity -Blood-to-blood contact -In utero transmission

A client has been prescribed propranolol to reduce and prevent angina. For what adverse effects should the nurse assess this client?

-Sleep disturbance -Sexual dysfunction -Bronchospasm -Gastric pain

A client is going to have bowel surgery in the morning. The physician orders 500 mL of GoLytely PO to be administered at 17:00. How many liters should the nurse adminsister?

1 L = 1000 mL Order: 500 mL 500 mL 1000 mL/L = 0.5 L

An 81-year-old client with congestive heart failure has been sent to a cardiologist who prescribes digoxin 125 mcg P.O. every morning. The pharmacy dispenses pills that contain 0.25 mg of digoxin. How many pills should the nurse teach the client to take every morning?

1 g = 1000 Order: 125 mcg Available: 0.25 mg 0.25 mg ÷ 125 mcg

The nurse is preparing to administer cefadroxil 1 g P.O.. The medication is supplied in 500-mg tablets. How many tablets should the nurse administer?

1 g = 1000 mg Order: 500 mg/tablet Available: 1000 mg 1000 mg ÷ 500 mg/tablet = 2 tablets

The client drinks 18 ounces of fluid at lunchtime. How many milliliters of intake should the nurse document?

1 ounce = 30 mL Order: 18 mL 18 mL 30 mL/oz x 18 oz = 540 mL

The nurse is assisting with a phase I drug study. What potential participant would be most appropriate??

22-year-old male with an unremarkable health history

The nurse receives a new medication order for a client to administer 300 mg of medication per day in equally divided doses every 8 hours. How many milligrams of the drug should the nurse administer for each dose?

24 hr ÷ 8 hr = 3 doses 300 mg ÷ 3 doses = 100 mg/dose

The client is a 6-year-old child who is taking 125 mg of amoxicillin every 6 hours. Assuming that the half-life of amoxicillin is 3 hours, approximately how much amoxicillin would be in the child's body at the time of the next administration of the drug?

31 mg

The triage nurse in the emergency department admits a client in distress. The client's parents attribute the client's distress to amphetamine use. What assessment finding would best corroborate this parent's suspicion?

Blood pressure 196/117 mm Hg

A client in distress is brought to the emergency department by ambulance. Emergency medical technicians state that an anaphylactic reaction from oral penicillin is suspected. Which of the nurses's assessment findings best supports this diagnosis?

Blood pressure: 186/100 mm Hg, shortness of breath

Why does the nurse need to be alert for any indications of an allergic reaction in clients?

To maintain the client's safety during drug therapy

A client with a gram-negative infection is being treated with an aminoglycoside. What assessment should the nurse prioritize during treatment?

Urine output and BUN and creatinine levels

The nurse is caring for a client receiving IV aminoglycosides for an intractable infection in the leg. What assessment should the nurse prioritize?

Urine output and creatinine clearance levels

A 25-year-old female client presents at the clinic with fever, chills, and achy joints. The client is diagnosed with influenza A, and ribavirin is prescribed. What should the nurse include in client teaching about this medication?

Use barrier contraceptives

The nurse is caring for client with influenza and is explaining why viruses are more difficult to treat than many bacteria. What should the nurse teach the client?

Viruses are contained inside the human cell and cannot be destroyed without destroying that cell

The nurse is caring for a client experiencing parasympathetic nervous system blockade cause. What assessment finding supports this diagnosis?

-Decrease in urinary bladder tone -Increase in heart rate -Decrease in gastrointestinal (GI) activity

A client has been diagnosed with gonorrhea and been prescribed oral tetracycline. What should the nurse include in health education about tetracycline?

-Do not take the drug with foods or other drugs that contain calcium -Do not take the drug at the same time as an iron supplements or high-iron foods

When the nurse cares for a client receiving an antibiotic, what instructions should the nurse provide not matter what medication is prescribed?

-Drink plenty of fluids to avoid kidney damage -Take all medications as prescribed until all of the medication is gone -Report difficulty breathing, severe headache, or changes in urine output

The nurse is admitting a client to the postsurgical unit from the postanesthetic care unit. The client is in pain, so the nurse administers 4 mg morphine IV as prescribed. After administering the drug, the PACU nurse calls to say a dose of morphine was given and not documented. What actions should the nurse perform?

-Ensure naloxone is readily available -Inform the client's health care provider -Document the event -Monitor the client's respiratory rate closely

A nurse who provides care n a gerontologic setting works with many clients who have rheumatoid disorders and chronic pain. The nurse should question the prescriber if what anti-inflammatories are prescribed for older adult clients?

-Ketorolac -Naproxen -Ketoprofen

A client who is 84 years old is experiencing chronic lower back pain that has not responded to NSAIDs. The provider has prescribed a transdermal fentanyl patch. What should the nurse do to ensure safe and effective care?

-Monitor the client's respiratory status closely -Keep the client's bed in the lowest position -Ensure that the client has access to the call light

The nurse is assessing a client who began taking donepezil a few weeks ago. What areas should the nurse assess, related to the medication?

-Nutritional status -Blood pressure -History of incontinence

The nurse is preparing to administer a client's scheduled ophthalmic adrenergic agonist. What actions should the nurse perform?

-Perform hand hygiene prior to administration -Instruct the client not to rub the eyeball after administration of the drops

The client is brought to the emergency department in respiratory arrest after overdosing on heroin. The person accompanying the client says he has been using heroin for years. After being administered one dose of naloxone, the client begins to breathe spontaneously but remains nonresponsive to stimuli so another dose is prescribed. The nurse should monitor for what signs and symptoms of acute narcotic abstinence syndrome?

-Tachycardia -Hypertension -Vomiting

The home care nurse is caring for a client newly prescribed a nonselective beta-blocking agent. What should the nurse include in the teaching plan related to this drug?

-Take with meals -Change position slowly -Avoid driving or operating hazardous machinery (until you know how the drug effects you)

The nurse is preparing to administer scheduled medication to a client in the community. What are the responsibilities of the nurse to the client's drug therapy?

-Teaching the client how to participate in therapy to ensure the best outcomes -Providing therapeutic interventions that complement the medications -Evaluating the effectiveness of the client's drug therapy

A client who regularly takes antihistamines for severe allergies is planning a tropical vacation. What health education related to drug therapy should the nurse provide?

"Avoid sightseeing during the hottest part of the day."

The telephone triage nurse receives a call from a client asking for a prescription for an opioid (narcotic) to manage his surgical pain. The nurse explains that opioid prescriptions must be written and cannot be called into the pharmacy. The client says, "Why are opioids so difficult to get a prescription for?" What is the nurse's best response?

"Controlled substances like opioids are controlled by the FDA and the DEA."

A nurse is assessing the client;s home medication use. After listening to the client list current medications, the nurse asks what priority question?

"Do you take an over-the-counter medications?"

A client tells the clinic nurse that he or she has been taking an over-the-counter (OTC) antacid to relieve acid indigestion daily for several months. This is the first time the client has ever reported this medication use to a health care provider. What health education should the nurse provide to the client?

"Ensure that you keep your provider up to date on your medication use so there aren't any unanticipated interactions."

The nurse is admitting a 12-year-old girl to the acute care facility and notices discolored secondary teeth. The mother says she doesn't know why the teeth are discolored because the child is very good about brushing and flossing and sees the dentist regularly. What question should the nurse ask?

"Has she ever received tetracycline?"

The client has been diagnosed with a serious infection caused by gram-negative aerobic bacilli. The client has been prescribed IV gentamicin. What statement by the client should the nurse follow-up most promptly?

"I feel like I'm having trouble hearing the last little while."

The nurse is evaluating the discharge teaching provided to a client concerning drug therapy. What statement from the client would indicate that teaching had been effective?

"I'll add the names and dosages of these new drugs to my medications list in my wallet."

A client calls the clinic and asks the nurse for a drug that was advertised on TV. The client is keen to experience the benefits described in the commercial. What is the nurse's best response?

"It's important to remember that drug advertisements emphasize the positive effects of drug therapy and not the adverse effects or contraindications."

A nurse is providing teaching to a group of clients who are beginning drug therapy for human immunodeficiency syndrome (HIV). What should the nurse teach the group?

"Make sure not to take more than prescribed, because poisoning can cause damage to more than one body system."

A nurse is instructing a pregnant client concerning the potential risk to her fetus from a Pregnancy Category D drug. What should the nurse inform the client?

"There is evidence of human fetal risk, but the potential benefits from use of the drug may be acceptable despite potential risks."

The nurse is caring for a client hospitalized with hepatitis B. The family comes to visit and a family member asks the nurse if it is safe to visit. What is the nurse's best response?

"There is no risk unless you come in contact with blood and body fluids."

A client with a history of motion sickness has been prescribed a scopolamine patch. Which statements by the client should lead the nurse to believe that the client knows how to use the patch?

-"I will change the patch every 3 days." -I will avoid taking over-the-counter motion sickness pills while the patch is in place."

The clinic nurse is teaching a client about transdermal clonidine, which has just been prescribed. What information should the nurse teach the client?

-"Rotate the site where the patch is placed." -"Monitor your blood pressure at least once per day." -"Keep your provider informed of any new diagnoses or medications."

The nurse should consider teratogenic effects when caring for what clients?

-A 29-year old clinet receiving prenatal care in her first trimester of pregnancy -A 37-year-old female client who is taking fertility drugs

What clients are likely to benefit from the administration of an anticholinergic medication?

-A 76-year-old client who has been diagnosed with Parkinson's disease -A client who has lived with asthma for several years -A client who has been admitted to the emergency department after eating wild mushrooms

For which clients would the use of a narcotic agonist-antagonist be appropriate?

-A client injured in a motor vehicle accident who rates his pain at 7/10 -A client who is in the second stage of labor -A client who will undergo general anesthesia for orthopedic surgery

A client with rheumatoid arthritis is taking gold salts. What drugs should the nurse teach this client that are contraindicated when taking gold salts?

-Antimalarials -Cytotoxic drugs -Penicillamine

The nurse has cared for an increasing number of clients who have antibiotic resistance. What principles should the nurse and the other members of the care team follow in order to prevent antibiotic resistance?

-Avoid broad-spectrum antibiotics when treating trivial or viral infections -Use narrow-spectrum agents if they are likely to be effective -Teach clients not to save antibiotics for self-medication in the future

The client, who takes an anticholinergic medication, tells the nurse about some of the herbal supplements that a Web site recommends. What herbs should the nurse caution the client to avoid?

-Burdock -Rosemary -Turmeric

What client is receiving prophylactic anti-infectives?

A client who is prescribed a 3-day course of antibiotics prior to dental surgery

A client with Parkinson's disease has been prescribed an anticholinergic medication. The client reports that he is having difficulty voiding. The nurse should recognize that this client is experiencing:

A secondary action of the drug

The nurse is caring for an older adult who needs to know that drugs, even when taken correctly, can produce negative or unexpected effects. The nurse should address what topic during health education?

Adverse Effects

The nurse is caring for a diverse group of client on a hospital medical unit. What client is most likely to experiencing a superinfection?

An older adult client with Clostrdium difficile-associated diarrhea

Which client should the nurse assess most closely for swallowing difficulties prior to administering an oral medication?

An older adult diagnosed with Parkinson's disease

The nurse is providing care for a client whose type 2 diabetes is treated glipizide. When monitoring the client for potential adverse effects, the nurse should assess for:

Confusion and lack of coordination

A nurse is caring for a client who is scheduled to receive three medications at the same time. What action should the nurse perform first?

Consult a drug guide to check for compatibility

The nurse is reviewing the client's medication orders and find an order stating "amoxicillin 250 mg 8 hours." What is the nurse's best action?

Ask the prescriber to confirm the route

A resident of a long-term care facility has been prescribed docosanol for the treatment of a cold sore. What action should the nurse perform first?

Assess the area for open lesions or abrasions

The nurse is preparing to administer a new anti-infective to a client. The nurse should prioritize what assessment?

Assessment for allergic reaction

The nurse is preparing to administer a medication to an older adult. The nurse should consider what factor that could affect therapeutic dosing in an older adult?

Changes in the gastrointestinal (GI) system can reduce drug absorption

The nurse administers a specific medication to an older adult client every 4 hours. The client has a history of chronic renal failure. The nurse should assess for indications of:

Cumulative drug effects

The nurse is preparing to administer a medication from a multidose bottle. The label is torn and soiled but the name of the medication is still readable. What is the nurse's priority action?

Discard the entire bottle and contents and obtain a new bottle.

The nurse is providing discharge education to a client who is leaving with a prescription of PO ampicillin. What should the nurse teach the client?

Discoloration of the tongue may occur but will subside when the drug is discontinued

The nurse has administered a drug that is known to be lipid soluble. This drug's solubility will primarily affect what aspect of pharmacokinetics?

Distribution of the drug

The nurse is providing client teaching before discharging a client home. The client is taking ciprofloxacin. What should the nurse encourage the client to do?

Drink at least 2 L of fluid per day

The nurse is providing health education to a client with an infection who lives in the community. What characteristic of the client's anti-infective regimen will best prevent the development of resistant strains of microbes?

Ensuring that the duration of drug use is appropriate

The nurse administered a scheduled dose of hydrochlorothiazide, a diuretic, 45 minutes ago. The nurse is not preparing to assess the client's blood pressure. In what phase of the nursing process should the nurse perform this action?

Evaluation

A client newly diagnosed with HIV is receiving client teaching from the clinic nurse about antiretroviral medications. The nurse should teach the client to report what adverse effect to a health care provider most promptly?

Full body rash

A nurse practitioner is teaching a health class in the local community center. The nurse should identify what group as being at the greatest risk for contracting hepatitis B?

Health care workers

The nurse is providing teaching to a client who takes a complex regimen of herbal therapies. What education should the nurse prioritize?

Herbs can interact with OTC and prescription drugs

The nurse is caring for a client who is receiving IV gentamicin and who reports difficulty hearing this morning. What should the nurse do?

Hold the dose and notify the prescriber immediately

The nurse is administering an anti-infective to a pediatric client. What assessments related to adverse effects in this client should the nurse prioritize?

Hydration and nutritional status

A nurse collects a culture sample from a client's infected wound bed. Laboratory testing of this sample will allow the care team to:

Identify the specific organism causing the infection

An 82-year-old client, who lives alone and has occasional memory lapses, is being seen by the home health nurse. In reviewing the client's medication, the nurse discovers that the client was recently prescribed azithromycin for urethritris. What characteristic of this drug makes in an appropriate choice for this client?

It is taken only once a day

A nurse practitioner is teaching a group of nurses about actions that have the potential to prevent antibiotic resistance. What teaching point should the nurse practitioner include?

It is very important to take the full course of an antibiotic as prescribed and not save remaining drugs for future infections.

A hospitalized client with complex health needs is receiving amantadine. What is the nurse's priority action after administering this medication?

Keep side rails up and ensure the client's call light is at the hand

A resident of a long-term care facility has just begun a course of rimantadine. What associated nursing action is most appropriate?

Maintain the client on isolation precautions

The nurse instructor is talking with the students about anti-infective medication and explains that drugs that are very selective in their actions are said to be what?

Narrow spectrum

The nurse is teaching a diabetic client to self-administer Humulin insulin to be taken each morning. The provider has ordered 12 units of Humulin insulin to be taken each morning. How many millimeters of insulin would the client prepare for one dose?

Order: 12 units Available: 100 units/mL 12units ÷ 100 units/mL = 0.12 mL

The physician prescribes 250 mg of a drug. The information on the drug vial says the concentration is 500 mg/mL. How much of the drug will the nurse prepare? (In millimeters)

Order: 250 mg Available: 500 mg/mL 250 mg ÷ 500 mg/mL = 0.5 mL

A client with an acute myocardial infarction is admitted to the coronary care unit. The physician has ordered heparin 25,000 units in 250 mL normal saline to infuse at a rate of 600 units/hour. The nurse sets the infusion pump to deliver how many milliliters in an hour?

Order: 600 units/hour 600 units x 250 mL = 150,000 ÷ 25,000 units = 6 mL/hr

The caregiver of an older adult client with ischemic heart disease tells the nurse that the client is only taking around half of the prescribed dosage of several medications. What possible effect should the nurse explain when providing health education?

Reduced therapeutic effect

The nurse is providing medication teaching for a client. The nurse has asked the client to provide a complete list of medications taken to health care providers. Ensuring this list is complete will have what potential benefit for the client?

Reducing the client's likelihood of drug-drug interactions

When assessing a client before starting a drug regimen, how should the nurse best assess the client's ability to excrete medications?

Review laboratory values indicative of kidney function

An older adult client who lives independently has just been prescribed a drug that can cause sedation. What would be the priority nursing diagnosis for this client?

Risk for injury

The nurse has cared for several clients who have requested a drug they have seen advertised on television or in a magazine. The nurse recognizes that this is an increasingly common phenomenon. In response, the nurse should set what learning goal?

Stay knowledgeable about current drug therapies.

The nurse is providing discharge teaching to a client who is being sent home on oral tetracycline. What instructions should the nurse include?

Take the drug on an empty stomach

The nurse is caring for a client with hepatitis B. The client is taking adefovir. The nurse should question the provider about a prescription for what other drug?

Telbivudine

A client has approached the nurse with varied and detailed questions about emerging viral infection that was identified for the first time a few months earlier. The nurse's unfamiliarity with this infection may have what effect on the nurse-client relationship?

The client may view the nurse as not being a credible source.

The nurse is planning care for a client with AIDS who has developed chronic severe diarrhea secondary to adverse effects of the antiviral drugs prescribed. What goal should the nurse prioritize during the client's care?

The client will remain free of electrolyte disturbances

The nurse is gathering assessment data from a client who is the sole caregiver for four children. What assessment should the nurse prioritize when providing care for this client?

The client's level of social and financial support

The Kardex of a male client who is prescribed antihistamines for treating an allergy reads as follows: "Age:32; Profession: Long-distance truck driver; Lifestyle & diet: Lives alone, chews tobacco, no alcohol use, no food preferences, practices martial arts; Medical history: Suffers from seasonal allergies, recent urinary tract infrection that has been treated successfully." What information from the Kardex is likely to have the greatest implication in educating the client about antihistamine administration?

The client's profession

A client has been prescribed a medication that is known to be a drug agonist. This drug will have what effect?

The drug will interact directly with receptor sites to cause the same activity that a natural chemical would cause at that site.

A client with a urinary tract infection has been prescribed Bactrim, a medication that is a combination of sulfamethoxazole and trimethoprim. What is the most likely rationale for the use of a combination antibiotic?

The drugs' combined effect exceeds the sum of their individual effects

A student nurse asks the study group how to define a drug allergy. What would be the peer group's best response?

The formation of antibodies to a drug protein causing an immune response when the person is next exposed to that drug

A female client has been diagnosed with tuberculosis and has been prescribed rifampin 600 mg PO daily. What health education should the nurse prioritize?

The need to increase fluid intake, even if the client feels nauseous

The nurse is caring for a client who takes several drugs. What client should the nurse monitor mos closely for adverse medication effects?

The newborn infant who has no known health problems

The nurse is assessing factors that may affect the absorption of a drug that the nurse will soon administer. What factor should the nurse prioritize?

The route of administration that has been prescibed

The nurse is conducting the evaluation phase of the nursing process. The nurse should perform evaluation primarily based on what data?

Whether the client is achieving health comes